2011年1月27日 星期四

DAISY nurse Jan. 大園敏盛 彭淑梅Peng Shu Mei



近年來社會貧富差距愈加顯著,因此不難想像現實生活中有許多弱勢家庭需要協助,下述個案(阿秀阿姨與李叔叔)就是一個典型的案例。
99.07.13~99.12.28)護理措施包含:
阿秀阿姨中風後呈現植物人狀態,李叔叔對她不離不棄,義無反顧的排除萬難將她接回家中照護,初次接觸到李叔叔時,他無助的眼神撼動人心,在那眼神中,流露出他的悲哀與不捨。彭員在居家護理專業介入這個家庭過程中,努力將居家護理與個案管理的角色作串聯,扮演著溝通者、諮詢者、協調者與傾聽者的角色,安排醫師訪視,引導團隊人員腦力激盪,共同思考著如何提供更適切的、個別性的照護。在照護期間(
1.          與家屬(案夫、案母、案子、案弟)共同召開討論會,鼓勵家屬陳述家庭現況中的問題與困境,並討論適切的社會資源。
2.          評估個案照護需求,經家屬同意後予以轉介非公部門(慈濟功德會)社會資源,取得氧氣製造機、噴霧器等輔具資源,成功的教導家屬儀器的使用及清潔與保養。
3.          引導醫師在訪視過程中,評估照顧者壓力負荷問題,團隊人員適時給予心理支持,並對家屬的付出與努力給予口頭肯定及讚賞。
4.          與某基金會的社工師聯繫,通報此個案,尋求安置照護。
5.          個案返院做健康檢查時(安置機構所需的例行性檢查),團隊人員主動尋找資源(民間救護車),減輕家屬的經濟負擔。
6.          協助案夫做生命回顧,適切表達肯定之意,鼓勵用正向態度面對人生。

經過一番努力,這個家庭終於能撥雲見日,現在阿秀阿姨安置在某基金會所成立的機構照護,李叔叔不捨之情雖猶存,在我們的鼓勵下,已能轉念學會「放下」,現在的他有份穩定的工作,一有空就去探視太太。
彭員在照護這個案、家庭中表現的是:護理不僅是執行常規的工作而已,多用一份心,不但可以讓個案的到更適切的照顧,也照顧到他的家人及家庭;也讓同仁學習到:在工作中需提醒自己學習「反思」,讓自己的護理工作注入「新」與「心」的感動,真實的體驗到護理的專業與價值也能夠多面向的去發揮。
彭員的表現:就體系的核心價值『HOPES』,對個案及家屬用心的照顧,協助解決問題及獲得信任,其為『誠信HONESTY』的展現,運用她居家護理的專業,整合醫療團隊的照護及社會資源的使用,為『卓越EXCELLENCE』的居家護理服務;另將此依經驗注入許多的感動,與同仁共同體驗護理專業與價值,為『分享SHARING』的成長


Although Taiwan enjoys a vibrant economy, pockets of poverty still exist and families among minority groups still need help to survive. Mr. and Mrs. Lee are typical examples.  Mrs. Lee had been in coma and in the vegetated stage after a stroke and being cared for by her husband at home for months.  Ms. Peng Shu-Mei RN, a home care nurse and case manager for the Lee family, played an important role of being a communicator, counselor, moderator, and listener.  During July 13th to December 28th 2010, nurse Peng Shu-Mei arranged physician home visits for Mrs. Lee, but also proactively led the care team to brainstorm and tried to figure out the best way to provide more appropriate and individualized care.  Here are some examples of her great work:
1.          The patient’s need is not the only concern for Ms. Peng.  She tried to identify the problems of the whole family by interviewing the patient’s husband, mother, son and brother.  She encouraged the entire family to express their concerns and difficulties and helped to obtain resources from the community.
2.          After identifying family’s financial difficulty, Ms. Peng helped the patient obtain a free O2 concentrator machine, a nebulizer, and other medical devices, and educated the family members about the usage, cleaning, and maintenance of those devices.
3.          During home visits, Ms. Peng also discovered the pressure and psychological burden of the primary caregiver.  She provided adequate mental support and encouragement for Mr. Lee.  She assisted Mr. Lee to do “life review” about Mrs. Lee.  By doing so, she encouraged Mr. Lee to build a positive attitude toward life.
4.          She proactively contacted social service that helped located a charity long term care center that can take ventilator patient.
5.          She obtained free ambulance for the patient's transport to the center, helping to lighten the family’s financial burden even more.

Thanks to Nurse Peng’s efforts, now Mrs. Lee has settled down in a charity institution.  Mr. Lee was able to get a job and can still visits Mrs. Lee very often.

Details matter.  Ms. Peng distinguished herself by paying close attention to the plight and taking care of the whole family of the patient, and not only conducting routine nursing works.  Nurse Peng has been an employee of Min-Sheng Health System for 12 years.  She has constantly take care the patient and family in an exceptional manner and performed beyond her job responsibilities.  She has consistently gone out of her to helping others.  She deserves the DAISY award because she met the MS health care core values of trust, professionalism, innovation, excellence, and sharing.  Her performance inspired other nurses, and reminded other nurses the reason for choosing nursing as a profession, which is to be the guardian to the patient and family.