特殊教育學校中的護理實踐－－－－非凡的愛給特別的孩子

Special education school nursing practice: An extraordinary love for the special schoolchildren

筆者試著回觀反映多年在特教學校護理實務現場的實踐知識。目前台灣共有25所特殊教育學校，特殊學校的身心障礙學生自我照顧能力不足，身心狀況皆需特別照顧。筆者所任職之學校有3歲到22歲發展遲緩身心障礙學生四百餘人。其中以中、重度智能遲緩者為主，亦包含多重障礙者。特教學校護理師有賴平日長期對於身心障礙學生的觀察，熟悉這些學生個性特質、健康病史和潛在危險因素，並且利用「身體評估與護理過程」確立護理診斷與預測可能病況，執行過程雖然不容易但卻是最有效的方法。特教護理實務之內涵著重在傷病護理、傳染病防治、口腔衛生、急迫性異物梗塞處理與穩住突發性危險病況、到院前救護、伊比力斯(epilepsy)護理與急救、特殊個案與罕見疾病之照護、教師與照顧者的照護教育等。此外，學生家庭與特教學生的照護息息相關、家庭與學校息息相關，要做好特教護理，更須瞭解其家庭的問題以及學習環境的助力與阻力；以發揮溝通的功能，串聯學生、老師、家長三方，彼此協同磨合，照護學生的同時，並深耕護理專業於學生的家庭。特教護理實踐，必須在不斷的解決問題當中，提煉與建構出適切的方法，之後才能使特教生多元的問題迎刃而解；也才能在完整且持續的護理過程中，將點點滴滴不凡的愛從實踐中付出給特殊學生！！

Disable students lack self-care ability, they need of special care in physical and mental fields. There are 25 Special schools in Taiwan. In addition to special education school, while a majority of disabled students in the school studying in ordinary schools. One of the special schools has more than 400 students; they are aged from 3 to 22. All of them are moderate severe mental retardation, most are multiple disabilities. After long-term daily observation, the observation understanding the students’ personality, health history, or some hidden risk factors, and find out that making use of “health assessment” to establish nursing diagnosis and disease prediction may be difficult but very practical. Nursing cultivation of special schools should emphasize on the followings: injury, disease care, prevention of infectious disease, oral hygiene, choking treatment, first aid, epilepsy nursing, special cases, rare disease care, teachers and caregivers nursing and so on. Families and school system are closely related in to do nursing care in special schools. The cares should focus on both physical and mental health at the same care. Professional nurses must good understand of the family and school systems; therefore, in making communication with students’ caregivers. The professional nursing knowledge was cultivated in families. And through problem-solving or structure building, the complicated problems are changed to be simple. In any case, the extraordinary love for those specially students.