照顧一位創傷性腦損傷外籍勞工之護理經驗

Nursing Experience of a Foreign Laborer with Traumatic Brain Injury

本文探討一位外籍勞工創傷性腦損傷術後之護理經驗，照護期間自2019年12月19日至2019年12月30日，筆者運用Gordon十一項功能健康型態進行身體評估，藉由觀察、會談及病歷調閱確立有顱內調適能力降低、身體活動功能障礙、焦慮等健康問題。護理過程透過主動關懷以建立信任關係，鼓勵表達感受，與案友協助翻譯說明治療過程，給予個別性護理措施，密切觀察生命徵象及神經學反應，預防續發性腦損傷；與醫療團隊共同擬定復健計畫並協助執行，給予鼓勵及正向支持增加自信心促進自主運動意願，提升自我照護能力，儘早恢復原有生活；考量個案於治療過程面臨溝通難題，以圖卡與翻譯軟體克服障礙，會同社工及雇主解決因暫時失能導致的經濟社會問題，藉由視訊軟體聯繫印尼家人提升家庭支持系統，降低個案焦慮。希望藉由此護理經驗分享，提供日後醫護人員照顧外籍人士之參酌。

This report describes the post-surgery nursing care for a patient with traumatic brain injury. The author applied the Gordon Functional Health Pattern, which includes 11 categories, combined with observation, communication, and medical record review skills to assess the patient when taking care of the patient during December 19th to 30th, 2019. Three major nursing diagnoses were concluded: decreased intracranial adaptive capacity, impaired physical mobility, and anxiety. The author built trust with the patient, encouraged the patient to express feelings, translated and explained treatment process with the assistance of the patient’s friend, provided individual care, and assessed vital signs and neurological reactions closely to prevent secondary traumatic brain injury. The author also cooperated with the medical team to build a rehabilitation plan for the patient, assisted the patient to carry out the plan, and encouraged and supported positively the patient to increase the patient’s self-care ability and willingness to exercise actively to return to usual life as early as possible. Since the patient had communication and financial difficulties, the author used graph cards and translation apps and cooperated with social workers to solve the problems. The patient’s level of anxiety decreased after connecting with the patient’s family in Indonesia and receiving family supports using videoconferencing apps. The author’s nursing experience can be used as a reference for healthcare professionals when taking care of migrating patients.