{"id":2159,"date":"2018-11-03T16:39:55","date_gmt":"2018-11-03T13:39:55","guid":{"rendered":"https:\/\/tatd.org.tr\/atab\/2018\/11\/03\/acil-serviste-kidem-catismalari\/"},"modified":"2021-11-11T04:45:15","modified_gmt":"2021-11-11T01:45:15","slug":"acil-serviste-kidem-catismalari","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/atab\/2018\/11\/03\/acil-serviste-kidem-catismalari\/","title":{"rendered":"Acil Serviste K\u0131dem \u00c7at\u0131\u015fmalar\u0131"},"content":{"rendered":"<p><strong><b>AC\u0130L SERV\u0130STE KIDEM \u00c7ATI\u015eMALARI<\/b><\/strong><\/p>\n<p>Merhaba arkada\u015flar ilk yaz\u0131mda size bence e\u011flenceli kimilerine g\u00f6re can s\u0131k\u0131c\u0131 olan k\u0131dem \u00e7at\u0131\u015fmalar\u0131ndan bahsetmeye \u00e7al\u0131\u015faca\u011f\u0131m. Bir b\u00f6l\u00fcm\u00fc ki\u015fisel deneyim, bir b\u00f6l\u00fcm\u00fc a\u015f\u0131r\u0131 bilimsellik i\u00e7eren bu yaz\u0131ma ba\u015flamadan kendi deyimimle kendimi tan\u0131mlayay\u0131m. Ben Sadi Konuk E\u011fitim Ara\u015ft\u0131rma Hastanesi Acil T\u0131p Klini\u011fi \u00a0\u00e7\u00f6mez k\u0131demlisi. Peki nedir bu \u00e7\u00f6mez k\u0131demlisi? Asl\u0131nda k\u0131demli de olamam\u0131\u015f alt\u0131na bir s\u00fcr\u00fc \u00e7\u00f6mez gelince kendini bir anda \u00e7\u00f6mezlerinin her konuda cevap bekledi\u011fi ancak \u00fcst k\u0131demlilerinin de g\u00fcvenip hasta emanet edemedi\u011fi buna ra\u011fmen klinik\u00e7e \u00a0k\u0131demli olarak ilan edilen bir acil t\u0131p asistan\u0131 diyebiliriz. Kar\u0131\u015f\u0131k oldu di mi, aynen bu durumdaki asistan\u0131n kafas\u0131 gibi i\u015fte. \u015eaka bi yana 16 ayl\u0131k acil t\u0131p asistan\u0131y\u0131m ve \u00e7\u00f6mezlik hepimizin ruhunda baki diyerek konuya giriyorum.<\/p>\n<p>Acil serviste k\u0131dem nedir \u00f6nce oradan ba\u015flayal\u0131m. Acil serviste k\u0131dem \u00e7o\u011fu hastanede bir cerrahi sertli\u011finde olmamakla beraber mevcut. Peki sebebi neydi ki dedi\u011finizi duyar gibiyim. Ba\u015flang\u0131\u00e7 olarak daha \u00e7ok hasta g\u00f6rmek etkili. Peki daha \u00f6nce pratisyenlik yapanlar diyebilirsiniz. Pratisyen olarak ne kadar \u00e7al\u0131\u015f\u0131l\u0131rsa \u00e7al\u0131\u015f\u0131ls\u0131n yeni bir ortama girdiniz, \u00e7al\u0131\u015ft\u0131\u011f\u0131n\u0131z klini\u011fin hasta yakla\u015f\u0131m\u0131 , kendi algoritmas\u0131 ve hastane d\u00fczeninde daha fazla hasta g\u00f6rm\u00fc\u015f olmak acil serviste k\u0131dem konusunda belirleyici etkenlerdir. Bunun d\u0131\u015f\u0131nda acil servis ba\u015fvurular\u0131 \u00fclkemizde 2017 ocak-ekim ay\u0131 verileri incelendi\u011finde 85 milyon ba\u015fvuru oldu\u011fu g\u00f6r\u00fcl\u00fcyor<sup>1<\/sup>. Bu ba\u015fvurular\u0131 kar\u015f\u0131layan acil servis \u00e7\u00f6mezinin en basitinden toksik hastay\u0131 ge\u00e7erken u\u011frayan hastadan ay\u0131rmak gibi temel g\u00f6rev ve sorumluluklar\u0131(!) bulunuyor ve bunu \u00e7o\u011fu zaman tek ba\u015f\u0131na yapmak m\u00fcmk\u00fcn de\u011fil. E\u011fitim ara\u015ft\u0131rma hastanelerinde uzmanlar\u0131n bulunmas\u0131 k\u0131demlinin y\u00fck\u00fcn\u00fc ortadan kald\u0131r\u0131yor mu k\u0131sm\u0131 tart\u0131\u015fmaya a\u00e7\u0131k olmakla beraber, \u00fcniversite hastanesinde bu y\u00fck tamamen k\u0131demlilerin \u00fczerinde. Bunun d\u0131\u015f\u0131nda hayat ve acil servisler maalesef \u00fcniversite hayat\u0131m\u0131zdaki gibi g\u00fcl bah\u00e7esi ve standart de\u011fil arkada\u015flar. Ne kadar iyi e\u011fitim ald\u0131\u011f\u0131m\u0131z\u0131 d\u00fc\u015f\u00fcn\u00fcrsek d\u00fc\u015f\u00fcnelim sahada elimizde kan gaz\u0131 enjekt\u00f6r\u00fc ya da elimizde hastan\u0131n kan gaz\u0131 sonucuyla ba\u015f ba\u015fa kald\u0131\u011f\u0131m\u0131zda ba\u015f\u0131m\u0131zda bir b\u00fcy\u00fck bulunsun mant\u0131\u011f\u0131yla k\u0131demlilere ko\u015ftu\u011fumuz g\u00fcnler mevcut. K\u0131dem acil serviste daha \u00e7ok asl\u0131nda bir dayan\u0131\u015fma yolu ba\u015f\u0131n s\u0131k\u0131\u015ft\u0131\u011f\u0131nda ko\u015fulacak b\u00fcy\u00fck abi, k\u0131demli i\u00e7in de ba\u015f\u0131n\u0131 ka\u015f\u0131yamad\u0131\u011f\u0131n anda ekmek almaya yollayaca\u011f\u0131n k\u00fc\u00e7\u00fck karde\u015f belki de. Peki gelelim \u00e7at\u0131\u015fmalara, \u00e7\u00f6mez asistan\u0131n o acil servise gelene kadar edindi\u011fi birikim, al\u0131\u015fkanl\u0131klar ve uygulamalar asl\u0131nda bu durumun temel kayna\u011f\u0131n\u0131 olu\u015fturuyor. K\u0131demli a\u00e7\u0131s\u0131ndan da ayn\u0131 \u015fey ge\u00e7erli asl\u0131nda. \u00c7al\u0131\u015ft\u0131\u011f\u0131 klinikteki uygulamalardan farkl\u0131 uygulama g\u00f6rmek ya da kendi \u00e7\u00f6mezli\u011finden farkl\u0131 bir \u00e7\u00f6mez g\u00f6rmek onun i\u00e7in can s\u0131k\u0131c\u0131 olabiliyor. Peki k\u0131demlilerin hepsi melek mi? Acil serviste \u00e7al\u0131\u015fmaya ba\u015flad\u0131\u011f\u0131mdan beri duydu\u011fum bir c\u00fcmle var size de aktaraca\u011f\u0131m \u2018\u2019k\u00f6t\u00fc k\u0131demli insan\u0131 iyi \u00e7\u00f6mez yapar\u201d. Bunu iki yandan da de\u011ferlendirmek m\u00fcmk\u00fcn. Onu \u00f6rnek al\u0131rsan\u0131z bu c\u00fcmle ge\u00e7erlili\u011fini kaybedecektir ancak k\u0131demlinizin bu tavr\u0131 sizde ara\u015ft\u0131rma iste\u011fi olu\u015fturuyorsa , farkl\u0131 g\u00f6r\u00fc\u015f ve uygulamalar\u0131 sentezleme yetene\u011finizi geli\u015ftiriyorsa, \u201cben onun gibi olmayaca\u011f\u0131m\u201d diyerek kendi fark\u0131ndal\u0131\u011f\u0131n\u0131z\u0131 artt\u0131r\u0131yorsa c\u00fcmle y\u00fczde y\u00fcz \u00e7al\u0131\u015f\u0131yor diyebiliriz. Bunun d\u0131\u015f\u0131nda k\u0131demlinin biz \u00e7\u00f6mezken ile ba\u015flayan c\u00fcmleleri hep bir kahramanl\u0131k hikayeleriyle sonlan\u0131rken mevcut soruna \u00e7\u00f6z\u00fcm getirmeyi\u015fi sadece \u00e7\u00f6mezin mi yaras\u0131d\u0131r? K\u0131demlendik\u00e7e artan art\u0131k daha rahat olmayal\u0131m d\u00fc\u015f\u00fcncesi \u00e7\u00f6mezin g\u00fcne\u015fli havada s\u0131rt\u0131nda tuz \u00e7uval\u0131yla da\u011fa t\u0131rmanmas\u0131yla m\u0131 ger\u00e7e\u011fe d\u00f6n\u00fc\u015f\u00fcr yoksa rahatlayaca\u011f\u0131n\u0131 sanan k\u0131demlinin asl\u0131nda bu sorumlulu\u011fun alt\u0131nda yava\u015f\u00e7a ezilmeye ba\u015flamas\u0131, kendisinden beklenenlerin orant\u0131s\u0131z artt\u0131\u011f\u0131 ve dolay\u0131s\u0131yla rahatl\u0131ktan eser bar\u0131nd\u0131rmayan bir s\u00fcre\u00e7 haline mi gelir? K\u0131demlilik Game of thrones taht\u0131na oturup taht sava\u015flar\u0131n\u0131n daha devam etti\u011finin fark\u0131nda olmakt\u0131r bence. Artan \u00e7\u00f6mez say\u0131s\u0131 mutluluk getirmez a dostlar bak\u0131n yurtd\u0131\u015f\u0131nda \u00e7\u00f6mez asistanlarla ilgili yap\u0131lan bir \u00e7al\u0131\u015fmaya g\u00f6z att\u0131\u011f\u0131m\u0131zda \u00e7\u00f6mez asistan say\u0131s\u0131 artt\u0131k\u00e7a acil servisin hasta kalabal\u0131\u011f\u0131, hastan\u0131n hastanede kal\u0131\u015f s\u00fcresinin art\u0131\u015f\u0131yla ilgili elimizde veriler mevcut<sup>2<\/sup>. Naps\u0131n yani \u00f6ls\u00fcn m\u00fc \u00e7\u00f6mezler sevgili Takahisa Kawano? Asl\u0131nda Takahisa abimizin demek istedi\u011finden \u00e7\u0131karmam\u0131z gereken sonu\u00e7 \u015fu; \u00e7\u00f6mez say\u0131s\u0131n\u0131n artmas\u0131ndan \u00e7ok denetleyici daha do\u011frusu k\u0131demli say\u0131s\u0131n\u0131n artmas\u0131 \u00e7\u00f6z\u00fcm. Tabiki onlar da olay tamamen duygusal. Adamlar e\u011fitim s\u00fcrecinin de\u011fil de hastan\u0131n hastanede kal\u0131\u015f s\u00fcresiyle olan ili\u015fkiyi de\u011ferlendirmi\u015fler. Dememi\u015fler ki bu \u00e7\u00f6mez ilerde k\u0131demli olacak, ne kadar hasta bak\u0131yorsa o kadar deneyim edinecek, hastay\u0131 daha az elinde tutacak ve h\u0131zlanacak dememi\u015fler. Neyse adam\u0131n kulaklar\u0131n\u0131 yeterince \u00e7\u0131nlatt\u0131ysak gelelim k\u0131ssadan hissemize. Acil servisteki k\u0131dem \u201cBen ne dersem \u00e7\u00f6mezim onu yapar.\u201d , \u201cK\u0131dem ne ya acil serviste k\u0131dem mi olurmu\u015f?\u201d , \u201cK\u0131demlim ne derse do\u011frusu odur.\u201d \u015eeklinde de\u011fildir. Acil serviste her bran\u015fa ait bir \u00e7ok bilgi, uygulama ,y\u00f6netim ve tarzlar g\u00f6r\u00fclmekte, \u00e7ok \u00e7e\u015fitli vakalara m\u00fcdahale edilmektedir. Bu kaotik ortamda sizden daha uzun s\u00fcre bulunmu\u015f, birikim edinmi\u015f ki\u015filerin size k\u0131lavuzluk etmesi zor zamanlar\u0131n\u0131zda Gandalf\u2019\u0131n be\u015finci g\u00fcn\u00fcn \u015fafa\u011f\u0131nda Do\u011fu\u2019dan g\u00f6r\u00fcnmesi gibi gelecektir. Fakat k\u0131demlendik\u00e7e bu \u00e7e\u015fitlili\u011fin var oldu\u011funu unutmay\u0131p \u00e7\u00f6mezinden de \u00f6\u011frenece\u011fin \u015feyler oldu\u011funu ak\u0131ldan \u00e7\u0131karmamak gereklidir.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>AC\u0130L SERV\u0130STE KIDEM \u00c7ATI\u015eMALARI Merhaba arkada\u015flar ilk yaz\u0131mda size bence e\u011flenceli kimilerine g\u00f6re can s\u0131k\u0131c\u0131 olan k\u0131dem \u00e7at\u0131\u015fmalar\u0131ndan bahsetmeye \u00e7al\u0131\u015faca\u011f\u0131m. Bir b\u00f6l\u00fcm\u00fc&hellip;<\/p>\n","protected":false},"author":1599,"featured_media":2160,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10015],"tags":[],"class_list":["post-2159","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sosyal-blog-yazisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/posts\/2159","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/comments?post=2159"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/posts\/2159\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/media\/2160"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/media?parent=2159"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/categories?post=2159"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/tags?post=2159"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}