照護一位老年憂鬱症患者服用鈣離子阻斷劑自殺之護理經驗

Nursing Care Experience of a Patient with Elderly Depression Who Attempted Suicide Using Calcium Channel Blockers

本文探討一位86歲患有老年憂鬱症個案，因下肢無力產生強烈無望感，故服用大量鈣離子阻斷劑自殺之急診加護護理經驗。照護期間自2017年8月2日至8月7日，筆者運用五大層面評估，藉由實際觀察、會談、傾聽、身體評估、查閱電子病歷等方式蒐集資料，確認個案有心輸出量不足、無望感、無效性因應能力等健康問題。護理過程中藉由解毒劑及昇壓劑維持生命徵象，病況穩定後運用傾聽、同理心，引導及鼓勵個案說出自殺原因、想法與感受，並轉介心理諮詢、精神科、社工等團隊，協助個案克服生活中的壓力事件，改善無望感、解除自殺危機。透過此照護經驗分享，期盼除了緊急救護及生理處置外，能兼顧心理、靈性及社會之照護，讓護理更具完善。

The nursing care experiences of an 86-year-old man with elderly depression. His lower limbs were weak, and he required assistance for daily activities. He experienced a strong sense of hopelessness and attempted suicide by ingesting large quantities of calcium channel blockers. He was admitted to the emergency intensive care unit. The period of care was from August 2, 2017, to August 7, 2017. The author collected information in five major areas through observation, interview, listening, physical examination, and chart review. The major problems observed during hospitalization were decreased cardiac output, hopelessness, and inability to cope. During the nursing process, we administered antidotes and inotropic agents to maintain vital signs. After we stabilized the patient's condition, we listened to and communicated with him, offering empathy and care. Encouraged to express negative feelings and reasons for feeling suicidal, the patient was helped to overcome stress, reduce hopelessness, and avert a suicide crisis with the help of social workers, a psychological team, and psychological counselors. Through this sharing of care experiences, psychological, spiritual, and social care can be used to achieve a more comprehensive nursing approach.