Transferance and Counter-Transferance

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

“But… what ARE you?” It was a question I encountered with discomfiting regularity. As a biracial child growing up in a working-class southern community, I was often the only non-white student in my classes. In this homogeneous town, my otherness stuck out like a sore thumb, and I learned from a young age that people can be unkind when they feel threatened by bucked conventions. Though I inhabited two cultures, I didn’t fit neatly in either. These experiences taught me the importance of inclusivity, and I developed a sensitivity for people deemed outsiders because of their differences. In college, these feelings became more acute when I learned that minority and multiracial patients often face specific medical challenges, and need culturally

It is important that the type of stroke is diagnosed quickly to reduce the damage done to the brain and also to determine the right type of treatment because one treatment for one kind of stroke can be harmful to someone who has had a different kind. A number of different medications may be given at the hospital to help break up the clot and prevent the formation of new clots. For Ischemic stroke the treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, along with an injection of a tissue plasminogen activator (TPA). TPA works by dissolving clots but it needs to be injected within 4.5 hours of stroke symptoms once they have presented themselves. Hemorrhagic stroke treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.(http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/treatment/txc-20117296) Because strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke,

The attitudes of the individuals interacting with the patients were positive and relatable. Behaviors of these individuals were

Furthermore, “clinicians will make better educated patient evaluations if they familiarize themselves with the history of the particular communities they serve” (Rondini 2015: pg. 1426). Communities are more than likely separated by races. This can be due to language barriers, economic barriers, and cultural differences. It is imperative to keep racial categories in healthcare because it builds a deeper relationship between a health care provider and patient by allowing more information to flow in their conversation.

In my counseling the older adult class we discussed in great detail the different types of culture, ethnicity, sexual orientation, etc. and how it affects the way we as health care providers of helpers should approach a person. I’ve learned in my ongoing time here at CMC that there are all kinds of diversity within the healthcare field, amongst the doctors, case managers, nurse practitioners, registered nurses and others caregivers. There is also a lot of diversity within the patients’ in the hospital. Some patients’ come from within the community and some may just be visiting or coming from surrounding communities. Along with the difference in community and backgrounds that the patients’ come from they also vary by illness or healthcare need. At first it is hard to realize the difference among those that come

This week I assisted someone with filling out an application for the counseling center. I thought the experience went well. When I assisted the patient with filling out the application I noticed that the application was long and tedious. I think being able to assist patients with completing an application is beneficial for patients who cannot read or understand the questions. I also communicated with a person that was experiencing anxiety. The patient was crying in my office because she was experiencing anxiety about her diabetes. I discussed with the patient some of the challenges that she was experiencing in her life. I felt that I did a good job with assisting the person and calming her down. I also walked the patient up to the counseling center because she was interested in communicating with someone on a long term basis. At the counseling center the patient picked up an application which I thought was a good solution to her problem. I think I am getting more comfortable with communicating with patients on my own.

Dr. Bolte Taylor made a list of things she needed the most from the people around her during her recovery process which can be summarized as the desire to have people support and believe in her recovery. Something that may hinder the recovery of stroke victims is the treatment itself. While it had to be Dr. Jill Bolte Taylor’s decision to recover, she was much more willing to put forth effort when her caregivers gave her direct eye contact and spoke to her gently and were generally kind people. She would tend to shut down when people seemed to be in a rush or seemed frustrated. It is also important that the people treating stroke victims know what they are capable of.

We are giving her an infusion every hour. After the infusion, we transferred your mother to the intensive care unit. We ordered neurology checks every two hours. On the second day in the hospital, your mother developed hypotension; which is where her blood pressure dropped below normal, and nausea and vomiting. Your mother was given Reglan through her IV to help stop the vomiting and nausea, as well as her normal saline dose being increased to prevent dehydration. After five hours, your mother’s blood pressure was back to normal and the nausea and vomiting ceased. We started your mother on Aggrenox to further prevent a stroke from occurring. On the third day, your mother was transferred to the medical floor due to her outstanding progress. Physical, occupational and speech therapy were ordered. We decreased the neuro checks to every four hours. Progress was staying steady. The fourth day, your mother responded well to her physical and occupational therapy. She could use a walker when assisted. Her walking and grip improved. No more neurological deficits were noted. We started a discharge plan for your mother. We have transferred your mother to a rehabilitation facility to continue her physical and occupational therapy. We recommend your mother continues her antiplatelet medicine to prevent anymore blockages. Your mother should follow up with a neurologist one week after she is

This influenced his patients to be able to connect with him and be willing to express their needs. In addition, patients find themselves a part with their practitioner and not that they are just a subject at the

The patient talked about her life when she used to work as a food researcher to becoming a lawyer then to how she ended up in the hospital. The patient was talkative and seemed to really enjoyed my company. After my encounter with the patient, I realized how valuable it is for some of these patients to have someone to share their stories and feelings with. (Self-awareness &

Patient name is Stella Baxter , a 93 years old pleasant lady . She worked in a court as clerk from where she retired 35 years ago. She was first hospitalised with a hip fracture in 2013 , later she had undergone a hip surgery . While she was recovering from the surgery , it was found out that she had a left basal ganglia stroke . Her combined diagnoses are Hypertension , Hypothyroidism , Osteoarthritis , Osteoporosis and GERD. She has right side weakness as a result of the stroke.

When my patients are of similar race or age range, I feel a stronger tide towards them. I

We recommend improvement of currently available stroke centers by increasing the number of trained personnel, upscaling of available facilities and establishing dedicated stroke care and rehabilitation centers where health personnel can cater to the needs of stroke survivors at individual level with great effect. We can utilize mass media not only to create awareness among common people regarding stroke but also provide better understanding of the risk factors leading to stroke. We also recommend developing support groups and stroke helplines for entertaining queries of stroke survivors on regular

Assessment will determine and influence the choice of interventions. Deterioration in neurological signs or failure to improve after initial insult may reflect decreased intracranial adaptive capacity requiring patient to be transferred to critical area for monitoring of ICP, other therapies. If the stroke is evolving, patient can deteriorate quickly and require repeated assessment and progressive treatment. If the stroke is “completed,” the neurological deficit is nonprogressive, and treatment is geared toward rehabilitation and preventing recurrence.