Nurse： Hi，Mr. Zhang，I am your nurse. You are going to receive the operation soon，so I would like to talk to you about the preparation for the surgery，OK?

护士： 张先生，我是你的床位护士。你马上就要手术了，现在我想与你谈谈，行吗。

（Mr. Zhang stared at Nurse Wang for a few seconds but said nothing.）

（张先生抬头望了一下护士小王，未吭声。）

Nurse： Mr. Zhang，you already have a colostomy on your abdomen. You are going to have a radical cystectomy. The ureter will be connected to the pouch of your colostomy. If you do not mind，I would like to check your colostomy，and clean it for the upcoming operation.

护士： 张先生，你腹部已有一个结肠造口，接下来要做的手术是根治性膀胱全切术，要把输尿管接在结肠造口袋内。如果你愿意，我想检查一下你腹部的造口，好为手术做好清洁准备。

Patient： No.（Mr. Zhang shouted very loudly. The nurse was taken aback and his roommates as well as their relatives were also surprised. Nurse Wang felt embarrassed and rushed out of the ward.）

病人： 不。（张先生大喝一声，吓了护士一跳，也使同病室的几位病人与家属惊呆了。护士小王感到很委屈，跑出了病房。）

（Nurse Wang ran into the nurses’station where she met the specialized nursing team leader，Teacher Li，who was writing the report for next shift.）（小王跑进护士办公室。遇到正写交班报告的专业组长李老师。）

Nurse：（sobbed）The patient in bed 3 is really a strange guy. I offered the preoperative instructions to him patiently，but he yelled at me in return. I can’t stand this guy.

护士：（充满委屈地哽咽道）3号床病人真怪，我好好地与他讲关于手术的事，结果他却冲我大喊大叫，真受不了。

Teacher Li： Xiao Wang，have you thought about from the point of the patient? He had double blow of losing anus and bladder with only one year. What does this mean to a young man of 23?

李老师： 小王，你有没有设身处地地站在病人的位置替他想想。仅仅一年的时间，他面临了失去肛门又将失去膀胱的双重打击，这对一个23岁的小伙子来说意味着什么?

Nurse： I know he is depressed and unhappy，but I was trying to help him. I was advising him about the operation and I was following the health education protocol of the“Nursing Care Plan”.

护士： 我知道他很沮丧，也很难过，可是我是在帮他呀。我是完全按《护理计划》中制定的健康教育方案去向他讲解有关手术的情况的。

Teacher Li： Well，you were doing your job which is fne. However，don’t you think your timing was a little off? The patient was in a physical，psychological，and sociological confusion state. Mentally he was not ready for the radical cystectomy，yet you are doing preoperation nursing on him. That’s why he was mad at you.

李老师： 是的，你是在按照计划执行没错。可你想过没有，你选择的时机不对，此时的病人正处在躯体、心理、社会诸多问题的紊乱之中。他还没有做好切除膀胱的心理准备，你已经在为他做术前准备了，叫他如何不迁怒于你呢?

Nurse： Oh，I see. Mr. Zhang is self-contempt now and I should deal with his self-pity of losing an organ，and disturbed self-image frst. I picked the wrong time to give him the health instructions.

护士： 哦，我明白了。这时的张先生很自卑，躯体器官的丧失和自我形象紊乱是我应首先解决的问题。看来，我是没把握好健康教育的时机。

（Teacher Li invited Mr. Zhang to have a face to face talk in the nurse’s station. Nurse Wang sat beside them.）

（在护士办公室，李老师约来了病人张先生面谈，一旁坐着小王。）

Nurse： I’m sorry，Mr. Zhang，I was too brusque. Could you tell me what you are worried about the most right now? My teacher and I are willing to help you.

护士： 对不起，张先生，刚才我太唐突了，能告诉我，现在你最担心的问题吗？李老师和我都非常希望能帮助你。

Patient：（lowered his head and spoke softly）I am fnished，absolutely useless. What’s the meaning to still be alive?

病人：（低下头去轻声说）我这辈子算是完了，废人一个，活着还有什么意思？

Teacher Li： Mr. Wang，we all will encounter many diffculties in our life. You have to conquer yourself before you can conquer those difficulties，and the key to conquering yourself is to accept the reality. I am very proud of you，a real man，taking all these hardships without letting your parents feel unhappy. However，the capability of one man is limited. We are willing to help you to conquer this hardship.（Mr. Zhang raised his head gradually and listened carefully...）

李老师： 张先生，每个人的一生都会遇到很多困难，要战胜困难首先得战胜自己，而战胜自己的关键是接受现实。我很佩服你，像个男子汉，为了不让父母伤心，一切都自己扛着。但个人的力量是有限的，我们想帮你一起跨过眼前的这道坎。（张先生渐渐抬起头，认真聆听着……）

Nurse： That’s right. The medical science is progressing very fast. Surgical techniques as well as care equipments are getting much better. The watertight bag for the colostomy is not only able to prevent back flow but can also improve the physiological function. The appearance of the bag is also approaching perfection.It can make you live like a normal man.（Mr. Zhang’s eyes were focused on Nurse Wang full of hope. Nurse Wang smiled as she took out the Colostomy Manual，pen and paper，and began to draw something to show Mr. Zhang.）

护士： 是啊，现在医学科学发展很快，手术方法、护理工具也日趋完善，造口贴袋不但能防倒流，而且也能完善生理功能，在外观上也能力求完美，可以让你像正常人一样地生活。（病人张先生紧盯着王护士，双眼闪现了希望。王护士会意地笑了，从口袋里拿出造口手册和纸笔，给张先生画了起来……）