Critical Reflective Report: Managing Hemiplegia in Clinical Practice

This report presents a critical reflection on the case of Mrs. Smith, a patient experiencing transient global amnesia and hemiplegia. Using Gibbs' reflective model, the author, a doctor, shares their experiences and feelings while interacting with Mrs. Smith. The reflection covers the initial consultation, diagnosis of hemiplegia resulting from untreated high blood pressure and lifestyle factors, and the challenges faced in determining the best treatment approach. The report evaluates the patient's condition, discusses positive and negative experiences during the interaction, and provides a detailed analysis of the patient's symptoms and potential treatment strategies, including rehab exercises and electrical stimulation. The importance of effective communication, person-centered care, and a comprehensive understanding of the patient's medical history and lifestyle is emphasized, with a focus on improving future patient management and treatment decisions.

Critical Reflective Writing

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Reflection on the case of Mrs Smith............................................................................................3
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Transient global amnesia is a sudden and temporary episode of memory loss as in this
condition recall of recent event vanishes (Spiegel and et.al., 2017). I Am going to reflect my
experience as a doctor while treating and dealing with Mrs Smith who was suffering with this
problem. This study will discuss some negative impacts of high blood pressure and ways in
which it leads to hemiplegia
MAIN BODY
Reflection on the case of Mrs Smith
As a care provider or doctor, I want to share my experience that I felt while discussing with one
of my patients, Mrs Smith. With the help of Gibbs reflective model, I want to share my feelings
by considering all stages such as:
Description: I want to discuss my experience of conversation, done with Mrs Smith.
What happened: Mrs. Smith come to my clinic and I asked some questions from her in
order to know her current condition. Firstly, I told her my name and asked her name as well. She
gave answer of this and said she is Mrs Smith, born in 2nd February, 1963. 58 years’ old woman
present and stated her condition (Alessandro and et.al., 2019).
Where did it occur: She said that she was driving car while going to work 2 days back as
usual but this time she lost for moment. She did not remember anything for a while. As soon as
possible, she went to her general practitioner or general professional in order to know her
condition as what happened with her.
When did it occur: 2 days back, when she was going to her work and for the first time this
she faced this problem. She said that her GP checked her blood pressure. Rather than this, her GP
did not take any test. When I asked her as on which time she goes to work then she replied and
said 9am. On this basis, I can say that she was a good listener as initially she was facing problem
in listening so, she asked me to speak loud a bit.
Who did it involve: After that this, I asked her as she was feeling weakness when she was
driving and lost for a while and she said no. Her GP is involved and the main causes of this
problem may be because of untreated high BP and smoking 20 cigarettes a day. On this basis, it
can be said that it may be a sudden loss of sense. This problem can be known as transient global

amnesia as it is a temporary episode of memory loss that cannot be attributed to a more
common neurological condition (Singer, 2020).
Feelings: After sharing my general experience of conversation and identifying the main
problem, I want to share my personal feeling about Mrs Smith and this case. When I asked he
about her past medical history then she told me that she has high blood pressure and high
cholesterol problem (Chen and et.al., 2021).
My personal feeling about MRS Smith: On the basis of this, I came to know that high blood
pressure can lead heart attack and stroke. On the basis of my personal experience, I can say that
the current problem from which Mrs smith is suffering is because of uncontrolled high blood
pressure and high cholesterol level. I also believe that people should be health conscious and
should not consume alcohol and smoke to this great extent. High cholesterol and high blood
pressure develop fatty deposits in blood vessels that makes difficult for enough blood to flow
through arteries. So, it may cause temporary episode of memory loss and heart attack problem. In
addition, I asked Mrs Smith as whether she is suffering from stomach and headache then she said
that her stomach is fine but face slide headache sometimes (Venkatesan, 2018). Currently, she
does not have fever, cough and vomit problem. I believe that my critical analysis and
communication skills are good. Oral communication skill made me able in interacting with Mrs
Smith and getting answers of my questions. I also feel that I made her feel comfortable and
engagement level of Mrs Smith in conversation boosted my confidence. I believe that I can
handle such cases in the future in an effective manner and this would help me out in deciding
better treatment for solving problems.
Evaluation: I want to evaluate the current condition of Mrs. Smith that I came to know
about while interacting and conversation with her. For knowing her current problem, I asked
some relevant questions such as: genetic reason as whether her father and mother had faced same
problem and side effects of drugs that she is having (Kim and et.al., 2018). In this context, I
came to know that her father had the same problem of memory loss and the best thing that she
told me was: not allergenic to anything and no side effects of drugs.
Negative experience: For knowing all about her current and actual condition I used my
experience. I tried to know about what has happened with her exactly so I touched her right hand
and asked her if she is feeling something. She said yes as she felt touch. Then I touched her left
hand and asked the same question then she said that she is not feeling anything. As I came to

know that her left side is not working but I wanted to make sure as if this is right or not. As I
knew that I am lacking behind in decision making skill and this weakness created barrier in
selecting the best treatment.
Positive experience: As I believe that I review patients’ report in a detailed manner and this
critical analysis skill helped me out in identifying her actual condition. For this purpose, I picked
up a pen and touched her left side of face and she denied as she is not feeling anything. This
helped me out in understanding that she has one sided paralysed. But I felt that lack of my
decision making skill created problems in deciding appropriate treatment that I can give her for
fast recovery (Lee and et.al., 2019). For knowing that if she has half side of upper part paralyses
or full part, I touched her left feet. This time she said that she has felt this touch so, on this basis I
can say that she is upper left side of paralyses.
Analysis: On the basis of above discussed case and experience of this case, I want to give
clear details of this scenario as what was the main problem from which Mrs Smith was suffering.
I made use of some techniques in order to make sure about her condition of half upper side of
paralyses. For this, I picked up my finger and placed in right direction and asked her to see.
When my finger was in right direction then she was able to see my finger but when I placed my
hand or finger in left direction then she was not able to see. As like this, I picked my both of
hands and asked her to see. She said that she can see only my right hand and cannot see my left
hand (Wang and et.al., 2021).
Overall sense that can be made on the basis of situation: So, on this basis, it can clearly
be said that she has problem with her left side of body part. It can also be said that on the basis of
this case that it is a problem of hemiplegia as it is a condition, caused by brain damage or spinal
code injury. There was no spinal code injury so, on this basis, it can be said that it happens with
her because of brain damage and high blood pressure. People become unable to make voluntary
movements in this type of condition. She said that she smokes 20 cigarettes a day and it has also
increased the problem of this condition. Along with this she drinks alcohol. On the basis of her
lifestyle, it can clearly be said that she is suffering from hemiplegia that needs proper treatment
(Shen and et.al., 2021).
Conclusion: It can be concluded from the above study that hemiplegia is one of the worst
condition as in this condition, people face problems in making voluntary movements. On the
basis of above discussion and reflection, I can say that strokes and high blood pressure is one of

the main causes of hemiplegia. Smoking and alcohol consumption increases this problem and
can have negative impacts on people’s physical and mental health (Du and et.al., 2020). As
patient was not feeling fast heart beating at the time of driving car and at the time when she
forgot everything for a moment. It can also be said that having proper conversation with patient
is important as it gives detailed information about patient as what she was suffering from, her
past medical history, family history and others. It can also be concluded that person centred
approach plays an important role as it makes doctors or care providers able in engaging patient or
service users in conversation as well as in treatment process (Dekker and et.al., 2018). Transient
global amnesia is one of the main stage or symptom of hemiplegia that Mrs Smith or service
user of this case felt. Some strategies such as watching hands, placed in both direction, watching
moving fingers can be used to make sure that service user is suffering with this condition and all
these strategies have been discussed above (Donepudi and Trottier, 2018).
Action Plan: Providing proper treatment and care services is important for doctors. I found
that Mrs Smith is suffering with hemiplegia and it is found when she stated that she lost for a
moment while driving a car. It was important for me to know as whether she has problems with
memory loss so, I shown her some objects like pen and others and she recognised them well (Cai
and Sun, 2021). So, in this context, I can clearly say that she does not have problems with
memory loss as she is half side paralysed because she was not feeling on her left side. I believe
that repetitive as well as passive rehab exercise can be beneficial in this case. Proper rehab
exercise can open up her muscles and I would suggest her to quick smoking and alcohol because
these can worsen the situation (Dominedò and et.al., 2021). As hemiplegia treatment starts with
the brain so by speaking some words and asking patient to repeat same words can increase
concentration power and it can help out in knowing as whether patient has listening problems or
not. This was being done and Mrs Smith repeated same words. Along with this, electrical
simulation can also help Mrs Smith in moving her left side of upper body part as it helps in
muscles moving while stimulating awareness in the brain (Weaver, 2017). One stands out or
mirror therapy can also be helpful to service user as it can improve hand mobility and practicing
can improve physical health.
CONCLUSION
It has been summarised from the above study that hemiplegia is one of the dangerous
condition caused by brain damage. I felt that people face number of problems and become

dependent on others because they become unable in virtual movement of their affected body
part. It has also discussed some main causes of this condition and on this basis, it has been found
that high cholesterol and untreated high blood pressure are main causing factors. People need to
take extra care and need to get proper treatment of blood pressure in a timely manner.

REFERENCES
Books and Journals
Alessandro, L. and et.al., 2019. Transient global amnesia: clinical features and prognostic factors
suggesting recurrence. Arquivos de neuro-psiquiatria. 77. pp.3-9.
Cai, J. and Sun, Q., 2021. Effects of 12-type guidance method combined with prokin balance
training instrument on the balance function and walking ability of stroke patients with
hemiplegia. MEDS Public Health and Preventive Medicine. 1(1). pp.1-7.
Chen, H. and et.al., 2021. A case report of atypical hemiplegic migraine with nonheadache onset
in a Chinese child. BMC neurology. 21(1). pp.1-6.
Dekker, S.E. and et.al., 2018. Spontaneous intracerebral hemorrhage. In Principles of
Neurological Surgery (pp. 334-342). Elsevier.
Dominedò, C. and et.al., 2021. A rare pheochromocytoma complicated by cardiogenic shock and
posterior reversible encephalopathy syndrome: case report. European Heart Journal-Case
Reports. 5(2). p.ytaa513.
Donepudi, B. and Trottier, S., 2018. A seizure and hemiplegia following contrast exposure:
understanding contrast-induced encephalopathy. Case reports in medicine. 2018.
Du, Y. and et.al., 2020. Early treatment in acute severe encephalopathy caused by ATP1A2
mutation of familial hemiplegic migraine type 2: case report and literature
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Kim, J.U. and et.al., 2018. Change in radial artery pulse wave in stroke hemiplegic patients:
Protocol for a case-control study. Medicine. 97(13).
Lee, M.L. and et.al., 2019. Systemic hypertension followed by insidious stroke in a 12-year-old
boy with childhood neurofibromatosis type 1 presenting with renal and cerebral artery
vasculopathy. The Turkish journal of paediatrics. 61(4). pp.629-634.
Shen, J. and et.al., 2021. Influence of hypertension classification on hypertensive intracerebral
hemorrhage location. The Journal of Clinical Hypertension.
Singer, T.J., 2020. Cardiovascular Response to an Acute Bout of Single Leg Cycling in
Individuals with Hemiplegia (Doctoral dissertation, Kent State University).
Spiegel, D.R. and et.al., 2017. Transient global amnesia: current perspectives. Neuropsychiatric
disease and treatment.
Venkatesan, K., 2018. Effect of scalp acupuncture on upper extremity functional recovery in
chronic hemiplegia: A Randomised control study (Doctoral dissertation, Government Yoga
and Naturopathy Medical College, Chennai).
Wang, H. and et.al., 2021. Acupuncture for patients recovering from lacunar infarction: A
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Weaver, D.J., 2017. Hypertension in children and adolescents. Pediatrics in review, 38(8),
pp.369-382.