The nurse in rehabilitation after severe brain injury

Abstract

Severe traumatic brain injury (TBI) may result in complex disabilities in those who survive which have important implications for nursing staff responsible for their early care. A detailed survey was made of 100 consecutive TBI admissions to a neurorehabilitation unit over a two-year period. Most patients were young men, and the great majority were direct transfers from acute neurosurgical units. About two-thirds were admitted for rehabilitation within three months of injury. Ninety-five patients had at least one neurological deficit, the commonest being limb paresis; 83 were dependent on nurses for one or more activity of daily living; 79 had problems with orientation or memory; and 28 exhibited aggressive behavioural disturbance. The case for specific facilities for these patients, the need for an expansion in the role of the nurse in the interprofessional team and the implications for nurse staffing and training are discussed in the light of these findings.