“ANY stroke is a life changing event - one minute you’re all right and the next minute everything changes,” Stroke Nursing Coordinator Judy Cronan says.
“With something like cancer or multiple sclerosis, there may be time to become accustomed to what you have but with a stroke, you could be getting ready for work or driving somewhere, babysitting the grandchildren or getting up to switch on the kettle when everything changes. Whatever plans you have made for the future, they can change dramatically in that moment.”
Salisbury District Hospital has a dedicated stroke unit with 30 beds, of which six are acute beds, where there is one-to-one nursing.
Its catchment area includes South Wiltshire, parts of Hampshire and Dorset.
Around 35 new patients come to the unit every month with an average length of stay being 13 days. However while some patients stay for a couple of days, others remain for a few months.
“There are varying levels of stroke,” Judy says. “Most people imagine it as somebody being in a wheelchair, unable to walk but you can have strokes which affect just the vision or speech.
“When they first come in, patients undergo a number of investigations such as CT head scan, or an MRI head scan and an ultrasound scan which aims to find out whether the carotid arteries that take blood up to the brain are furred up with plaque. If they are then that’s something we can treat with surgical intervention which looks to prevent further strokes.
“Patients have therapy - occupational therapy, physiotherapy and speech and language therapy - from the day they come in.
“We aim for 45 mins for each type of therapy needed - it might be a block of ten or 15 minutes in the morning and then more in the afternoon. The programme depends on what the patient can manage as tiredness is a big thing for stroke patients.”
Depending on when you had a stroke you may be treated with thrombolysis, a clot-busting drug. SDH provides a 24/7 service for this with other hospitals in the area, with the stroke consultants on a rota.
“If a patient came in at 2am when the consultants are at home, the on call stroke consultant would get a call and be sent the CT scan so they can see it on their home computer and then advise on treatment.
“However, if somebody woke up having had a stroke, this would exclude them from this treatment because we wouldn’t be able to pinpoint when they had had their stroke, but if somebody had got up, had breakfast and then collapsed, they may well be eligible –this treatment needs to be given within a four-and-a-half hour window.”
The unit staff includes two stroke consultants, a senior sister and two junior sisters, trained nurses and health care support workers and several therapists Judy who has been doing stroke nursing for 25 years said: “Strokes can happen at any age but the average is 65 years and over.
“We also take care of patients who have suffered a transient ischaemic attack (TIA) or ‘mini stroke’ which can last a few minutes or just a few hours as opposed to being a permanent thing.
"We take it in turns to offer a weekend TIA clinic service here alongside Bournemouth and Poole hospitals so should you have a TIA on a Friday, for example, and you go to the GP or come here to the Emergency Department, they will make a clinic appointment for you to have all the scans the next day, whether that’s in Salisbury, Bournemouth or Poole, this reduces the risk of anything else occurring.”
Due to retire this year, Judy came to SDH 16 years ago having previously been the ward sister on the stroke unit in Southampton.
“The job in Salisbury appealed to me because I wanted to be more involved in what happened to patients after they were discharged.
“When I was a ward sister, I enjoyed the acute side of things but felt something was missing - this job offers me the chance to follow up on patients. I can support them and continue caring for them once they’ve gone home - I see them in clinic and they can ring me at any point to check on anything. It’s a lot more personal.”
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here