The Postoperative Management of the Neurosurgical Patient with Particular Reference to the Nursing Problems *

In no field of surgery does the immediate welfare of the patient depend so much upon the postoperative management and nursing care as in surgery of the nervous system. Of necessity, the nursing care must all be "intensive." Aside from the factors of age, general physical condition before operation, and immediate postoperative condition, the site of operation determines particularly which phase of the postoperative care is likely to require the most attention. Each patient presents an individual problem. It is only by meticulous attention to detail that these patients are given their fullest chance for recovery. Only by the closest type of teamwork between the nursing and surgical staffs can the management of these patients be carried out with the greatest facility and most benefit. It must be kept in mind constantly that the welfare of the patient is paramountand that inconvenience to the attending staff, no matter how great, weighs little in comparison to the life of the patient. Of greatest importance is the attitude and conduct of the attending nurse which must be one of encouragement. The nursing care of neurosurgical patients requires intelligence, observation, and alertness, and entails considerable hard work. It becomes the duty of each nurse attending the patient to exert her capacities to the utmost. There is no routine in this type of work; each problem, whether the control of hyperthermia, the care of the back, or the control of the intracranial pressure, becomes a challenge to the nurse as well as to the attending surgeon. The quality of observation and of constant alertness characterizes the nurse who is trained in neurosurgical nursing. Observations correctly made and recorded aid materially in the diagnosis and localization of lesions of the nervous system. As an example, notes regarding the occurrence of a convulsion should indicate the extremities involved and the order of involvement, the side first or most