照護一位呼吸器依賴個案撤除維生醫療之護理經驗

Nursing Experience of Caring for a Patient with Ventilator-dependent during Withdrawal of Life Support Medical Treatment

本文描述一位呼吸器依賴個案撤除維生醫療之照護經驗，護理期間自2022年1月7日至2月23日，運用整體性護理評估，確立有氣體交換功能障礙、家庭因應能力失調、預期性哀傷等健康問題。以病人及家庭為中心，透過醫療團隊評估，釐清家屬之間對不施行心肺復甦及撤除醫療的想法，適時澄清錯誤訊息，引導並關懷家屬進行哀傷輔導，協助撤除呼吸器，讓個案能在家人的陪伴下，走完人生的最後一段旅程。此次照護經驗家屬共同參與決策顯著重要，建議護理人員在家庭會議中，需強化溝通能力，讓家屬能盡早瞭解彼此想法，並得到共識，減輕家屬不安與痛苦，以提升臨終的照護品質。

This paper describes the nurse’s experience of a ventilator-dependent patient was weaned of life support treatment. The nursing care period was from January 7 to February 23, 2022, during which the patient was assessed comprehensively to identify health issues such as gas exchange dysfunction, family coping dysfunction, and anticipatory grieving. Patient and family-centered care was provided, and the medical team worked together to clarify misunderstandings and provide guidance and support to the family in coping with grief. The respiratory support was removed to allow the patient to complete the final journey of life in the company of family members. Family involvement in decision-making was significant in this care experience, and it is recommended that nursing staff enhance their communication skills during family meetings to facilitate early understanding and consensus-building among family members and alleviate their anxiety and distress when making decisions, to improve the quality of end-of-life care.