- 期刊
運用Watson關懷照護理論照顧一位嚴重創傷的壯年之急診護理經驗
Emergency Nursing Experience of Caring for a Severely Traumatized Middle-aged Man Using Watson Care Theory
摘要
本文描述一位遭受工安意外導致嚴重創傷而可能癱瘓之壯年於急診之護理經驗，照護期間自2017年12月30日09:30至15:45。嚴重創傷個案常血液動力學不穩，而需醫護人員即時介入密切照護以挽救生命。除生理層面維護外，個案在急診崩潰痛哭之畫面震攝筆者，自省醫護人員常注意生理疾患而忽略心理需求故引發筆者選擇此個案深入照護之理由。期間藉由身體評估、實際照護、會談、觀察、傾聽及查閱病歷等方式進行生理、心理、靈性及社會資料收集，確立急診期間健康問題為疼痛、抉擇衝突及無望感。筆者運用Watson關懷照護理論與醫療團隊合作，藉由主動關懷建立治療性關係，除穩定生命徵象外教導以深呼吸、音樂、輕撫等方法轉移注意力以緩解疼痛；當個案面臨重大手術而產生抉擇衝突時，提供手術相關資訊，陪伴並鼓勵個案表達正負向感受；另於個案負面情緒出現時，持續不放棄的接觸個案，與個案一同回顧生命中重要的人事物，終讓個案卸下心防，接受照護及衛教，引導個案以正向心態決定接受手術及後續治療。藉此經驗分享，建議急診照護嚴重創傷病人時，除維持其生命徵象外，醫護人員能適時傾聽病人的聲音，協助其面對疾病造成之心理問題及挑戰。
並列摘要
This article describes the nursing experience of a middle-aged patient with severe injury caused by an industrial accident and possible post-traumatic paralysis in the emergency room. The nursing period was from 09:30 to 15:45 on December 30, 2017. Severe trauma cases are often haemodynamically unstable and require immediate intervention and intensive care to revive. In addition to the maintenance at the physical level, the image of the patient crashing and crying in the emergency room shocked the author. Introspection about medical staff often pays more attention to physical diseases and ignores psychological requirements that led the author to choose this case for in-depth care. Data were collected through physical assessment, actual care, interviews, observation, listening, and reviewing medical history and so on. Hence established health problems during the emergency period include pain, decision conflict and hopelessness. The author uses Watson's nursing theory to work with the medical team to establish a therapeutic relationship through active care. In addition to stabilizing vital signs, the author teaches deep breathing, uses methods such as music and stroking to divert attention to ease pain. When the client faces a major surgery and encounters decision conflict, provide information about the surgery, accompany and encourage the client to express positive and negative feelings; when the case come across negative emotions, communicate with the case persistently, and review the important life events together with the case, and finally lead the case to let go of his guard, receive care and health education, and guide the case to accept surgery and follow-up treatment with a positive attitude. Based on sharing this experience, it is recommended that in emergency care of severely traumatized patients, in addition to maintaining their vital signs, medical staff can also listen to the patient's voice in a timely manner to help them face the psychological issues and challenges caused by the disease.
參考文獻
延伸閱讀
- 劉思君、呂沛晴、吳麗淑（2019）。運用Watson關懷理論照護一位婚姻暴力個案之急診護理經驗。若瑟醫護雜誌，13(1)，75-87。https://www.airitilibrary.com/Article/Detail?DocID=1819026x-201906-201907080010-201907080010-75-87
- 李佳薇、黃莉媛、葉素娥（2014）。運用Watson關懷理論照顧一位腦瘤復發病人之護理經驗。長庚護理，25(3)，364-373。https://doi.org/10.3966/102673012014092503011
- 鍾佩婷、武香君、胡嘉桂（2022）。運用Watson關懷理論照顧一位確診COVID-19病人之護理經驗。馬偕護理雜誌，16(1)，13-23。https://doi.org/10.29415/JMKN.202201_16(1).0002
- 邱群芳、林妙璦（2010）。運用Watson關懷理論照顧一位腦中風病人之護理經驗。榮總護理，27(1)，73-78。https://doi.org/10.6142/VGHN.27.1.73
- 李萱妮、王淑芳（2008）。A Nursing Care Experience of Applying Watson Theory for a Single Pregnant Woman Suffering from Domestic Violence。助產雜誌，(50)，36-44。https://doi.org/10.6518/TJOM.2008.50.6