Reflective practice in hyper acute stroke nursing: integrating patterns of knowing and trauma theory

Background: Reflective practice is essential in nursing, yet its role in hyper acute settings remains underexplored. Stroke presents unique challenges, combining time critical interventions with sudden trauma and disruption to patients’ lives. Aim: To examine how nursing knowledge and theory shape reflective practice in hyper acute stroke care. Methods: This paper adopts a conceptual and reflective approach, drawing on Carper and Chinn and Kramer’s patterns of knowing, alongside Judith Herman’s three-stage trauma theory. These frameworks are critically explored and applied to lived practice within a hyper acute stroke unit. Results: The integration of multiple patterns of knowing demonstrates how nurses balance empirical urgency with ethical sensitivity, emotional awareness and person-centred care. Herman’s theory offers additional insight into safety, identity disruption and recovery following a stroke, highlighting the psychological dimensions of care often constrained by time and environment. Conclusion: Theoretical knowledge and diverse ways of knowing are essential to safe, ethical and holistic stroke nursing. Reflective practice is shown to be an active, present process that informs judgement, relationships and care delivery within complex clinical settings.