目的 探讨ICU护士在应对心脏及大血管术后谵妄患者伤害行为过程中的真实心理体验，为制订针对性心理支持及职业安全防护策略提供实证依据。 方法 采用描述性现象学研究设计，于2025年1月—2月运用目的抽样法，选取浙江省某三级甲等医院ICU内17名直接遭受谵妄患者伤害行为的护士为研究对象。通过半结构化深度访谈收集资料，采用Colaizzi 7步分析法进行编码、归纳并提炼主题。 结果 共提炼出4个核心主题及8个亚主题：应激反应中本能防御与职业角色的冲突（威胁情境下的本能防护反应与警觉、职业责任感驱动下的行为克制）、创伤事件所致的心理状态与职业信念震荡（创伤记忆引发的持续心理异常、职业价值认同的弱化与怀疑）、创伤修复过程中的安全重建诉求（安全保障措施的迫切需求、职场情感理解与回应的强烈渴求）、多维支持系统的整合性需求（家庭情感关怀的精神依托需求、 组织系统性援助的专业支撑需求）。 结论 管理者应针对护士应对谵妄患者伤害行为时的多重困境，建立分阶段干预机制：平衡应激中的本能防御与职业克制，缓解创伤引发的心理异常并重塑职业认同，强化安全保障与情感回应以支持创伤修复，整合家庭与组织支持形成合力，从而阻断创伤累积，保障护士身心健康与职业稳定。

Objective To explore the real psychological experience of ICU nurses in coping with the injurious behaviors of patients with delirium after cardiac and major vascular surgery，and to provide empirical evidence for the development of targeted psychological support and occupational safety protection strategies. Methods Using a descriptive phenomenological research design and purposive sampling，17 nurses in the ICU of a tertiary hospital in Zhejiang Province who had directly suffered from injurious behaviors of patients with delirium were selected as study subjects from January to February 2025. Data were collected through semi-structured in-depth interviews，and the Colaizzi 7-step analysis method was used to code，summarize，and refine themes. Results Four core themes and eight sub-themes were distilled. Four themes included the conflict between instinctive defense mechanisms and professional roles in stress responses（instinctive protective reactions and vigilance in threatening situations，behavioral restraint driven by professional responsibility），psychological states and professional belief crises caused by traumatic events（persistent psychological abnormalities triggered by traumatic memories，weakened and questioned professional value recognition），the demand for safety reconstruction during trauma recovery（the urgent need for security measures，the intense craving for workplace emotional understanding and response），and the integrated demand for a multi-dimensional support system（spiritual reliance on family emotional care，professional support from organizational systemic assistance）. Conclusion Managers should establish a phased intervention mechanism to address the multiple challenges nurses face when dealing with harmful behaviors of delirious patients：balancing instinctive defense mechanisms and professional restraint under stress，alleviating trauma-induced psychological abnormalities and reshaping professional identity，strengthening safety guarantees and emotional responses to support trauma recovery，and integrating family and organizational support to form a collective effort，thereby preventing the accumulation of trauma and ensuring the mental and physical health and professional stability of nurses.