从叙事医学视角探索社区临终关怀护士培训新路径

The new way for training the community hospice care nurses from the narrative medicine view

目的:通过叙事情景模式下的实践提高社区临终关怀护士的情感沟通能力。方法:选取社区临终关怀科舒缓疗护病房的11名护士进行观察、访谈。通过倾听患者的叙事、舒缓疗护个性化照顾计划书、护士日志、讲述心情故事等方式收集临床资料。结果:社区临终关怀护士沟通与共情能力有所增强,自我价值认同度与职业满意度有所提高,减少了护患沟通障碍,提供了优质护理服务。结论:叙事医学为社区临终关怀护士提升人文素养与情感沟通提供了坚实的理论依据,特别是面对伦理冲突时,能以患者为中心做出最佳的伦理选择,使临终患者能够安适、宁静离世,家属也得到了安慰和关怀。

Objective： To improve the emotional communication ability of the hospice care nurses in the community through the mode of the narrative medicine. Methods： Eleven hospice care nurses in the palliative care wards of the community hospice care department were selected for observation and interview. The clinical data were collected through listening to the patients＇ narratives, individual palliative care plan, nurses＇ diary, telling the mood stories and other methods. Results： The communication and empathy abilities of the hospice care nurses were improved, and their self value perception and career satisfaction were enhanced which reduced the obstacle of the mutual nurse-patient communication and provided the high quality nursing service. Conclusion： The narrative medicine offers the strong theoretical foundation of the humanistic accomplishment and emotional communication for the hospice care nurses, especially when they are facing the ethical conflicts, it can make the best choice considering the patient as the center, which makes the dying patients comfortably and quietly pass away and their family members get comfort and care.