從護病關係反思兒科急診友善照護

Reflection on Child-Friendly Healthcare in the Emergency Department From the Perspective of the Nurse-Patient Relationship

急診護理師通常是在繁忙的情境中建立護病關係，尤其是在照護急診兒童時。為了幫助兒童在短時間能接受多項醫療處置，常以半哄騙或略具壓力的方式進行，讓彼此之間的關係常處於緊張狀態。本篇文章以Swanson關懷理論為基石，提出兒科急診友善照護之臨床應用。首重以真誠、關懷的方式與急診兒童和其家屬建立友好的橋樑，瞭解兒童與家屬就醫時的需求。在旁陪伴且適時傾聽、回應，適時給予決定及選擇的權力，更要提供專業照護及方式，讓家屬有能力照護兒童等，以提升急診兒童與家屬的信任感，降低焦慮等負向感受及壓力，期許藉由護病關係的反思進一步能促進兒科急診友善照護之實踐。

Emergency nurses, especially when caring for pediatric patients, typically establish relationships with their patients under hectic and busy conditions. Thus, these nurses often rely on semi-coaxing / slightly stressful methods to quickly prepare patients to undergo necessary medical procedures. However these approaches cause tense relationships. To establish friendly bridges with pediatric patients, emergency nurses should adopt sincere and caring approaches. An approach based on Swanson’s caring theory for applying child-friendly healthcare in the emergency department is proposed in this article. It is important to establish a friendly bridge with pediatric patients with emergency treatment needs and their families in a sincere and caring manner; to understand the needs of these children and their families when seeking medical treatment; to be present, listen, and respond to these patients and provide decision-making power when appropriate; and to provide professional care and method knowledge to empower families to care for their children. Accomplishing this may be expected to improve trust in both children with emergency medical needs and their families and thus decrease their anxiety, negative emotions, and stress. We hope that reflecting on the relationship between nurses and patients may further promote the practice of friendly healthcare in pediatric emergency departments.