# 一位反覆照護瀕死加護病房病人的護理師表示感到被系統背叛、情緒耗竭和疏離感。哪些措施有助於辨識和處理道德傷害？請選出所有適用的選項。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=zh-tw  
> language: zh-TW  
> subject: Basic Care and Comfort  
> category: BCC

## 題目

一位反覆照護瀕死加護病房病人的護理師表示感到被系統背叛、情緒耗竭和疏離感。哪些措施有助於辨識和處理道德傷害？請選出所有適用的選項。

1

在組織變革下促進個人韌性實踐

2

鼓勵參加重大事件後之結構化debrief

3

認識moral injury與burnout為系統性問題而非個人失敗

4

轉介EAP並提供同儕支持資源

5

建議護理師更堅強且不要將情緒帶入工作

## 解析

道德傷害發生於醫療工作者經歷系統性違背其道德信念時（例如，無法提供他們知道病人需要的照護）。它與職業倦怠有重疊但不同。有效的應對方式結合個人支持（員工協助方案、同儕支持、結構性匯報、復原力練習）和系統性變革（人力配置、領導、倫理氛圍）。叫人堅強一點是無效的、有害的，且忽視了根本原因。認知到這是系統性而非個人的失敗，是基本前提。

## 深入解析

Schwartz Rounds、Code Lavender、同儕支持計畫、倫理諮詢服務有實證可降低道德傷害。

## 臨床情境

畢業18個月之新進護理師。近期多次目睹失敗之急救。

## 重要概念

- **道德傷害** — 從從事、目睹或未能阻止違反道德信念之行為所生痛苦。
- **Burnout** — Maslach症候群:情緒耗竭、去人格化、成就感降低。
- **Schwartz Rounds** — 員工討論病人照護社會與情緒層面之結構化論壇。

## 相同主題題目

- [A patient with cirrhosis and grade 2 hepatic encephalopathy has been started on lactulose.…](https://mymerci.kr/pages/nclex_q.php?qn_id=372852&lang=zh-tw)
- [A 78-year-old with end-stage pancreatic cancer is admitted to the medical ward. After revi…](https://mymerci.kr/pages/nclex_q.php?qn_id=372916&lang=zh-tw)
- [A patient is in the active dying phase from end-stage heart failure. Family members are at…](https://mymerci.kr/pages/nclex_q.php?qn_id=373259&lang=zh-tw)
- [A nurse is caring for an immobile, malnourished older adult at high risk for pressure inju…](https://mymerci.kr/pages/nclex_q.php?qn_id=373515&lang=zh-tw)
- [A patient is post-op day 0 from a transurethral resection of the prostate (TURP) with a th…](https://mymerci.kr/pages/nclex_q.php?qn_id=374201&lang=zh-tw)
- [A 6-year-old is admitted with newly diagnosed nephrotic syndrome: proteinuria 4+, serum al…](https://mymerci.kr/pages/nclex_q.php?qn_id=374922&lang=zh-tw)
- [A nurse is caring for a postpartum patient who has saturated 2 perineal pads in 30 minutes…](https://mymerci.kr/pages/nclex_q.php?qn_id=374930&lang=zh-tw)
- [A nurse is implementing trauma-informed care for a client with a history of intimate partn…](https://mymerci.kr/pages/nclex_q.php?qn_id=374978&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375097&lang=vi)

---

More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw)

_僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_