Lifelong Learning Programme

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Personal Experience

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I used to run those stairs daily.

Kristína Vančová
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Eva is 38 years old. Only a week ago she was working as a bookstore manager. Today she is afraid to get up alone and taking a shower is quite a task. She is 5 days after a hip joint fracture surgery caused by a fall down the stairs on her way to a bakery. Eva lived her pleasant ordinary every day life in a small town together wit her husband and an eight year old daughter. There were public stairs, a bit worn out and smooth which she took every morning for a few years to buy fresh bakeries for breakfast. Then the parents went to work and the little daughter to her school nearby. That morning the stairs were a bit damp after the night rain. She slipped and fall down. When she wanted to get up she felt a strong pain in her right leg in the hip area. The fall scared her, she also hit her head. For a little while she was trying to get up but pain and fear were stronger. A walk by neighbor after a little talk called both the ambulance and Eva’s husband. They took Eva to the hospital and operated on her within the next few hours. On the fifth day after the surgery, she was released to a home care with a condition that she can use but not overwhelm her limb. Physiotherapy was recommended. Eva is trying very hard to manage everything by herself. Her husband and daughter help her. However, she feels uncomfortable, like a burden in her own household. Together with her husband they agreed to aplly for a professional support until the time when Eva’s condition will allove her to manage all self selvice activities. The doctor told her the recovery period will take about 4-6 weeks. Eva has huge bruises on the outer side of her thighs and she dreads them. During the first visit the nurse talks to Eva about the important matters to manage in her changed situation and what she sees as a burden. Eva tells she dreads the bruises and feels very insecure when she sits down and gets up. She is afraid to walk alone even when holding by objects or when the crutches are available. In their bathroom they have a bathtub. She was used to take a shower every morning but now it loooks like an impossible task. She would like to wash her hair after 10 days but she is not able to sit in the bathtub and at the same time, she is afraid to stand up in a fear of next possible slip. She is quite puzlled in the situation when putting on underwear and socks is a tough task. The nurse leads a clarifying talk with Eva. She explains that the bruises have their origin in the surgery. It is a normal, even though scary looking, reaction of the body to the surgery. Eva and the nurse work out a plan together and set mutual shor time goals. During the first three weeks Eva will accept help and together they will take the morning shower and dress up, as well as the night hygiene and getting ready to sleep. Eva, together with the nurse, will find techniques by which her operated leg will not hurt and the risk of possible fall will be minimized. The nurse encourages Eva to express her worries, her fear and the lost feeling of security. She normalizes Eva’s sensing of reality. Eva callms down when she realizes that after such big and surprising injury it is normal to worry and be insecure. She is successfull in gaining her independence and becoming again that dynamic woman as she felt before the injury. The nurse recommends Eva to buy an appropriate tool, a showering bench, which can be safely fixed at the bathtub ends so she can take showers sitting as on a chair. Eva lsi finds in her own bathroom the way how to sit down on this bath tub bench secured by the nurse and holding by. She is even able to wash her hair with minor help. She is very happy for the success. She starts to believe again that her life will soon get into the normal tracks. They agreed with the nurse on not risking, during the first three weeks of recovery the nurse will accompany Eva when using her conserved resources with the self service activities and hygiene. In the next three weeks they will add walking outside of the household and up and downn the stairs. A physiotherapist will take care of the professsional physiotherapy treatment twice a week so Eva can adopt again the correct movement patterns. OBJECTIVES: The client accepts nurse‘s sprofessional support with the daily hygiene and self service activities for a period of time that her health conditions require it. Under supervision she regains confidence in movement. She knows the procedures to avoid pain and loosing her stability. She regains again her brittle self-esteem and self-confidence. Her husband and daughter will not therefore be overwhelmed with the new situation. MEANS AND STRATEGY: Motivational and clarifying talk with channeling the burdensome feelings and normalize perception of the patient. Facilitate transition coping strategies and use the available tools. Step by step improvement in taking care of the self service activities with stressing out even the partial successes. The nurse leads Eva to realizing that every day she can do more and more independently. Eva uses her skills and ingenuity in coping with the situation safely. CONCLUSIONS Eva needs to reestablish feelings of certainty and control in the new conditions. She needs to start believing that the consequences of her injury are a transitional and manageable affair. Eva starts to see pain more as a signal for approach changes and less as a threat.


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