護理人員在安寧療護照護之角色與使命

The Role and Mission of Nurses in Hospice Care

安寧療護(hospice care)在台灣發展至今已邁入第19年，截至目前為止已有30餘家醫院設有安寧病房，護理人員皆積極扮演適切的角色，彰顯並發揮其重要性。安寧療護的使命是陪伴末期病人善終，創造生命的希望與美好，護理人員運用意義、懷舊、環境及靈性等治療方式，除了症狀控制外，更主動關懷病人及家屬靈性需求，創造人生最後意義與價值，期望死別除哀傷不捨外，也感受生命的璀璨與溫暖。本文藉著幾則臨床實例，陳述安寧病房的護理人員如何在謹守本分之餘，積極發揮個人於團隊中的價值，以四全照護理念結合醫療團隊力量，於陪伴病人過程中也予遺族關懷安頓性靈。我們期待更完善的善終，全力推動落實安寧療護，使所有末期病人提升生活品質之餘，更達到生死兩相安的境地，亦為安寧療護的最終目標。

The concept of ”hospice care” was first institutionalized in Taiwan 19 years ago. Today, 30 hospitals in the country provide hospice care, with healthcare teams actively providing humane and compassionate care to those in the last phases of incurable disease so that they may live out their remaining time as fully and as comfortably as possible. Typical therapeutic approaches to hospice care include meaning/existential, nostalgia, environmental and spiritual. Aside from managing symptoms, healthcare teams should address proactively the spiritual needs of a patient's spouse and family in order to create meaning and value by helping them look beyond grief and death to appreciate the warmth of life. This study used a number of clinical cases as examples to illustrate how nurses in an interdisciplinary team setting collaborate to perform their responsibilities and integrate with one another. Ultimately, the healthcare team works to improve the living quality of patients and their families so that all can 'rest in peace'.