— 照護管理 · HARD · MCQ —
一位病人有 DNR 醫囑，家屬情緒激動並不同意此決定，護理師的優先行動為何？
A nurse is caring for a client with a DNR order. The family is upset and disagrees with the DNR status. What is the nurse's priority action?
- ACall the hospital chaplain to handle the family呼叫醫院教牧人員處理家屬事宜
- BTell the family that the DNR order is final and cannot be changed告知家屬 DNR 醫囑已確定且無法更改
- CListen to the family's concerns and explain the DNR legal standing✓ 正解傾聽家屬的擔憂並解釋 DNR 的法律地位
- DInitiate an emergency code because the family is distressed因家屬情緒激動而啟動緊急代碼
— Explanation · 中文詳解 —
面對對 DNR 醫囑有疑義的家屬，護理師應展現同理心，傾聽其不安與困惑，並以專業態度解釋 DNR 的法律程序與病人原意。直接強硬拒絕溝通會導致醫病關係破裂。若爭議持續，應通知醫師介入，或引入社會工作者、倫理委員會協助處理。
When the family disputes a DNR order, the nurse should respond with empathy, listen to their concerns and confusion, and professionally explain the legal basis of the DNR and the client's wishes. Refusing to communicate or taking a rigid stance damages the therapeutic relationship. If the dispute persists, the nurse should notify the physician for intervention or involve social workers or the ethics committee for further assistance.
✦ 台美臨床差異
美國護理師常受過倫理溝通培訓；台灣護理師則常因家屬壓力大，選擇由醫師介入溝通，護理師較少承擔溝通說明責任。