道德經譯文14

(經) 繽紛的色彩令人眼花撩亂, 紛雜的音調令人聽覺不敏, 飲食饜飫令人舌不知味, 縱情狩獵令人心放蕩, 難得的財貨令人行為不軌。因此, 聖人只求安飽而不逐聲色之娛, 所以摒棄外物的誘惑而保持安足的生活。
(傳) 百年的樹木, 破開來做成犧樽, 用青、黃的顏料來紋飾, 砍斷不用的部分被拋在溝中。犧樽與棄於溝中的斷木相比, 有美醜之別, 然而喪失本性卻是一樣的。夏桀、盜跖和曾參、史魚, 行為的善、惡有所不同, 然而都一樣喪失本性。喪失本性有五種: 一是五色擾亂眼目, 使得眼睛不明; 二是五聲擾亂耳朵, 使得耳朵不聰; 三是五臭熏鼻, 使鼻腔受很強的刺激; 四是五味敗壞口舌, 使得味覺喪失; 五是好惡取捨擾亂心智, 使得性情浮躁。這五種事物, 都是生命的禍害。而楊朱、墨翟想出人頭地而以為有所得, 這並不是我所說的自得。有所得反而受困擾, 能算是自得嗎? (如果算是自得的話,) 那麼斑鳩在籠子裡, 也算是自得了。況且好惡聲色充塞於心中, 冠冕朝服束縛於體外, 內心塞滿了欄柵, 體外束縛著重重繩索, 眼看在繩索的捆縛之中還自以為得意, 那麼罪人被反縛雙手, 虎豹被囚在獸籠裡, 也都算是自得了。

道德經譯文13

(經) 通曉四方, 能不用心智嗎?
(傳) 子貢南遊於楚國, 返回晉國, 經過漢陰的時候, 看到一個老者在菜園子裡, 挖地道至井中, 抱著甕取水澆灌, 費力很多而收效少。子貢說: "有這樣一種機械, 一天能灌溉百畝田, 費力少而收效多, 先生不想用嗎?"
        澆園人仰頭看著他說: "怎麼樣?" 子貢說: "鑿木頭為機械, 後頭重前頭輕, 提水就像抽引, 快速如同沸湯湧溢, 它的名稱叫槔。" 澆園人面現怒色而嘲笑說: "我聽我的老師說過, 有機械必定有機事, 有機事必定有機心。機心存於胸中, 那麼純潔空明就不能完備; 純潔空明不完備, 那麼心神就不會安定; 心神不安定的人就不能載道。我不是不知道 (你說的機械), 以用之為羞而不用罷了。"
        子貢滿面羞愧, 低頭不答話。
        過了一會兒, 澆園人說: "你是做什麼的呀?"
        子貢說: "我是孔丘的徒弟。"
        澆園人說: "你不就是以博學比擬聖人, 以矜誇超群出眾, 以自吟自誦換取名聲於天下的人嗎? 你要是忘掉你的形氣, 不執著於你的形骸, 還有可能接近道吧! 你自身都不能修持好, 又怎麼能治理天下呢? 你走吧, 不要耽誤我的事!"
        子貢慚愧失色, 悶悶不樂, 走了三十里路之後才恢復原來的氣色。
        子貢的弟子說: "剛才那個人是誰呀? 先生為什麼見了他之後變容失色, 整天都沒有恢復過來呢?"
        子貢說: "起初我以為我的老師孔子是天下獨一人, 不知道還有這樣的人存在。我聽老師說, 事情求可行, 功業求成就, 用力少而收效顯著的, 就是聖人之道。現在知道不是這樣。執守大道的人德性完備, 德性完備的人形軀健全, 形軀健全的人精神完備。精神完備, 是聖人之道。託生人世悠遊自在而不知所往, 淳和真樸, 這樣人的心裡肯定沒有功利機巧。像這樣的人, 不是他志向的不會去求, 不是他心所願的不會去做。縱然天下人都讚譽他, 只要合於他的心意, 便傲然不顧; 縱使天下人都非議他, 只要不合他的心意, 便漠然不受。天下人的非議和讚譽, 對他沒有什麼損益, 這就是全德的人啊! 我卻是為世俗左右而搖擺不定的人。"
        子貢回到魯國之後, 將這件事告訴了孔子。孔子說: "他是借渾沌氏的道術以修身的人, 執守內心的純一, 心神不外分; 修養內心, 而不管外在的行為。像這樣明澈純素, 自然歸於真樸, 體性抱神而遨遊於世俗之間的人, 你當然會感到驚異。而且渾沌氏的道術, 我與你又怎麼能夠認識啊!"

道德經譯文12

(經) 執持盈滿, 不如適時停止。顯露鋒芒, 銳勢不能保持長久。金玉滿堂, 無法守藏。富貴而驕, 自取禍患。功業完成, 含藏收歛, 合於自然的道理。
(傳) 吳王泛舟於長江, 登上獮猴山。眾獮猴見到他, 都驚慌地跑開, 逃到荊棘叢中藏起來。有一隻獮猴, 卻在樹枝上來回跳躍, 向吳王顯示它的靈巧。吳王射它, 它敏捷地接住箭。吳王命令左右上前來射, 獮猴逐被射死。吳王對他的朋友顏不疑說: "這隻獮猴, 誇耀它的靈巧, 自恃它的敏捷而傲視我, 以至於喪命。要引以為戒呀! 唉, 不要以意態驕人啊!" 顏不疑回去之後便拜董梧為師, 去除他的驕態。顏不疑捨棄淫樂辭去顯榮, 三年之後吳國的人都稱頌他。

道德經譯文11

(經) 居處善於選擇地方, 心靈善於保持沉靜, 待人善於兼愛無私, 說話善於遵守信用, 為政善於精簡處理, 處事善於發揮所長, 行動善於把握時機。只因為有不爭的美德, 所以沒有怨咎。
(傳) 從前堯舜因禪讓而成為帝王, 燕王噌和燕相子之卻因禪讓而滅亡; 商湯和周武因爭奪而成為帝王, 楚國白公勝因爭奪而滅亡。由此看來, 爭奪和禪讓的體制, 堯和桀的行為, 哪一種可貴、哪一種可賤是有時間性的, 不可以視為恆常不變的道理。棟樑之木可以用來衝擊城池, 但不能用來塞小洞, 這是說器用的不同; 騏驥驊騮等好馬, 一天能跑一千里, 但捕鼠還不如貓和黃鼠狼, 這是說技能有所不同; 貓頭鷹夜裡能抓跳蚤, 明察秋毫, 但白天瞪大了眼睛也看不見丘山, 這是說本性的不同。常常有人說, 為什麼不取法對的而拋棄錯的, 不取法治理得好的而捨棄變亂的呢? 這是沒有明白天地的理數和萬物的實情的說法。這就好比只取法天而不取法地, 只取法陰而不取法陽, 很明顯是行不通的。然而人們還是不停地講這種話, 那不是愚蠢就是故意瞎說。帝王的禪讓彼此不同, 三代的承繼各有差別。不符合時代, 違逆世俗的, 就被稱為篡奪者; 符合時代, 順應世俗的, 就被稱為高義之人。

道德經譯文10

(經) 上善之人如水一樣。水善於滋養萬物而不與萬物相爭, 停留在人們所厭惡的地方, 所以接近於 "道"。
(傳) 有個跛足、駝背、無唇的人去遊說衛靈公, 衛靈公很喜歡他; 而看到形體完整無缺的人, 反倒覺得他們的脖子太細小了。有個脖子上長了盆大的腫瘤的人去遊說齊桓公, 齊桓公很喜歡他; 看到形體完整無缺的人, 反而覺得他們的脖子太細小了。
        所以, 德性有過人之處, 形驅上的殘缺就會被人遺忘。人們如果不忘記所應當遺忘的 (身驅), 而忘記不應當遺忘的 (德性), 才是真正的遺忘。
        所以, 聖人悠遊自適, 而智巧是災孽, 約束是膠漆, 施小惠於人是交接的手段, 工巧是商賈的行徑。聖人不謀慮, 哪裡還用智巧? 順應自然哪裡還用膠漆? 渾然無缺, 哪裡還用德行? 不求利, 哪裡還用算計? 這四者就是 "天鬻", "天鬻" 就是受自然的養育。受自然的養育又哪裡還用人為! 有人的形貌, 而沒有人的情感。有人的形貌, 所以與人同群而處; 沒有人的情感, 所以一般人的是非影響不了他。渺小啊, 那與人同類的形貌! 偉大啊, 能與自然同體!

Body mechanics

Establishing body alignment
Establish a firm base of support by placing both feet flat on the floor, with one foot slightly in front of the other
Distribute weight evenly on both feet
Slightly bend both knees
Hold abdomen firm and tuck buttocks in so that spine is in alignment
Hold head erect, and secure firm stance
Use this stance as the basis for all actions in moving, turning and lifting clients
Maintain weight to be lifted as close to your body as possible
Align the three natural curves in your back, i.e. cervical, thoracic and lumbar
Prevent twisting your body when moving the client

Maintain proper body alignment
Begin with the proper stance outlined as above
Evaluate working height necessary to achieve objective
a) Test parameters of possible heights (i.e. bed moves within an appropriate range of 18 inches from floor)?
b) Establish a comfortable height in which to work; usual height is between waist and lower level of hip joint
Test that this level minimizes muscle strain by extending your arms and checking that your body maintains proper alignment
If you need to work at a lower level, flex your knees
Make accommodations for working at high surface level (?)
Work close to your body so that your centre of gravity is not misaligned and your muscles are not hyper-extended
Use your longest and strongest muscles (biceps, quadriceps, and gluteal) when moving and turning clients
Whenever possible, roll, push, and pull objects instead of lifting
Plan muscle movements to distribute workload before you actually begin turning, moving, or lifting clients
Move muscles in a smooth, coordinated manner
When working with another staff member, coordinate plans and movements before implementing them

Transferring a patient from bed to stretcher

Planning
Collect the necessary equipment:
- draw sheet or transfer board (patslide)
- stretcher
- blanket (optional)

Implementation (three persons)
Perform hand hygiene
Identify the patient and explain the procedure
Move the bed and equipment to make room for the stretcher. Make sure assistants are available
Lower the head of bed completely or to a position that is as low as the patient can tolerate
Raise the bed to a comfortable working height and slightly higher than the level of stretcher to make it easier to move the patient. Lower the side rails
Place a draw sheet under patient if one is not in use. Use the draw sheet to move patient to the side of bed where the stretcher will be placed
Roll the draw sheet as close to patient's side as possible
Position the stretcher next to the bed and parallel to it. Lock brakes on the bed and stretcher. Remove pillow from the bed and place it on the stretcher

Transfer by using draw sheet:
a) The 1st staff should kneel on the side of bed away from the stretcher. Position one knee at the upper torso (trunk) closer to the patient than the other knee. Grasp the draw sheet securely
b) The 2nd staff should stand on the side where the stretcher is and reach across stretcher to grasp the draw sheet at the head and chest areas of the patient
c) The 3rd staff (stands on the same side as 2nd staff) should reach across the stretcher and grasp the draw sheet at the patient's waist and thigh area
d) At a signal given by the 1st staff, the 2nd and 3rd staff pull and press the body against the stretcher while the 1st nurse lifts the patient from the bed to the stretcher

Transfer by using a transfer board (patslide)
a) The 1st staff stands on the side of bed away from the stretcher, while the 2nd and 3rd staff stand on the far side of bed next to stretcher after assisting the 1st staff to turn patient onto his side with the back facing the stretcher
b) The 1st staff continues to support patient in the lateral position
c) The 2nd and 3rd staff position the transfer board lengthwise and midway between the bed and stretcher (with smooth side of board facing upward)
d) Return patient to his back with a draw sheet between patient and the board. Place patient's arms across his chest
e) On the count of three, grasp the sheet as close to patient as possible and slide across the transfer board onto the stretcher with one firm and coordinated movement
f) Roll patient slightly over one side, and pull transfer board out from under his back, if necessary

Center patient on stretcher and secure him until side rails are raised
Assist patient to a comfortable position. Place blanket over patient and adjust head of stretcher accordingly to patient's limitations
Leave draw sheet in place for transfer back to bed later
Perform hand hygiene

bandage

內到外 (anatomical position?)

upper limb 2 inches

lower limb 3 inches

trunk 6 inches

(depends on pt. body size)

簡單螺旋形紮法

- 前臂, 上臂, 大腿, 小腿出血的紮法

人字形紮法

- 肘部 (elbow), 膝部, 足跟出血紥法

"8"字形紮法

- 手部出血紮法

- 足部出血或足踝 (knee) 扭傷紮法 (足跟不包)

Ebola

Ebola (伊波拉病毒) is a viral genus. It causes the disease Ebola hemorrhagic fever. The virus interferes with the endothelial cells lining the interior surface of blood vessels and with coagulation.

Transferring a patient from bed to chair/wheelchair

Planning
Collect the necessary equipment:
- wheelchair or chair with arm support
- non-skid slippers or shoes
Remove obstacles from the area used for the transfer
Obtain sufficient assistance to complete the procedure with ease

Implementation (two persons)
Perform hand hygiene
Identify patient and explain the procedure
Offer bedpan/urinal or provide perineal care before transferring, if necessary
Move furniture as required to make room for the procedure
Bring the chair close to the side of the bed
Place it at a 45 degree angle to the bed if patient experienced difficulty in walking or place the wheelchair parallel to the bed if the patient is able to walk a few steps. If the patient has a weaker side, place the chair on the patient's stronger side. Lift up the foot pedals and lock brakes for wheelchair
Place the bed to the lowest position, and raise head of bed as far as patient can tolerate. Lower side rails
Assist patient to side-lying position, facing the side of bed he will sit on
Two staff stand on the same side as the chair. The first staff stands near the head of the bed place arm around patient's shoulders ( to support head and neck) and place the other hand on the bed surface to provide support and balance. The staff shift weight to back leg and lifts patient
The second staff stands near the foot of the bed swinging patient's lower legs off the bed in one single and coordinated motion. Keep back straight, avoid twisting
Support patient in a sitting position at the side of the bed with his legs dangling for a few minutes, and assess for signs and symptoms of orthostatic hypotension (do not leave patient unattended during dangling)
Help patient to put on robe and non-slip footwear as necessary
Assist patient to move as close to the edge of bed as possible until feet are firmly on the floor and slightly apart
Two staff stand on each side of the patient, with the hand closest to the patient places just below but not directly under the axilla. Using a wide stance, flex knees and assist the patient to a standing position
Standing close to the patient. Pivot or take a few steps until the patient's back is toward the chair/wheelchair
Instruct patient place hands on the arm supports of chair to gain balance and judge the distance to seat
Flex hips and knees while lowering patient into a sitting position
Assist patient to maintain proper body alignment. Support weak side of the body with pillows in order to prevent slumping (sudden fall) in the chair/wheelchair if needed
Make sure tubes and lines, arms and hands are not pinched or caught between the patient and the chair
Cover patient and supply a seat belt if needed
Place the foot pedals back to the wheelchair or offer footrest (chair) as necessary
Position call bell for easy reach
Perform hand hygiene

Positioning a patient in bed

Assessment
Assess patient's body alignment and comfort level in current position
Check patient's record and physician's order. Determine if any condition that influence patient's physical ability to move or to be positioned (e.g. muscle strength, fractures and presence of paralysis)
Note the presence of tubes, IV lines, incisions or equipment that may interfere with the positioning procedure
Assess patient's level of consciousness and ability to understand instructions in positioning
Assess patient's weight and your strength. Determine if additional assistance is needed

Planning
Collect the necessary equipment: pillows for positioning; draw or lifting sheet
Obtain sufficient assistance to complete the procedure with ease

Implementation (2 persons)
Perform hand hygiene
Identify patient and explain the procedure
Adjust the head of bed to flat position or as low as the patient can tolerate
Elevate the bed to a comfortable working height
Remove pillow and place it at the head of bed to prevent striking patient's head during lifting
Coordinate the movement between two staff. One staff is responsible for stating when to move patient, "on count of three"

For partially dependent patients:
a) Position one staff on each side of the patient
b) Each staff place one arm under the patient's shoulders and one arm under the patient's thighs. This supports the heaviest part of the body
c) Assume broad base of support; position front foot facing head of bed, body slightly turned toward head of bed
d) Ask patient to flex knees with feet flat on bed
e) Instruct patient to flex neck, tilting chin toward chest
f) Instruct patient to assist moving by pushing with feet on bed surface
g) Staff flex knees and hips, bringing forearms closer to the level of bed
h) Instruct patient to push with heels and elevate trunk while breathing out, thus moving toward head of bed on count of three

For totally dependent clients:
a) Position one staff on each side of bed
b) Place lifting sheet under patient's body extending from shoulder to the thighs
c) Position patient in a supine position
d) Roll up sides of lifting sheet as close as possible to the sides of patient
e) Assist patient to flex knees and fold arms across the chest, if not contraindicated
f) Each staff firmly grasp sheet at level of patient's upper back with one hand and at level of buttocks with the other hand, placing weight on back foot
g) Place feet apart with forward-backward stand. Flex knees and hips

Shift weight back and forth from the back leg to front leg, and on count of three, lifts patient toward head of the bed with a firm, coordinated and rocking movement
Repeat if necessary
Ensure patient is in correct body alignment, replace pillows and arrange bedding as necessary
Position drains, tubes and IV to accommodate a new position in order to prevent accidental dislodgement and discomfort from movement
Maintain patient safety. Raise the side rails and resume the bed to lowest position. Place cell bell within patient's reach
Perform hand hygiene

Position patient in side-lying position
Perform hand hygiene
Identify patient and note any mobility restrictions
Lower head of bed as flat as patient can tolerate if not contraindicated
Elevate the bed to a comfortable working height
Position one staff on each side of the bed and lowers the side rails
Using draw sheet. Roll up the sheet as close as possible to the patient's body and grasp firmly. Staff pull the patient with draw sheet to the opposite side of the bed that he will be turned
On the side that patient will be turned, abduct patient's arm slightly away from his body. On the other side, position patient's arm across the chest and flex the knee before turning
Place one hand on the patient's hip and the other hand on the shoulder
Staff assumes a broad stance with knees slightly flexed. Gently roll patient over onto the desired side by using the draw sheet
Observe patient's skin condition after turning
Maintain patient's body alignment
Place pillows under head and behind back to provide additional support to the spine
Bring shoulder blade forward and out from under patient (?)
Position both arms in slightly flexed position. Support patient's upper arm with pillow level with shoulder, if necessary
Place pillow lengthwise between patient's legs from thighs to foot. Shoulder and hips should be aligned
Raise the side rails and adjust the bed position as necessary. Place call bell within patient's reach
Perform hand hygiene

Evaluation
Patient's tolerance and response of procedure
The skin condition of patient
Patient's position in alignment and comfortable
Level of assistance received from patient