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Rising to the challenge of a project to develop Whanganui’s stroke service – a specialty area new to her – won Amanda Van Elswijk the Whanganui nursing hero nomination.

NAME: Amanda Van Elswijk 
DHB: Whanganui
JOB: Clinical nurse manager AT&R and acute stroke unit

Rising to the challenge of a project to develop Whanganui’s stroke service – a specialty area new to her – won Amanda Van Elswijk the Whanganui nursing hero nomination.

Amanda Van Elswijk’s career took a sharp turn in 2012. Following many years working as a paediatric, neonatal and public health nurse, she was asked to lead the Whanganui DHB’s stroke service development project. It was a challenge she rose to and, four years on, Amanda is making her mark on stroke services and has fully embraced her new specialty.

In 2014, she was instrumental in establishing Whanganui Hospital’s acute stroke unit in the assessment, treatment & rehabilitation (AT&R) ward. So rather than the traditional path of acute stroke patients being treated in medical wards and then being transferred to ATR, they are now admitted straightaway to a unit within ATR. 
Amanda says the new approach is proving successful, with a stroke patient’s rehabilitation beginning as soon as they are admitted to the acute stroke unit.

Amanda and her team were determined to provide an acute stroke unit where people of all ethnicities feel comfortable, so they are guided by Mason Durie’s Te Whare Tapa Wha* model of care, which describes concepts of health and wellbeing from a Māori perspective.

Amanda stresses to her staff how important it is to understand and empathise with stroke patients and their families.

“When a person has a stroke their lives can change irrevocably,” Amanda says. “They might be with us for three to four months and almost overnight, they (and their family) might have to come to terms with knowing they may never work again, that their house will need to be modified and they may struggle to speak.

“They have so much to take in and there are times when stroke patients’ behaviour can be challenging. So to address this, I and my team have done a lot of training to learn about grief, loss and change; how a patient is feeling and how to adapt their care plan around that,” says Amanda.

“From the moment a patient enters our acute stroke unit, their rehabilitation begins and that can be very challenging for some people. Our job is to help them achieve the best recovery possible and I’m confident that we are doing this. The results we’re getting point to that.”

Besides her work in the hospital, Amanda sits on local, regional and national working groups for stroke and has been instrumental in developing services for primary, and well as secondary care, of stroke patients.

She’s currently completing her clinical master’s degree, with her research component focused on caring for stroke patients. Amanda also heads up the Map of Medicine for stroke, which sees her working closely with the Whanganui Regional Health Network, GPs, and St John Ambulance, among others.

*Te Whare Tapa Whā compares health to the four walls of a house where all four walls (the psychological, physical, spiritual and family/whānau dimensions of health) are necessary to ensure strength and symmetry.