Coffey Rebecca, Everett Sherman, Miller Sidney, Brown Jacqueline
The Ohio State University Medical Center, 410 W. 10 Avenue, N748 Doan Hall, Columbus, OH 43210, USA.
Int J Crit Illn Inj Sci. 2011 Jul;1(2):129-31. doi: 10.4103/2229-5151.84799.
The issues related to end of life decisions and mortality in the intensive care unit are common occurrences for the nursing staff. For the Critical Care/Burn nurse, issues such as who should be resuscitated, what are the end points of treatment, and what will be the quality of life for the patient if he/she survives are major factors in end of life decisions. Furthermore, the close relationships that can develop between the nurse and the patient and/or the patient's family make end of life decisions emotionally difficult. Unlike the other members of the multidisciplinary team, the nurses spend more time with the dying patient and his/her family, answering questions, explaining the care and course of the illness, and assisting the patient and family in understanding what the doctors have said. Repeated explanations are needed because the family and patient are under tremendous stress. Nurses experience emotional distress and need to develop resilience to continue to care for and work with patients approaching the end stages of life. The purpose of this paper is to briefly review the literature and use a case scenario to illustrate the challenges the Critical Care/Burn nurse faces when caring for the dying patient.
在重症监护病房，与临终决策和死亡相关的问题对于护理人员来说是常见的情况。对于重症护理/烧伤科护士而言，诸如谁应该接受复苏、治疗的终点是什么以及如果患者存活其生活质量将会如何等问题，是临终决策中的主要因素。此外，护士与患者及/或患者家属之间可能建立的密切关系，使得临终决策在情感上变得困难。与多学科团队的其他成员不同，护士与临终患者及其家属相处的时间更多，要回答问题、解释护理和病情发展过程，并协助患者和家属理解医生所说的话。由于家属和患者承受着巨大的压力，所以需要反复解释。护士会经历情感困扰，需要培养适应能力，以便继续护理和陪伴接近生命末期的患者。本文的目的是简要回顾相关文献，并通过一个案例来阐述重症护理/烧伤科护士在护理临终患者时所面临的挑战。
