Empowering Stroke Patients through Strength-Based Care

The article discusses the importance of Strength-Based Nursing (SBN) in supporting stroke patients, particularly Emma who suffered a stroke at age 24. The author highlights the need for SBN to empower patients and families, promote health, and foster partnerships in healthcare. The approach focuses on individual strengths, resources, and resilience, rather than deficits and problems. The author emphasizes that SBN can help mitigate negative societal attitudes towards stroke patients, such as avoidance or piercing looks. By empowering patients and families, SBN can promote a positive attitude, inner drive, and sense of purpose, ultimately leading to better health and well-being outcomes.

Running head: STRENGTHS-BASED NURSINGAND HEALTHCARE 1
Strength-based Nursing and Healthcare –Emma Gee Case Study
Institutional Affiliation
Date

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Strength-based Nursing and Healthcare –Emma Gee Case Study
This discussion looks at the life of Emma Gee and the relevance of implementing a
Strengths-Based Nursing (SBN) plan in her healthcare as she struggled to recover from a stroke.
Emma Gee was an energetic young therapist whose life was turned around after suffering a
stroke. Due to the presence of an arteriovenous malformation (AVM), doctors scheduled a brain
surgery for Emma. It was during the high-risk surgery procedure that Emma developed
complications and suffered a stroke. Doctors immediately put Emma into an induced coma after
the surgery. She later woke up unable to move or even speak. Through nursing and healthcare
efforts from Dalcross Hospital, Royal Talbot Rehabilitation Centre and her family, Emma was
able to recover and she is now a renowned motivational speaker and occupational theapist.The
discussion looks at Emma’s healthcare experiences after she regained consciousness and during
her rehabilitation. Based on her experiences, the discusion suggests how implementing a
Strenths-Based Nursing and Healthcare approach could have made a difference in Emma’s
recovery.
Overview of Strengths-Based Principles
Strength-based nursing and health care (SBNC) is an approach that aims to create
conditions whereby patients experience healing in their lifespan through the promotion of health
and optimisation of their wellbeing and functioning. SBNC is about discovering, uncovering,
understanding, and releasing social, interpersonal, intrapersonal, and biological strengths to meet
healthcare and personal goals while dealing with the challenges. SBN is based on the guiding
principles of collaborative partnership, relational care, empowerment and movement, person and
family-centered care, and holistic care (Gottlieb, Gottlieb and Shamian, 2012). These principles
provide hope, self-efficacy, and empowerment. It means that there should be a collaboration

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between the healthcare team and the patient while empowering him/her and the family to find
meaning and attain their objectives. It also requires the health care team to understand the
individual in whole by facilitating personalized care, holistic care, and whole-person nursing
care.The principles aim to ensure the affected individual is responsible and takes charge of his or
her healing and recovery process. Gottlieb (2012) outlined eight values that underly SBN. These
include self-determination, person and environment are integral, subject reality and created
meaning, holism, and embodiment, uniqueness, health and healing, collaborative partnership,
learning, timing, and readiness. According to Gottlieb (2012), practicing a SBN model of health
care promotes the quality of life, health behaviors, and brings hope to stroke survivors such as
Emma Gee. It is especially important in Australia’s healthcare system whereby there are over
440,000 Australians directly affected by the effects of stroke (Rosamond et al., 2008). The
National Stroke Foundation which is among the leading stroke support group in Australia
approximates that over $44 million is needed to tackle the effects of stroke over a four year
period.
Implementation of Strengths-Based Nursing in Emma’s case
This discussion looks at a case study on Emma Gee and investigates on the most
appropriate ways in which a SBNC approach could have been implemented to assist Emma
during her journey after suffering a life-changing stroke. After suffering a stroke at such a young
age, Emma faced a lot of challenges in her new way of life. Being an active girl as evidenced by
her various outdoor activities such as running and netball, Emma was devastated after the stroke
and she had to accept her new reality. While in the induced coma, after regaining consciousness,
during her rehabilitation, and in her integration back to the community, Emma had various health
care needs. Implementing a SBN approach during her recovery journey could have greatly

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impacted the healthcare outcome and facilitated her wholesome recovery. Most importantly, a
SBNC approach would have empowered and ensured collaboration between Emma, her family,
and her healtcare providers. There are various challenges Emma encountered in her journey that
could have been better addressed using a SBN model. These challenges range from dysphagia,
balance and mobility complications, loneliness, environmental irritation, dysarthria, double
incontinence, societal issues, to dependency. Furthermore, it is important to empower patients
and ensure that they participate in their well being by involving them in decisin making
activities.
Relationships In Nursing Practice
SBNC provides a guidance framework for nurses and other healthcare professionals. It
facilitates the expansion of a nurse’s imaginary horizon and the providence of innovative
solutions that solve long-term health care problems. While delivering medical services,
healthcare professionals should have put themselves in Emma’s shoes. It would have ensured
they understand what she went through physically, mentally, emotionally, and even spiritually
(Kobau et al., 2011). According to Lietz (2007), SBNC broadens healthcare focus to include the
well being, quality of life, healing and health of the whole person. It encourages a shift from
analyzing the outcomes of health care as assessed by health practitioners to focusing on client-
based outcomes. It is all about patients and the health care system combining effort to get the
most of what is both meaningful and important to them.Such an approach would ensure the
suffering experienced by stroke victims is minimised. While in hospital, Emma experienced
double incontinence meaning she had lost control of her bowels and therefore needed to use a
catheter. The nurses showed little or no empathy for her as evidenced by how they treated and
acted towards her care. Emma even often felt embarrassed by the situation. Involving her parents

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or sister in cleaning up Emma would have made her feel more comfortable. Collaboration
between her family and the nurses would have ensured Emma recovered from this stage of her
journey in a personalized manner. Generally, nurses should have taken a personalized approach
aimed at empowering Emma while collaborating with her family.
Transition Points
When formulating a SBN care plan, it is crucial to involve the patients, their families, and
carers to facilitate procedures, clear health care expectations, investigations, and discharge of the
patients in a collaborative manner. This helps in empowering the patient and helping him/her
take charge of their recovery. A strength-based nursing care plan must consider verbal
communication with the patient and family, previous documentation on the patient, clinical
handover, and an assessment of the patient.
Regaining Consciousness
This discussion presents a SBN care plan following Emma regaining consciousness and
focuses on collaboration between Emma, her family and other healthcare professionals involved
in Emma’s case. For clinical documentation of Emma’s case, the study will adopt a
multidisciplinary team approach and a SOAP framework to provide collaborated health care and
communicate information on Emma’s progress to everyone invested in her recovery (Donohoe,
2015).After Emma regained consciousness, she faced various deficits such as trouble
swallowing, vertigo, double incontinence, diplopia, left-side paralysis, right-side facial paralysis,
mobility and balance issues among others. To facilitate her recovery, it is crucial to implement a
SBN care plan that propagates collaboration between Emma, her family and healthcare
professionals. The first step in developing the SBN care plan is to assess existing medical and

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personal information on Emma. It includes her emotional, social, family, mental, and physical
history. To help her successfully transition and recover after the coma, it is important to
determine and understand the factors surrounding her current condition. The next step of the care
plan would be to observe the real-time progress of Emma. It includes Emma’s current condition
such as her inability to swallow food. Through collaboration between Emma, her family
members and the multidisciplinary team consisting of nurses under the guidance of a speech
therapist, Emma’s situation can be analyzed, and appropriate interventions applied. This care
plan would encompass educating and involving Emma’s family in assisting her with her
swallowing complications. The outcome of the procedure would then be analyzed, and
appropriate changes implemented based on Emma’s response to the intervention. Aside from
educating and sensitizing them on the importance of collaborative healthcare approach, Emma’s
family would constantly be updated on her progress and response. The care plan would further
ensure that Emma’s family are consulted before, and present during any landmark decisions and
progress on Emma’s recovery journey in the hospital.
Rehabilitation
SBN practices during a patient’s rehabilitation should be geared towards helping the
patient bounce back from their unfortunate scenario. A SBN care plan for Emma while at the
Royal Talbot Rehabilitation Centre should have been focussed on empowerng Emma to take
active part in her rehabilitation process. It was the responsibility of the nurses and Emma’s
parents to work together with Emma and give her the motivation she needed. Under a SBN care
plan, Emma’s nurses such as Fran, should have used a person-centered approach while
rehabilitating Emma. A SBN care plan would include a multidisciplinary team comprised of
nurses and specialists to help in the therapy process of Emma. This team would focus on making

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Emma feel valued in order to motivate and empower her to perform. The care plan would follow
a carefully formulated therapy scheduleas determined by the input of Emma, her parents and the
therapists at Talbot. It is also important to ensure patients are rehabilitated in a condusive
environment. Unlike the brisk and careless attitude experienced at Talbot, a warm and nurturing
approach to give Emma a sense of belonging would have been better suited to Emma’s situation.
Such an environment would foster a feeling of comfort synonymous with having a family. Emma
often felt dependent and powerless as a result off the care plan practiced at Talbot. This only
made Emma feel vulnerable instead of empowered. Emma’s family and friends clearly supported
her as evidenced in their unannouced visits and even the ‘RUN to GEE’ fundraiser to support
Talbot. This kind of support compliments a SBN care plan by fuelling the recovery of a patient.
Reflection of Emma’s Experience
Although Emma had caring parents and an identical twin sister who understood her, she
felt lonely and sad while in admitted in the hospital, during rehabilitation and even after being
integrated back into the community. The best approach would have been to sensitize her family
and friends on the importance of communal support in facilitating the recovery process of a
stroke victim (Wells et al., 2014). Emma needed to be emotionally motivated and supported to
ensure her quick recovery, health, and quality of life. It is important to have a sense of belonging
and a hand to help you through such a difficult time (Havens, Wood and Leeman, 2006). It was
of grave importance for her family and friends to be actively involved in her recovery by visiting
her a frequent as possible and showing her that they cared and supported her along her journey.
Knowing she had the support of her family and medical staff would have fostered resilience in
Emma throughout her recovery journey.

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Before the unfortunate incident, Emma had been fond of food and cuisines as seen in her
association of family time and visitors with food and other gifts.It however, took a negative turn
since she started showing symptoms that were later diagnosed as an Arteriovenous malformation
(AVM). The situation only worsened when she suffered a stroke and upon gaining
consciousness, experienced dysphagia. Due to the difficulties faced by Emma while trying to
swallow food, tubes were shoved down her throat to help her. During her recovery process in the
hospital, Emma’s speech therapist taught her feeders to encourage the food downwards by
stroking her neck although Emma found the idea quite unpleasant. By facilitating a SBN
approach focused on empowering Emma while ensuring family involvement, it would have been
more prudent to involve Emma’s parents or sister in this particular process. By providing her
with the understanding yet familiar touch of her family, Emma would have been more
comfortable. This familiarity coupled with her evident determination to recover and return to
normal eating habits would have benefitted both Emma’s well being and functioning.
Emma was greatly disturbed by sound and visual irritations. Her communication and
mobility challenges made it hard for her to do anything about these irritations. It is important for
health facilities to incorporate a holistic approach to their health care services. Such an approach
would ensure the outcome of the health services focus on the patient and his family by
considering all their needs. By proving a conducive environment, hospitals and rehabilitation
facilities enhance a patient’s quality of life. In Emma’s case, the hospital admitting her should
have ensured the hospital facility and the rooms of sensitive patients such as Emma are located in
a secure location with minimum irritants.
Due to dysarthria developed as a result of the stroke, Emma had difficulties in
communicating and the people around could not understand her. This challenge plagued her both

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in the medical facilities and in the community. While in hospital, it would have been pivotal if all
concerned parties collectively participated in Emma’s speech and mobility therapy.It would have
encouraged self-dependency in Emma by motivating her. Their collaboration would make it
easier and faster to understand Emma’s communication attempts. While back in the community,
Emma found it difficult to relay information to others effectively and she was even occasionally
misunderstood. Such scenarios could have been mitigated by the use of a SBNC approach that
sensitized the community on how to take care of stroke patients. Additionally, Emma’s family
would be able to accompany her at times and help her around. The outcome of this approach will
be a community that is united in the health and general well being of stroke victims.
Promotion of self-efficacy is among the main principles underlying SBNC. Individuals
under SBNC need to be self-dependent and in control certain aspects of their health and healing
process Family and health care professionals play a great part in eliciting positivity and self-
efficacy in a patient. This was however not the case in Emma’s journey. Emma frequently felt
dependent on the medical staff for her day to day routine activities to a point she felt helpless and
that the health professionals dominated her life. This feeling of dependence manifested itself
even after she was released from hospital whereby she felt useless in her parents’ house. Her
twin sister further reminded Emma of the life she had before she suffered the stroke. The society
must also be involved in supporting stroke patients. Incidences such as people directing piercing
looks or avoiding Emma in the pool should be mitigated to cultivate self-confidence. An
effective SBNC approach would ensure that those around Emma such as the nurses, her family,
and other people in the community elicit positivity. This positive attitude would, in turn, reflect
on Emma and give her an inner drive to take charge and responsibility of her health and healing
journey (Resnick, 2011).

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Conclusion
In conclusion, it is important to ensure the individuals have a sense of purpose and are
adequately empowered to make their own decisions.SBN can help achieve patient and family
empowerment, health promotion, and partnerships in Australian healthcare by facilitating a
healthcare system in which the community is actively involved and sensitive to patients and their
needs. SBN considers the resources and strengths possessed by the individual and his family and
uses these strengths to alleviate the existing deficits and problems. Organizations such as the
Borrondara Stroke Support Group (BSSG) and the National Stroke Foundation enhance strength-
based care in Australia through their various events and activities. These interventions
collectively work to promote the well being of stroke patients, enhancing their resilience, and
softening their suffering. SBN’s guiding principles of collaborative partnership, relational care,
empowerment and movement, person and family-centered care, and holistic care provide hope,
partnership, self-efficacy and empowerment to stroke victims in Australia.

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