Psycho-social Support

The aneurysmal subarachnoid hemorrhage (aSAH) event is sudden and frightening to the patient/family as well as observers. This shocking event also carries a 50% mortality rate during the first two weeks. Family members are often made aware of this prognosis which understandably increases their anxiety.

The informed nurse can provide vital support to the patient and family by helping them address any knowledge deficit about aSAH. The nurse will provide patient/family education that reinforces the primary physician and neurosurgeon's explanations about aSAH, including diagnostic procedures, treatment measures, surgery, and complications.

Patient and family education regarding the importance of the ICU environment and routines including aneurysm precautions is a priority. Being alert for cues indicating areas of concern and providing information with a patient centered approach will assist the nurse to discuss coping assistance and strategies available to the patient and family.


Unconscious patient and family centered care

About 25% of patients also have a decrease in their level of consciousness on admission. If the patient is unconscious at any time, family members should be encouraged to talk to him or her about routine but non-stressful family events. Patients always should be talked to and not about in their presence. We know from research patients often can hear and understand what is being said even though they cannot respond (Lawrence, 1997). To feel the love and support of friends and family members is important for their recovery.

Similarly, try to discourage or prevent people from visiting who might drain the patient with their negativity. The patient can only protect themselves by retreating further into their unconscious state. The above is particularly important to remember when unconsciousness has just occurred, the patient is coming out of unconsciousness, or has just been moved.

For more information about care of a patient who is unconscious see the Experiences of Previously Unconscious Patients course.

If the patient has come close to dying, they may experience a transpersonal event, such as a near-death experience. The patient will usually want to talk about what was experienced. It is important for the nurse to assess patients who have come close to dying for these experiences. These patients are critically ill and these events need to be normalized for them as to not cause additional stress or concern. For more information on these events see the Caring for the Patient Experiencing a Near-Death or Other Transpersonal Event course.

Throughout hospitalization, the nurse will be involved in interdisciplinary patient management. Most patients who survive a SAH will require further rehabilitation. The nurse can assist the patient and family by providing information, needs assessment and arrange social service consultation to help the patient and family plan for the future.

Lawrence, M. (1997). In a World of Their Own, Experiencing Unconsciousness. Westport: Praeger.