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Meet some of the staff from our stroke service

Clare Holmes

Clare Holmes

What is your role?

Stroke consultant and clinical lead for stroke and care of the elderly

What does this involve?

I provide emergency care for patients arriving in A&E. This includes giving a treatment called thrombolysis which is a 'clot busting' drug for patients experiencing a stroke caused by a blood clot in the brain. This as well as other treatments can be lifesaving but can only be offered in the first few hours after someone develops symptoms of a stroke.  It is therefore vital if someone develops stroke like symptoms, they and those around them act FAST.

I also work with our large multidisciplinary team to care for patients during the first few days after stroke on the acute unit at the Bristol Royal Infirmary but also during their rehabilitation at South Bristol Community Hospital.

I will also see patients in our Prevention clinic (TIA Clinic) and follow up clinic.   My role also includes being a principle investigator in stroke research studies and the education and training of doctors and medical students.

How long have you worked at UH Bristol?

I joined UHB in my final years of training as a registrar in care of the elderly and adult general medicine. I then went through specialist training in Stroke Medicine and became a consultant in the trust in January 2015

If you could ask people to remember one thing from stroke awareness month, what would this be?

During Stroke awareness month I want people to remember that strokes can happenat any ageand being aware of symptoms and acting FAST in seeking urgent medical care can make a huge difference#

 

Joanne Upton

What is your role?

I work as an advanced care practitioner within the stroke service at the BRI.

 What does this involve?

I work as an autonomous practitioner to provide advanced clinical assessment and treatment of stroke and TIA (transient ischemic attack) patients. This includes assessing patients in the emergency department and those referred to the TIA clinic as well as reviewing patient referrals from colleagues within the hospital.

My role also focuses on strategically developing the stroke service at the Trust to ensure that it is line with best practice whilst providing excellent patient experience

How long have you worked at UH Bristol?

I have worked at the trust since September 2018. Prior to this I worked for North Bristol NHS Trust as an Advanced Nurse Practitioner in stroke for 16 years and then for Ashford and St Peters Hospitals NHS foundation Trust as a Stroke Nurse Consultant.

 If you could ask people to remember one thing from stroke awareness month, what would this be?

High blood pressure is a major risk factor for stroke and rarely has noticeable symptoms. Getting your blood pressure checked is quick and easy and could save your life.

 

Sophie Jenkins

Sophie Jenkins

What is your role?

Band 4 combined therapy technician

What does this involve?

I treat non-complex stroke patients, from initial assessment all the way through to discharge. I also fully participate in the treatment and rehabilitation of more complex patients. On top of this role, I am an elected staff-side governor and a member of the joint union committee, so I carry out these duties on Thursdays.

How long have you worked at UH Bristol?

I've been part of the stroke team at UH Bristol for more than 10 years

If you could ask people to remember one thing from stroke awareness month, what would this be?

I would ask people to know their own risk factors for stroke. How at risk you are can be impacted by all sorts of things including whether you smoke, how much exercise you do, your overall lifestyle, whether you have diabetes or hypertension, what your cholesterol levels are, and more. These can make a massive difference to how at risk somebody is of having a stroke. Knowing about them is essential, and can make all the difference.

 

Amy Steele and Mairead Osborn

What are your roles?

Clinical nurse specialists, stroke research.

What does this involve?

We assess patients for suitability for the research we are running and collect data at a clinical level. We have worked very hard to embed research in to everyday care in the stroke unit. My colleague Mairead and I have worked on more than 20 studies and consented over 1200 participants to date.

We often assist with patient care while assessing for suitability for trials we are running here at UH Bristol. We are also interested in possible genetic links to stroke, controlling blood pressure after stroke and monitoring the safety of blood-thinning medications, and work with hospitals and universities to provide them with the data they need. Our experience in this specialty is essential as we regularly approach people who have altered speech, vision, perception and motor weakness not to mention feeling shocked and often frightened.

How long have you worked at UH Bristol?

Amy - 15 years. Mairead - over 20 years.

If you could ask people to remember one thing from stroke awareness month, what would this be?

People are generally aware of the common risk factors for stroke such as high blood pressure, diabetes, smoking, raised cholesterol but one of the lesser-known risk factors is an irregular heart rhythm called atrial fibrillation (AF).  

AF is a common abnormal heart rhythm that happens when electrical impulses fire off from different places in the atria (the top chambers of the heart) in a disorganised way. This causes the atria to twitch (fibrillate) and can increase the risk of clots forming; these clots can move in the circulation to the brain and is a major cause of stroke. Detection can be as simple as a regular pulse check.

If you are in AF, your pulse will feel irregular and beats may vary in strength. You might also feel this pattern if you have missed beats or extra beats, these can be very common and usually nothing to worry about. Some people have AF which comes and goes.In modern hospitals we use machines for monitoring but it is vital for clinicians to take a manual pulse and blood pressure (BP) every now and then to ensure we know whether the pulse or sound of the blood flow when taking a BP is regular.

 

Irina Lapadatu

Irina Lapadatu

What is your role?

I am a clinical psychologist and in the last three years I have been working with stroke survivors in the early stages after stroke. I am based at the stroke rehab unit at South Bristol Community Hospital.

What does this involve?

My role focuses on improving the service provision of psychological care to stroke survivors while in hospital. This can mean working with stroke survivors directly, but mostly indirectly, providing training to therapists and nurses to increase understanding of psychological needs after stroke and to enable them to support stroke survivors at this difficult time.

How long have you worked at UH Bristol?

Since March 2016

If you could ask people to remember one thing from stroke awareness month, what would this be?

One in three people will experience depression at some point after stroke, with implications for functional and social outcomes, and for quality of life. Apart from emotional problems, there are also changes in cognitive function (attention, memory, speed of information processing, problem solving, mental flexibility). Even though these can be subtle, they nonetheless affect a person's functioning and indeed their return to meaningful activity and work. Therefore, psychological issues are of equal importance as physical issues after stroke, and require adequate consideration, particularly as often they are not as noticeable as physical difficulties.

 

Emily Highfield

What is your role?

I am the lead speech & language therapist (SLT) for stroke services at the Bristol Royal Infirmary.

What does this involve?

I work closely with other SLT colleagues, the wider multi-disciplinary team (MDT), and colleagues at South Bristol Community Hospital to help care for people who have had a stroke.

We work with people who have communication and/or swallowing difficulties as a result of their stroke. This can be very common;  about half of people who have had a stroke will have difficulty swallowing, and a third will have problems communicating. If people cannot eat and drink safely, they are at risk of chest infections caused by aspiration pneumonia. This is one of the most dangerous complications after a Stroke.

I work with both communication and swallowing difficulties, but my favourite area is a condition called Aphasia, which is where a person's language is affected following a stroke. They know what they want to say but, due to lasting damage to the brain caused by the stroke, can't find the right words, or put them into a sentence.

How long have you worked at UH Bristol?

I have worked here since 2007 in a few different roles, but this has always included working with people who have had a Stroke. It is a fascinating, complex and challenging area to work in. I love the fact that we work as part of an MDT, with everybody contributing their expert knowledge and skills.

If you could ask people to remember one thing from stroke awareness month, what would this be?

I would ask that people remember that not all of the symptoms after a stroke are visible. We often think of people with weakness down one side and difficulty using their arm or leg. They may use an aid or wheelchair that signals to others that they may need additional support. But a lot of the effects of a stroke can be invisible - communication, cognition, perception, may all be affected and the person looks the same as they always did. We need to make sure we check if someone has a disability that we cannot immediately see, and adapt to their needs accordingly.