{"id":1591,"date":"2021-01-04T15:15:59","date_gmt":"2021-01-04T12:15:59","guid":{"rendered":"http:\/\/acilbulten.net\/?p=1591"},"modified":"2021-11-16T03:11:42","modified_gmt":"2021-11-16T00:11:42","slug":"calisma-ortamimiz-bizi-ne-kadar-etkiliyor","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2021\/01\/04\/calisma-ortamimiz-bizi-ne-kadar-etkiliyor\/","title":{"rendered":"\u00c7al\u0131\u015fma Ortam\u0131m\u0131z Bizi Ne Kadar Etkiliyor?"},"content":{"rendered":"\n

Yazar: Ayhan \u00d6zhasenekler<\/em><\/strong><\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Erciyes \u00dcniversitesi\u2019nde T\u0131p Fak\u00fcltesini, Dicle \u00dcniversitesi\u2019nde Acil T\u0131p Uzmanl\u0131\u011f\u0131n\u0131 bitirdi. Diyarbak\u0131r Devlet Hastanesinde mecburi hizmet sonras\u0131, evi \u2013 ailesi olarak g\u00f6rd\u00fc\u011f\u00fc Dicle Acil T\u0131p Ailesinde \u00d6\u011fretim \u00dcyeli\u011fine ba\u015flad\u0131. Halen Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t \u00dcniversitesi T\u0131p Fak\u00fcltesi Acil T\u0131p AD \u00d6\u011fretim \u00dcyesi, Dekan Yard\u0131mc\u0131s\u0131, Ankara \u015eehir Hastanesi Acil T\u0131p Klini\u011fi E\u011fitim G\u00f6revlisi, TATD YK \u00fcyesidir. EKG\u2019yi gece g\u00fcnd\u00fcz anlatacak kadar sever. Sim\u00fclasyon merakl\u0131s\u0131, T\u0131p E\u011fitiminin \u015fimdilik alayl\u0131s\u0131d\u0131r.<\/p>\n\n\n\n

Yazar: \u00c7a\u011fda\u015f Y\u0131ld\u0131r\u0131m<\/em><\/strong><\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

1986 y\u0131l\u0131nda Antalya\u2019da do\u011fdu. \u0130lk, orta ve lise \u00f6\u011frenimini Antalya\u2019da g\u00f6rd\u00fc. 2004-2010 y\u0131llar\u0131 aras\u0131nda Eski\u015fehir Osmangazi \u00dcniversitesi T\u0131p Fak\u00fcltesi\u2019nde \u00f6\u011frenimine devam etti. 2010-2011 y\u0131llar\u0131 aras\u0131nda Isparta \u015earkikaraa\u011fa\u00e7 Devlet Hastanesi Acil Servisinde mecburi hizmet g\u00f6revinde bulundu. 2012-2016 y\u0131llar\u0131 aras\u0131nda Ankara Atat\u00fcrk E\u011fitim ve Ara\u015ft\u0131rma Hastanesi Acil T\u0131p Klini\u011fi\u2019nde ihtisas\u0131n\u0131 yapt\u0131. 2016-2018 y\u0131llar\u0131 aras\u0131nda Acil T\u0131p Uzman\u0131 olarak Kahramanmara\u015f Elbistan Devlet Hastanesi Acil Servisinde \u00e7al\u0131\u015ft\u0131 ve Acil Servis Sorumlusu olarak g\u00f6rev yapt\u0131. A\u011fustos 2018 tarihinden itibaren Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t \u00dcniversitesi T\u0131p Fak\u00fcltesi Acil T\u0131p Ana Bilim Dal\u0131nda Dr. \u00d6\u011fr. \u00dcyesi olarak \u00e7al\u0131\u015fmaktad\u0131r. Evli ve 1 \u00e7ocuk babas\u0131d\u0131r.<\/p>\n\n\n\n

Acil Servisler s\u0131kl\u0131kla kaotik ve dinamik ortamlard\u0131r. Di\u011fer bran\u015flara g\u00f6re daha fazla olan i\u015f y\u00fck\u00fc, hasta yo\u011funlu\u011fu; \u00f6zellikle \u00fclkemiz, bu konuda n\u00fcfusundan daha fazla acil ba\u015fvurusu olmas\u0131 ile alan\u0131nda en tepedeki yerini korumaktad\u0131r. Bu yo\u011funlu\u011fun \u00fczerine bir de n\u00f6bete dayal\u0131 bir \u00e7al\u0131\u015fma tarz\u0131 ve \u00e7al\u0131\u015fma ortam\u0131ndan kaynaklanan zorluklar da eklenince acil t\u0131p hekiminin hayat\u0131n\u0131 daha da zorla\u015ft\u0131rmaktad\u0131r.<\/p>\n\n\n\n

Yap\u0131lan bir derlemede; acil t\u0131p hekimleri, d\u00fczenli olarak y\u00fcksek stres bildirmekte, buna kar\u015f\u0131l\u0131k kendilerini y\u00fcksek \u00f6zerkli\u011fe sahip, becerisi, tak\u0131m \u00e7al\u0131\u015fmas\u0131 ve ileti\u015fimi daha iyi \u00f6zellikli bir pop\u00fclasyon olarak tan\u0131mlamaktad\u0131rlar. Bununla birlikte acil serviste \u00e7al\u0131\u015fma deneyimi kazand\u0131k\u00e7a stres fakt\u00f6rleri ile ba\u015fa \u00e7\u0131kmak daha kolayla\u015fmaktad\u0131r. Ancak bu ba\u015fa \u00e7\u0131kma s\u00fcresi ki\u015fiden ki\u015fiye, \u00e7al\u0131\u015f\u0131lan ortama, stres fakt\u00f6rlerinin s\u00fcresi ve tekrarlanmas\u0131na g\u00f6re de \u00e7e\u015fitlilik g\u00f6stermektedir. N\u00f6bet \u00e7\u0131k\u0131\u015f\u0131 veya rutin yap\u0131lan geri bildirim toplant\u0131lar\u0131 da personelin stresini d\u00fc\u015f\u00fcrmektedir. Acil servis personelinin stres d\u00fczeyini azaltan bir di\u011fer ve \u00f6nemli fakt\u00f6r ise di\u011fer bran\u015flara g\u00f6re daha fazla ya\u015fad\u0131klar\u0131 mesleki tatmindir. Ba\u015far\u0131l\u0131 bir res\u00fcsitasyondan sonra veya i\u011fne dekompresyondan sonra hangimiz bir s\u00fcreli\u011fine o kaostan uzakla\u015f\u0131p \u00fctopik bir boyuta ge\u00e7miyoruz ki?<\/p>\n\n\n\n

Peki kendimizden ziyade bize etki eden \u00e7al\u0131\u015fma ortam\u0131m\u0131zdaki ufak dokunu\u015flar bizi nas\u0131l daha mutlu ve daha az t\u00fckenmi\u015f k\u0131labilir?<\/em><\/strong><\/em><\/strong><\/p>\n\n\n\n

G\u00fcvenlik<\/strong><\/p>\n\n\n\n

\u0130lk yard\u0131m uygulamalar\u0131nda da oldu\u011fu gibi her \u015feyin ba\u015f\u0131 g\u00fcvenlik. Bir\u00e7ok \u00e7al\u0131\u015fma, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na \u015fiddetin s\u0131kl\u0131kla ve bildirilenden daha fazla oldu\u011funu g\u00f6stermi\u015ftir. Acil Servisi g\u00fcvenli k\u0131lmak i\u00e7in nas\u0131l \u00f6nlemler al\u0131nabilir:<\/p>\n\n\n\n

  • Hasta ve ziyaret\u00e7iler i\u00e7in metal dedekt\u00f6r<\/li>
  • Acil Servise tahsisli g\u00fcvenlik g\u00f6revlisi<\/li>
  • Hasta bak\u0131m alanlar\u0131nda panik d\u00fc\u011fmeleri<\/li>
  • Sald\u0131rgan hastalarla ba\u015fa \u00e7\u0131kmak i\u00e7in personel e\u011fitimi<\/li>
  • Yat\u0131\u015ft\u0131rma ve kendini koruma teknikleri e\u011fitimleri gibi\u2026<\/li><\/ul>\n\n\n\n

    \u00c7al\u0131\u015fan \u00e7al\u0131\u015ft\u0131\u011f\u0131 ortamda kendini ne kadar g\u00fcvenli hissederse hem kendisine hem de hastalar\u0131na daha \u00e7ok katk\u0131s\u0131 olacakt\u0131r.<\/em><\/strong><\/em><\/strong><\/p>\n\n\n\n

    Dayan\u0131\u015fma<\/strong><\/p>\n\n\n\n

    B\u00fct\u00fcn personelin dayan\u0131\u015fma i\u00e7inde olmas\u0131 da \u00e7al\u0131\u015fma ortam\u0131n\u0131n huzuru i\u00e7in \u00f6nemlidir. Hekimler, hem\u015fireler ve yard\u0131mc\u0131 personelin aras\u0131nda iyi ileti\u015fim ve tak\u0131m \u00e7al\u0131\u015fmas\u0131 hem iyi hasta bak\u0131m\u0131 sa\u011flar hem de \u00e7ekilebilir mutlu bir n\u00f6bet ge\u00e7irilmesini sa\u011flar.<\/p>\n\n\n\n

    Son zamanlarda yap\u0131lan bir ara\u015ft\u0131rmada, i\u015fyeri dayan\u0131\u015fmas\u0131n\u0131n iki anahtar \u00f6zelli\u011finin samimiyet<\/strong> (birlikte \u00e7al\u0131\u015ft\u0131\u011f\u0131n\u0131z ki\u015fiyi tan\u0131mak ve bak\u0131\u015f a\u00e7\u0131lar\u0131n\u0131 anlamak) ve g\u00fcven <\/strong>(sa\u011flay\u0131c\u0131n\u0131n hastalar\u0131n akl\u0131nda en iyi menfaatlere sahip oldu\u011funu bilmek vb.) oldu\u011funu ortaya koymaktad\u0131r. Acil Servis d\u0131\u015f\u0131nda personelin birbirine kar\u015f\u0131 g\u00fcvenini ve samimiyetini kazand\u0131ran aktiviteler de (sim\u00fclasyon e\u011fitimi, ak\u0131lc\u0131 ileti\u015fim \u00fczerine grup e\u011fitimi vb.) i\u015fyeri dayan\u0131\u015fmas\u0131n\u0131 geli\u015ftirir. Ayr\u0131ca yap\u0131lacak sosyal etkinliklerin de faydas\u0131 olaca\u011f\u0131n\u0131 herkes bilir.<\/p>\n\n\n\n

    Ortam<\/strong><\/p>\n\n\n\n

    \u0130yi bir \u00e7al\u0131\u015fma ortam\u0131, sa\u011fl\u0131kl\u0131 ve verimli bir \u00e7al\u0131\u015fman\u0131n olmazsa olmaz\u0131d\u0131r. Ortam\u0131n g\u00fcn \u0131\u015f\u0131\u011f\u0131 almas\u0131, g\u00fcr\u00fclt\u00fc kirli\u011finin \u00f6nlenmesi, acil m\u00fcdahale i\u00e7in hasta bak\u0131m alan\u0131na yak\u0131n temiz ve rahat yemek yeme alanlar\u0131 olmas\u0131, hasta bak\u0131m\u0131n\u0131n tart\u0131\u015f\u0131lmas\u0131 ve planlanmas\u0131 i\u00e7in ergonomik alanlar\u0131n olmas\u0131 iyi bir \u00e7al\u0131\u015fma ortam\u0131n\u0131n \u00f6zellikleri aras\u0131ndad\u0131r.<\/p>\n\n\n\n\n\n\n\n

    Sistem<\/strong><\/p>\n\n\n\n

    Hastane y\u00f6netim sisteminin en kritik anda (kap\u0131n\u0131n \u00f6n\u00fcnde 50 hasta beklerken veya kritik bir travma hastas\u0131n\u0131n tomografilerine bakarken) \u00e7\u00f6kmesi veya bir hastaya tan\u0131 atmak i\u00e7in hasta hakk\u0131nda 10 tane bilginin sisteme girilmesi \u00e7o\u011fu acil hekiminin n\u00f6bet s\u0131ras\u0131nda v\u00fccudunda terler bo\u015falmas\u0131na neden olan anlardan birka\u00e7\u0131d\u0131r. Yap\u0131lan \u00e7al\u0131\u015fmalarda kullan\u0131c\u0131 dostu sistemlerin acil servis ak\u0131\u015f\u0131n\u0131 h\u0131zland\u0131rd\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Daha az s\u0131ra daha mutlu hekimler\u2026<\/p>\n\n\n\n

    Mola<\/strong><\/p>\n\n\n\n

    \u00d6\u011fle yeme\u011fimizi nefes almadan yiyerek veya en hayati ihtiya\u00e7 olan tuvaletimizi tutarak hasta bakmaya hemen her zaman devam etmiyor muyuz? Dur durak bilmeyen bu \u00e7al\u0131\u015fma temposu acil t\u0131p hekimini zay\u0131flatan en \u00f6nemli fakt\u00f6rlerden biridir.<\/em><\/strong> N\u00f6bet s\u0131ras\u0131nda olu\u015fturulan dinlenme s\u00fcrelerini b\u00fct\u00fcn acil servis personeli i\u00e7in fiziksel ve mental olarak yeniden do\u011fma zaman\u0131 olarak tan\u0131mlayabiliriz.<\/p>\n\n\n\n

    Takvim<\/strong><\/p>\n\n\n\n

    N\u00f6bet planlamas\u0131 acil t\u0131p i\u00e7in stres kayna\u011f\u0131d\u0131r ve hekim sa\u011fl\u0131\u011f\u0131 i\u00e7in b\u00fcy\u00fck etkilere sahiptir. Asgari seviyede g\u00fcnd\u00fcz ve gece n\u00f6betlerine ge\u00e7i\u015flerde sirkadiyen ritme uygun n\u00f6bet planlamas\u0131 yap\u0131lmal\u0131<\/em><\/strong> ve bu ge\u00e7i\u015fler aras\u0131nda toparlanma i\u00e7in gerekli izin personele verilmelidir. \u201cKasino<\/em><\/strong> n\u00f6betleri<\/em><\/strong>\u201d sirkadiyen ritmi korumak i\u00e7in \u00f6nerilen bir y\u00f6ntemdir (Fig\u00fcr 1). Geceyi kapsayan n\u00f6betler 20-04 ve 04-12 olarak planlan\u0131r.  Sirkadiyen ritmi korumak i\u00e7in, insan\u0131n 02-06 aras\u0131n\u0131 fizyolojik \u00e7al\u0131\u015fmalarda uyumas\u0131 gerekti\u011fi ortaya konulmu\u015ftur. Bu s\u00fcre \u201c\u00c7apa Periyodu\u201d<\/em><\/strong> olarak tan\u0131mlan\u0131r. Kasino n\u00f6beti ise \u00e7al\u0131\u015fanlar\u0131n bu periyodun bir k\u0131sm\u0131n\u0131 n\u00f6bet\u00e7i oldu\u011fu g\u00fcn uyuyarak ge\u00e7irmesini sa\u011flamaktad\u0131r. Yap\u0131lan \u00e7al\u0131\u015fmalarda g\u00f6re n\u00f6betten sonra daha uzun uyuma s\u00fcreleri, daha az kognitif bozulma ve yenilenmek i\u00e7in daha k\u0131sa s\u00fcreler Kasino n\u00f6beti sistemi ile sa\u011flanm\u0131\u015ft\u0131r. K\u0131sa n\u00f6betler gibi esnek \u00e7al\u0131\u015fma saatlerinin de hekimlerin sa\u011fl\u0131\u011f\u0131n\u0131 iyile\u015ftirdi\u011fi g\u00f6sterilmi\u015ftir.<\/p>\n\n\n\n

    \"\"
    \u015eekil 1. <\/strong>Kasino N\u00f6bet sistemi<\/figcaption><\/figure><\/div>\n\n\n\n

    Di\u011fer<\/strong><\/p>\n\n\n\n

    Daha iyi bir \u00e7al\u0131\u015fma ortam\u0131n\u0131 sa\u011flamak i\u00e7in yap\u0131labilecek di\u011fer maddeler ise doktorlar i\u00e7in ya\u015fam ko\u00e7lu\u011fu, \u00fccretli izin opsiyonlar\u0131, s\u00fcrekli \u00f6\u011frenme ve kariyer geli\u015ftirme se\u00e7enekleri i\u00e7in te\u015fvikler ve \u00f6nemli olaylardan sonra rutin kritik olay geri bildirim toplant\u0131lar\u0131<\/em><\/strong> say\u0131labilir.<\/p>\n\n\n\n

    \u00c7al\u0131\u015fma ortam\u0131n\u0131n iyile\u015ftirilmesi konusu sadece acil servisler i\u00e7in de\u011fil, art\u0131k hastanelerin genelinde de \u00f6nem arz etmektedir. Amerika\u2019da bu konuda \u00f6nlemler al\u0131nmaya ba\u015flanm\u0131\u015ft\u0131r. Se\u00e7ilen pilot hastanelerde sa\u011fl\u0131kl\u0131 yiyeceklere tam zamanl\u0131 eri\u015fim, \u00e7al\u0131\u015fma yerinde fiziksel akitivite olanaklar\u0131, %100 sigaras\u0131z ortamlar ve sigara b\u0131rakma programlar\u0131 hayata ge\u00e7irilmi\u015ftir.<\/p>\n\n\n\n

    \u00d6rne\u011fin en radikal \u00f6nlemleri alan Cleveland Clinic, kamp\u00fcs\u00fcnden b\u00fct\u00fcn k\u0131zarm\u0131\u015f yiyecekleri, \u015fekerleri ve gazl\u0131 i\u00e7ecekleri kald\u0131rm\u0131\u015ft\u0131r. Yemek otomatlar\u0131nda ve kafeteryada sadece sa\u011fl\u0131kl\u0131 yiyecek se\u00e7enekleri sunulmu\u015ftur. \u00a0Egzersiz anlam\u0131nda Stanford ki\u015fisel fitness e\u011fitmenleri, sa\u011fl\u0131kl\u0131 ya\u015fam dan\u0131\u015fmanlar\u0131 ve kamp\u00fcste egzersiz aletlerini kullan\u0131ma sunmu\u015ftur.<\/p>\n\n\n\n

    \"\"<\/figure>\n\n\n\n
    \"\"
    Resim 1. Sa\u011fl\u0131kl\u0131 ve sa\u011fl\u0131ks\u0131z yiyecekler (Ankara \u015eehir Hastanesinden\u2026)<\/strong><\/figcaption><\/figure>\n\n\n\n

    Daha fazla ye\u015fil alan, dinlenmek i\u00e7in sessiz odalar, ki\u015fisel hizmetler (kuru temizleme, araba y\u0131kama) gibi k\u0131saca hizmet odakl\u0131 de\u011fil insan odakl\u0131 bir \u00e7al\u0131\u015fma ortam\u0131 ile hem hekim hem de hasta daha sa\u011fl\u0131kl\u0131 olacakt\u0131r\u2026<\/p>\n\n\n\n

    \"\"<\/figure><\/div>\n\n\n\n
    \"\"
    Resim 2. \u00c7al\u0131\u015fanlar\u0131n g\u00fcn i\u00e7inde ki\u015fisel i\u015flerini hastane i\u00e7inde halledebilecekleri alanlar (Ankara \u015eehir Hastanesinden\u2026)<\/strong><\/figcaption><\/figure><\/div>\n","protected":false},"excerpt":{"rendered":"

    Yazar: Ayhan \u00d6zhasenekler Erciyes \u00dcniversitesi\u2019nde T\u0131p Fak\u00fcltesini, Dicle \u00dcniversitesi\u2019nde Acil T\u0131p Uzmanl\u0131\u011f\u0131n\u0131 bitirdi. Diyarbak\u0131r Devlet Hastanesinde mecburi hizmet sonras\u0131, evi \u2013 ailesi…<\/p>\n","protected":false},"author":1599,"featured_media":1603,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10015],"tags":[35,60,154],"class_list":["post-1591","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sosyal-blog-yazisi","tag-acil-tip","tag-calisma-ortami","tag-saglik"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/1591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/comments?post=1591"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/1591\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media\/1603"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media?parent=1591"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/categories?post=1591"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/tags?post=1591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}