Traumatic brain injury is a leading cause of death and disability in the U.S, with the CDC reporting that around 1.5 million Americans experience a TBI every year. Around 230,000 of these are hospitalized and survive, but around 80,000 to 90,000 experience a long-term disability. Nurses have various responsibilities in caring for patients with TBI throughout each step of treatment and recovery. Just a handful of these roles include assessing patient problems, coordinating care, providing physical and technical care, giving emotional support, advocating for patient care, and communicating with families. What are the biggest challenges for nurses, and how can these be overcome?
Adapting Plans Of Care
As stated in a study by T Oyesanya et al, nurses are likely to need to modify plans of care depending on whether a patient has acute, new-onset moderate/severe TBI, or they are in the chronic phase. The latter group may already have support systems and may already have access to a wider array of services. They may have obtained their legal rights via traumatic brain injury lawyer services and may therefore be able to afford complementary and alternative medical treatments. Just a few of these may include hyperbaric oxygen therapy, creatine and acupuncture. As stated by J Cantor et al, some treatments “hold a host of potential benefits for individuals with TBI.” New-onset patients, on the other hand, are likely to be more reliant on nurses for information and guidance.
A Gap In Clinic Guidelines
J Cantor et al report that another challenge for nurses is the lack of clear guidelines for how to treat chronic patients who are seeking care later in life for other health conditions. This is because patients in the chronic phase of moderate/severe TBI often face other acute health problems. For instance, the cognitive impairments they experience as a result of their initial injury will affect the health care they receive for the rest of their lives. They may have specific challenges in communicating with nurses and remembering the information they have been given. Therefore, nurses need to modify their plans to accommodate these specific needs. The problem is that there is currently a lack of specific guidelines on who is to provide care to patients in chronic care for moderate/severe TBI.
The Road Ahead
In order for nurses to modify their plans as required by both acute and chronic patients, greater awareness of the different needs of these patients should be provided via continual education. Research indicates that nurses are concerned about caring for patients with TBI, and that they need clearer guidelines so that hospital and health care centers can be adapted. Communication and memory barriers can be overcome through the provision of all information in written form, for instance, or by sharing such information with approved personal carers and family members.
Most nurses will likely encounter patients with TBI at some point in their practice. Direct education is therefore required to enable them to adapt their care plans appropriately. Chronic TBI patients may have a better strategy in place, but they may develop complications as the years pass, and cognitive issues may pose a problem in terms of the way information is delivered, communicated and retained between patient and nurse. Clearer guidelines are also required so that nurses can easily refer to them when in doubt.