一位喝清潔劑自殺老人運用急診安寧之照護經驗

An Emergency Hospice Nursing Experience of Caring an Elderly who Committed Suicide by Drinking Detergent

本文敘述一位85歲男性，因服用清潔劑自殺，在急診救護的照護經驗，照護期間為2020年1月27日至2020年1月28日，護理過程中運用觀察、會談與個案及其家人互動收集生理、心理、社會及靈性等四大層面資料，確立個案有低效性呼吸型態、急性疼痛及治療決策衝突之健康問題。於急診照護期間除優先穩定其生命徵象外，針對個案與家屬對於急救意願與若病況惡化不可逆是否接受安寧照護產生意見分歧的問題，在繁亂的急診環境中提供一獨立空間，照會急診安寧團隊，藉由了解、傾聽、陪伴與提供足夠的安寧照護知識以釐清家屬疑慮，達成個案與家屬對於未來照護方向及期待的一致性，並引導個案與其家屬嘗試討論彼此內心感受。希望藉此照護經驗分享，提升急診護理人員安寧緩和之照護能力。

This article describes an emergency nursing experience of caring an elderly male who attempted suicide by ingesting detergent. The nursing duration extended from January 27 to 28, 2020. Through observation, conversation, and engagement with family members, data was collected across four major dimensions: physiology, psychology, society, and spirituality. Identified health problems included an ineffective breathing pattern, acute pain, and decisional conflict. Throughout the nursing process, stabilizing vital signs took precedence. Addressing the disagreement between the patient and his family regarding resuscitation preferences and acceptance of hospice care in case of exacerbation, we sought guidance from the emergency hospice team and provided an independent space. Employing understanding, active listening, companionship, and the provision of comprehensive knowledge about hospice care, we endeavored to address the concerns of the family members. This approach facilitated achieving consensus between the patient and his family regarding the prognosis. Additionally, guided discussions facilitated an open expression of true feelings among all parties under the supervision of the medical team. This nursing experience aims to enhance the emergency team's proficiency in caring for patients with hospice care needs.