护患情境会话

拇指再植术前病人的护理

Preoperative Nursing for a

Thumb Re-plantation Patient

交流

病人：（点了点头）想到明天真要做手术，我真的好害怕、好紧张又担忧，所以我不想做了。

护士长：我非常理解你此刻的心情，只是我们现在要做的是消除这些心理影响而不是逃避手术。这样你才能争取早日出院。

病人：可是，我还是不想做手术。

护士长：手术是肯定要做的。你可能还不知道人的拇指的重要性吧？让我来对你说说。

病人：哦。

护士长：人的五个手指中，拇指的功能约占全手功能的一半以上，缺失了将严重影响手的抓、捏、握功能。你还年轻，以后的工作、学习、生活都离不开手，何况，这还是你的右手呢？

病人：（若有所思地点了点头，表情有所舒展）那手术后少了一个脚趾头会不会影响走路呢？

护士长：这你不用担心，因为走路的着力点是在足底部，没有第2足趾对行走是影响不大的。你还有什么担心吗？

病人：我还担心手术会不会失败？手术后手指外形怎么样？功能又怎样？

护士长：你别焦急。这类手术的成功率在我院是99%以上，而且手术是主任亲自为你做你可放心。至于外形和功能，你起床，我带你到其他病房去看看那些就要出院人的手指，相信你更会放心了。

病人：（一脸惊喜）真的吗？

护士长：当然。

（一路上，护士长边走仍边和小陈谈心，20min后返回病房。）

护士长：小陈，现在还需要什么帮助吗？

病人：（害羞地）不需要了，真谢谢你的帮助。

护士长：没关系，这是我应该做的。现在你心情怎样？Interactions

Patient：（nodding）I am so scared and worried about tomorrow’s operation.I don’t feel like doing it.

Head Nurse：I understand.What we should do now is to eliminate these psychological influences，not to avoid the surgery，so you can go home as soon as possible.

Patient：But，I still don’t want to have this operation.

Head Nurse：You must have the operation.Let me tell you the importance of your thumb.

Patient：Oh.

Head Nurse：The thumb carries 50%of the functions of your hand.Without your thumb you can not grasp，pinch，and hold.You are still a young girl.You can not work，and study well and live a happy life without your thumb.This is especially true since you are a right hand dominant person.

Patient：（thinking，nodding，and relaxing a little bit）Will missing one toe affect walking after the operation？

Head Nurse：Don’t worry.Walking relies mainly on the thenar and the heel.It should not have much effect to your walk without the second toe.Do you still have any worries？

Patient：I am afraid my operation will fail and I can not image the shape and the function of the constructed“thumb”.

Head Nurse：Take it easy.The success rate of this operation is more than 99%in our hospital and the chief surgeon will perform the operation for you.As to the shape and function of the reconstructed thumb，I can show you the other patients who have received this operation and will be discharged soon.

Patient：（gladly）Really？

Head Nurse：Of course.

（The head nurse talked with Miss Chen while walking.After 20minutes，they came back to the ward.）

Head Nurse：Can I do anything else for you？

Patient：（shyly）Noting else.Thank you so much for your help.

Head Nurse：You are welcome.This is my duty.How do you feel now？