Yu Wan-Chen, Lin Kai-Hui
MSN, RN, Neonatal Intensive Care Units, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
MS, RN, Head Nurse, Neonatal Intensive Care Units, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2021 Aug;68(4):96-102. doi: 10.6224/JN.202108_68(4).12.
When a newborn requires immediate hospitalization due to a potentially life-threatening situation, parents face a sudden and significant increase in stress. This situation and the potential loss of their child will bring great grief and loss to the parents, which may lead to conditions that foster dysfunctional family dynamics. This article describes the author's experience providing hospice care to a dying infant with a group B streptococcus infection in the neonatal intensive care unit. The author served as the primary care nurse from April 5th to July 6th, 2019. Data were collected during direct care provision, observations, and interactions with parents, while overall systemic assessments were used in analysis to establish that the health problems of the case were: (1) existing infection: related to group B streptococcus; (2) ineffective tissue perfusion: insufficient perfusion of multiple organs, including brain, heart, lung, and kidney, due to sepsis infection; and (3) caregiver grief: facing the death of a newborn. Nursing care provided to the patient included maintaining individualized physical functions and retaining physical integrity during the end-of-life period. The nursing care provided to the parents included the use of art therapy to encourage them to express their inner emotions through the writing of memoirs and diaries and their participation in companionship. This intervention was designed to help the parents transition from the grief of denying the collapse to the fact that their baby had died. As Taiwanese culture typically avoids discussions of death, the nursing experience described in this article may provide a reference for caring for similar patients. This article highlights the beauty of nursing through art therapy, demonstrates the achievement of whole-person and family-centered nursing, shows how the case was successfully helped through the crisis, and illustrates how normal family functions may be maintained.
当新生儿因潜在的危及生命的情况需要立即住院时，父母面临的压力会突然大幅增加。这种情况以及可能失去孩子会给父母带来巨大的悲痛和损失，这可能导致家庭关系失调。本文描述了作者在新生儿重症监护病房为一名患有B族链球菌感染的濒死婴儿提供临终关怀的经历。作者在2019年4月5日至7月6日期间担任主要护理护士。在直接护理、观察以及与父母的互动过程中收集数据，同时运用全面的系统评估进行分析，以确定该病例的健康问题为：（1）现存感染：与B族链球菌有关；（2）组织灌注无效：由于败血症感染，包括脑、心、肺和肾在内的多个器官灌注不足；（3）照顾者悲伤：面对新生儿的死亡。为患者提供的护理包括在临终阶段维持个性化的身体功能并保持身体完整性。为父母提供的护理包括运用艺术疗法，鼓励他们通过撰写回忆录和日记来表达内心的情感，并参与陪伴。这种干预旨在帮助父母从否认崩溃的悲痛过渡到接受孩子已经死亡的事实。由于台湾文化通常避免谈论死亡，本文所述的护理经验可能为护理类似患者提供参考。本文通过艺术疗法凸显了护理之美，展示了全人及以家庭为中心护理的成果，说明了该病例是如何成功度过危机的，并阐述了如何维持正常的家庭功能。
