Opinion

NRT: What does your job involve? CP: Our team deals exclusively with claims on behalf of people who are injured somewhere other than in their home country. We predominantly represent English people who are injured on holiday or working abroad, but sometimes we represent claimants from other countries injured here in England and Wales. We deal with cross-border litigation, where we often have to consider whether a different country’s laws might apply or govern the claim. Sometimes there’s a choice as to where you bring the claim, and there are often arguments about which law will determine how much compensation a claimant can expect to receive.

A recent report published by Neurological Alliance member charity Sue Ryder revealed that more than 15,000 people in England with complex neurological conditions such as head injury, motor neurone disease, MS, Parkinson’s disease and Huntington’s disease, are living in old people’s nursing homes.This is shocking news and yet another case of the UK’s ‘postcode lottery’ in which access to health services and medical treatments is determined by the area of the country in which individuals live. Is it not ethically wrong to hide an articulate young person with motor neurone disease trapped in a dying body or a middle-aged man with a brain injury acquired in a road traffic accident in a setting inappropriate to their age and without a care plan or rehabilitation prescription?

With the average life expectancy in the UK on the rise, more and more care homes are taking shape all over the country. These facilities cater to people of all abilities and the equipment they choose to include can make all the difference in delivering consistently high-quality care. One key obstacle in any nursing home is creating a homely, cosy facility is patient lifting hoists. These are necessary if you are needing to carry out transfers to and from different locations, but they can often feel quite cold and clinical – precisely the opposite of what you would want your care home to feel like.

There are many specialisms within the field of practice, from those which are linked to long- term neurological conditions such as stroke to life-limiting neurological conditions including Huntington’s disease and neurotrauma from a brain or spinal injury. Due to the variations between specialisms, one of the core elements of care for any neuroscience nurse is the person-centred approach. Most people with long-term neurological conditions can live fulfilling lives, whether this be in a hospital or care setting, and central to their fulfilment is the understanding of their wants and needs.

Chris Bryant (Rhondda, Lab) and chair of the debate opened the session by outlining the obvious and more hidden forms of brain injury. “Sometimes a brain injury is really obvious – where the skull has been fractured or penetrated—but often the sheer force of the soft tissue colliding at speed against the hard inside of the skull bruises the brain, leading to a contusion or a haemorrhage that is outwardly invisible. “Injuries can also be caused by stroke, tumours, infection, carbon monoxide exposure and hypoxia—oxygen starvation. These are hidden injuries with complex and fluctuating life-changing effects that strike close to the heart of what it is to be human, to be conscious, to be alive and, in many cases, to want to be alive.”

High above the M25, a buzzard cuts through the December sky. Scanning the tarmac below, it spots something edible and begins its rapid descent. At ground level, Michelle Munt is driving her smart car, completely unaware that her life is about to change forever. Traffic ahead suddenly slows. She takes her foot off the gas. The lorry behind should be slowing too. But in those crucial seconds of reaction, the buzzard has smashed beak-first into its windscreen. The driver can’t see the road, or Michelle, and sends her relative tin can of a car flying into the crash barrier.

In a packed auditorium not far from the Yangtze River, hundreds of delegates are on their feet clapping vigorously. They have just discovered that one of their national heroes has been sitting among them undetected all evening. Xia Boya is China’s rehabilitation poster boy (or man, since he’s now 70). In his twenties during an attempt to scale Everest, his team hit bad weather just 250 metres from the summit. Xia gave his sleeping bag to a teammate who was struggling to survive. But his kindness came with a heavy cost – frostbite and the subsequent amputation of both his legs. Yet 43 years after that failed mission, he finally achieved his dream of climbing the world’s most unforgiving peak.

Having worked as a neurosciences occupational therapist in the NHS for more than 15 years, it felt somewhat surreal leaving behind my team and service, which had become deeply embedded in my daily routine. The opportunity to undertake an exciting new challenge in my career, despite the anxieties of the unknown and a loyalty to a service of which I was extremely fond and proud, paved the way for a move that in the end proved difficult to decline. Before I could hesitate, I was driving to Cornwall to complete an immediate needs assessment and I was delighted to complete my report within the 21-day deadline. Phew! I reflect on my first year in case management noting the increased consumption of coffee but more significantly with immense pride of my achievements.

Led by a team of occupational, physio, music, and speech and language therapists, the delivery of music therapy has, so far, been enthusiastically received by patients, staff, and family members across the ward, and there is now demand for music therapy on both the hyper-acute and in-patient rehabilitation wards. Working closely alongside the team at Charing Cross, Chroma has been delivering two weekly days of neurologic music therapy (NMT) and traditional psychoanalytic music therapy to help the multidisciplinary team achieve patient recovery goals, and to offer them a way of managing the emotional demands of life immediately after a stroke.