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Just like you and I, stroke patients are not all the same. One way in which they differ is the way they think about things, depending on which side of the brain has been damaged. Referrals often are made to the clinical nurse specialist as a result of frustration over the resulting behavioral differences of these otherwise intelligent persons.
Referrals relating to ward management concerns do not end with time spent with the patient. Nursing staff on all shifts are an integral part of the patient's new environment. Additionally, family and friends of the patient have many concerns, particularly relating to discharge planning.
PLANNING NURSING INTERVENTION
I found that by videotaping an inservice presentation, a general review could be shared with the optimal number of nursing staff. The following information relates to the most frequently asked questions in a manner I found to be most useful and understandable to all levels of nursing staff.
An Overview of Brain Function
The human brain, as viewed from the top, has two distinct halves called the "left hemisphere" and the "right hemisphere." The human nervous system is connected to the brain in a crossed-over fashion. The left hemisphere controls the right side of the body; the right hemisphere controls the left side.
Human brains have developed differently from animals brains in many ways. One way is that the two hemispheres of an animal's brain essentially are alike. Human hemispheres, on the other hand, develop differently in terms of function.
For over 100 years, we have known that the "word factory" is located on the left side of the brain in the great majority of persons, regardless of whetherthey were right or left handed.
The left hemisphere quickly was dubbed the "major" hemisphere because speech and language are so highly valued in our society. The right brain was relegated to a "minor" role. The prevailing view has been that the right half of the brain is less advanced than the left. This view recently has undergone change in scientific circles, but we have been slow to recognize its importance clinically. We often expect too much of the verbal left hémiplégie and too little of the aphasie right hémiplégie.
Picture in your mind for a moment patients with left-sided paralysis....