護患情境會話

拇指再植術前病人的護理

Preoperative Nursing for a

Thumb Re-plantation Patient

交流

病人：（點了點頭）想到明天真要做手術，我真的好害怕、好緊張又擔憂，所以我不想做了。

護士長：我非常理解你此刻的心情，只是我們現在要做的是消除這些心理影響而不是逃避手術。這樣你才能爭取早日出院。

病人：可是，我還是不想做手術。

護士長：手術是肯定要做的。你可能還不知道人的拇指的重要性吧？讓我來對你說說。

病人：哦。

護士長：人的五個手指中，拇指的功能約占全手功能的一半以上，缺失了將嚴重影響手的抓、捏、握功能。你還年輕，以后的工作、學習、生活都離不開手，何況，這還是你的右手呢？

病人：（若有所思地點了點頭，表情有所舒展）那手術后少了一個腳趾頭會不會影響走路呢？

護士長：這你不用擔心，因為走路的著力點是在足底部，沒有第2足趾對行走是影響不大的。你還有什么擔心嗎？

病人：我還擔心手術會不會失敗？手術后手指外形怎么樣？功能又怎樣？

護士長：你別焦急。這類手術的成功率在我院是99%以上，而且手術是主任親自為你做你可放心。至于外形和功能，你起床，我帶你到其他病房去看看那些就要出院人的手指，相信你更會放心了。

病人：（一臉驚喜）真的嗎？

護士長：當然。

（一路上，護士長邊走仍邊和小陳談心，20min后返回病房。）

護士長：小陳，現在還需要什么幫助嗎？

病人：（害羞地）不需要了，真謝謝你的幫助。

護士長：沒關系，這是我應該做的。現在你心情怎樣？Interactions

Patient：（nodding）I am so scared and worried about tomorrow’s operation.I don’t feel like doing it.

Head Nurse：I understand.What we should do now is to eliminate these psychological influences，not to avoid the surgery，so you can go home as soon as possible.

Patient：But，I still don’t want to have this operation.

Head Nurse：You must have the operation.Let me tell you the importance of your thumb.

Patient：Oh.

Head Nurse：The thumb carries 50%of the functions of your hand.Without your thumb you can not grasp，pinch，and hold.You are still a young girl.You can not work，and study well and live a happy life without your thumb.This is especially true since you are a right hand dominant person.

Patient：（thinking，nodding，and relaxing a little bit）Will missing one toe affect walking after the operation？

Head Nurse：Don’t worry.Walking relies mainly on the thenar and the heel.It should not have much effect to your walk without the second toe.Do you still have any worries？

Patient：I am afraid my operation will fail and I can not image the shape and the function of the constructed“thumb”.

Head Nurse：Take it easy.The success rate of this operation is more than 99%in our hospital and the chief surgeon will perform the operation for you.As to the shape and function of the reconstructed thumb，I can show you the other patients who have received this operation and will be discharged soon.

Patient：（gladly）Really？

Head Nurse：Of course.

（The head nurse talked with Miss Chen while walking.After 20minutes，they came back to the ward.）

Head Nurse：Can I do anything else for you？

Patient：（shyly）Noting else.Thank you so much for your help.

Head Nurse：You are welcome.This is my duty.How do you feel now？