護患情境會話

患兒恐懼手術的心理護理

Psychological Nursing Care for a Child’s Fear before Surgery

背景

病人××，女，10歲，學生。全身火燒傷后疤痕攣縮，需手術治療而收住入院。此病人因反復多次手術，對手術充滿恐懼。一進手術室就哭鬧不止，無法給她做術前的準備工作。手術室護士在手術室門口接待病人時就要開始進行心理護理。

Background：

A 10year old female student was hospitalized for surgical treatment on the scar formations after she suffered whole body burns.This little girl was so scared of operation after her multiple surgeries.It was a challenge to make preoperative preparations for her，because she couldn’t stop crying once she got in the operating room.Operating room nurses began psychological nursing care as soon as the patient arrived at the door of the operation room.

交流

護士：喂！小天使××（喊患兒小名，倍顯親切），你來啦，昨晚睡得好嗎？（用大手拉著小手，面帶微笑 ）

患兒：我怕開刀，我睡不著，我不要開刀。

護士：怎么啦，××，是不是怕開刀時痛呀？剛才在病房里打針了嗎？

患兒：打了，我打針的地方好痛，我不要開刀（邊哭邊講）。

護士：××，告訴你，剛才打的可是定心針哦。等一會兒，讓麻醉師給你打一點睡覺的藥，等你一覺醒來，已經開好刀了，而且又把昨天的覺補回來了。多好呀！（邊交談邊撫摸孩子的額頭）

患兒：（停止哭鬧，沉默。）

護士：××，你看，這是魔術麻醉師，她的本領可大了，有許多比你小的小朋友開刀也一點不痛呀。不過你要配合她哦！

患兒：（患兒點頭），我能配合你們一起完成術前準備。

Interactions

Nurse：Hello，little angel××（calling her name，feel-ing very close to her.）Did you sleep well last night？（holding her hands gently with a smile.）

Girl：I’m afraid of the operation.I couldn’t fall asleep.I don’t want the operation.

Nurse：How is that？×× are you scared of the pain？Have you got an injection in the unit？

Girl：Yea，it hurts so much where they gave me the injection.I don’t want the operation（crying as she spoke.）

Nurse：That injection will make you calm.The doctor in the operation room will give you some sleeping drugs which will make you fall to sleep.When you wake up，the operation will be over.It’s magic，right？（chats while fondling the child’s forehead）

Girl：（The girl stopped chatted orying but kept silent.）

Nurse：Look at her.She is the anesthetist，agreat magician.She has made many patients younger than you to have no pain during their operation.If you want no pain，then you must cooperate with her.

Girl：（nodding）I will cooperate with you.

點評

在對病人術前心理護理過程中，最為重要的是要深切體會病人此時的恐懼心理。病人擔心安不安全？手術時痛不痛？我們理解到病人的心理需要，展開耐心細致的解釋工作。并在解釋的過程中讓病人感受到護士對他們親人般的溫情。消除手術室對病人所造成的心理上的那種既神秘又恐怖的色彩。用護士的耐心、愛心、熱心來引導病人配合術前準備。

Comments

The most important thing in the process of preoperative psychological nursing care is to understand the fear of the patients.They are afraid of the pain，and worried about their safety.Therefore，we must understand patients’psychological need，and show our care and compassion while carefully explaining the process and eliminate.Eliminate their fear and mystery of the operating room.We must use our patience，be caring and enthusiastic，and make patients cooperate with preoperative preparations.