{"id":2209,"date":"2018-12-10T10:59:05","date_gmt":"2018-12-10T07:59:05","guid":{"rendered":"https:\/\/tatd.org.tr\/atab\/2018\/12\/10\/acil-tip-asistanligi-ve-burnout-sendromu\/"},"modified":"2021-11-11T04:46:38","modified_gmt":"2021-11-11T01:46:38","slug":"acil-tip-asistanligi-ve-burnout-sendromu","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/atab\/2018\/12\/10\/acil-tip-asistanligi-ve-burnout-sendromu\/","title":{"rendered":"Acil T\u0131p Asistanl\u0131\u011f\u0131 ve Burnout Sendromu"},"content":{"rendered":"

Acil T\u0131p Asistanl\u0131\u011f\u0131 ve Burn out Sendromu<\/p>\n

Yo\u011fun bir n\u00f6bet s\u0131ras\u0131nda fiziksel yorgunlu\u011fumuzla m\u00fccadele ederken, stres ve t\u00fckenmi\u015flik hissi ile doldu\u011fumuz, i\u015fimizi sorgulad\u0131\u011f\u0131n\u0131z anlar\u0131 pek \u00e7o\u011fumuz ya\u015fam\u0131\u015f\u0131zd\u0131r. Acil servis kalabal\u0131\u011f\u0131, zor hastalar\u0131n y\u00f6netimi, kritik kararlar\u0131 h\u0131zl\u0131ca ve do\u011fru \u015fekilde alma gereklili\u011fi, uzun \u00e7al\u0131\u015fma saatleri, uyku d\u00fczensizli\u011fi, mesleki ili\u015fkilerdeki baz\u0131 problemler ve i\u015f yerindeki sorunlar\u0131n sosyal hayat\u0131m\u0131za yans\u0131malar\u0131 \u2026 olarak uzay\u0131p giden bu liste, bir bakm\u0131\u015f\u0131z ki \u2018Kafam yand\u0131!\u2019 diye d\u00fc\u015f\u00fcnmemize sebep olmu\u015f.<\/p>\n

Freudenberger\u2019e g\u00f6re burn out; yorgunluk, a\u015f\u0131r\u0131 zorlanma, isteksizlik ve bedensel \u015fikayetlerle birlikte g\u00f6r\u00fclen bir t\u00fckenmi\u015flik halidir. Belirtileri \u00fc\u00e7 ana ba\u015fl\u0131kta kategorize etmek m\u00fcmk\u00fcnd\u00fcr. Duygusal t\u00fckenmi\u015flik\/\u00e7abuk yorulma, yabanc\u0131la\u015fma ve d\u00fc\u015f\u00fck verimlilik\/ yetersizlik duygusu ile seyreden, ki\u015finin stres fakt\u00f6rlerine kar\u015f\u0131 ba\u015f edebilme konusundaki yetenek ve imkanlar\u0131na ba\u011fl\u0131 olarak a\u011f\u0131rl\u0131\u011f\u0131 ve ba\u015flang\u0131c\u0131 etkilenen bir s\u00fcre\u00e7tir. Pek \u00e7ok bran\u015f i\u00e7in farkl\u0131 rakamlar belirtilse de acil t\u0131p hekimleri %30-%65 aras\u0131nda de\u011fi\u015fen oranlarda t\u00fckenmi\u015fli\u011fi ya\u015famaktad\u0131r.1-2<\/sup><\/p>\n

\u0130\u015f verimlili\u011fini ve ki\u015finin ya\u015fam kalitesini olduk\u00e7a etkileyen bu s\u00fcrece neden olan \u00e7e\u015fitli fakt\u00f6rler s\u00f6z konusudur. EMRA, bir \u00e7al\u0131\u015fmada kad\u0131n asistanlarda stres d\u00fczeyi ve depresyonu daha yayg\u0131n saptam\u0131\u015f, t\u00fcm asistanlarda asistanl\u0131k e\u011fitimi s\u00fcresince y\u0131llara g\u00f6re stres veya depresyonda anlaml\u0131 bir farkl\u0131l\u0131k bulmam\u0131\u015f, acil t\u0131p uzmanlar\u0131n\u0131n di\u011fer uzmanl\u0131k alanlar\u0131ndan farkl\u0131 olarak ya\u015fad\u0131klar\u0131 mesleki stres ve depresyondaki farkl\u0131l\u0131klara dikkat \u00e7ekmi\u015ftir.3<\/sup> Yine \u00fclkemiz s\u0131n\u0131rlar\u0131nda yap\u0131lan bir Acil Servis \u00e7al\u0131\u015fmas\u0131nda kad\u0131n olmak ve d\u00fc\u015f\u00fck gelir elde etmek stres d\u00fczeyi i\u00e7in y\u00fcksek risk fakt\u00f6r\u00fc olarak saptanm\u0131\u015ft\u0131r.4 <\/sup><\/p>\n

Vardiya usul\u00fc \u00e7al\u0131\u015fanlarda sirkadyen ritme uyumda zorluk ve uyku kalitesinde azalma burn outa yatk\u0131nl\u0131\u011f\u0131 artt\u0131rmaktad\u0131r. 5<\/sup> M\u00fcmk\u00fcn oldu\u011funca d\u00fczenli aral\u0131klarda \u00e7al\u0131\u015fmak, ayn\u0131 saatlerde uyumak, g\u00fcr\u00fclt\u00fcs\u00fcz ortamda dinlenmek, gece n\u00f6betleri s\u0131ras\u0131nda kafeinli i\u00e7eceklerin ve a\u011f\u0131r g\u0131dalar\u0131n t\u00fcketimini azaltmak, egzersiz yapmak ve sa\u011fl\u0131kl\u0131 beslenmek biyolojik ritmin d\u00fczenlenmesinde katk\u0131 sa\u011flayacakt\u0131r. Uygun dinlenme i\u00e7in izin s\u00fcrelerinin de yeterli kullan\u0131labilmesi i\u015f memnuniyetini artt\u0131ran etmenler aras\u0131ndad\u0131r.<\/p>\n

\u0130\u015f sa\u011fl\u0131\u011f\u0131 ve i\u015fyeri g\u00fcvenli\u011fi de acil servis hekimlerinin stres d\u00fczeyine etkide bulunmaktad\u0131r. Riskli davran\u0131\u015flar g\u00f6steren hasta ve hasta yak\u0131nlar\u0131na s\u00fcrekli maruziyet, acil servislerin farkl\u0131 \u015fiddet t\u00fcrlerine u\u011frama konusunda en y\u00fcksek orana sahip alanlardan biri olmas\u0131 ve \u00e7al\u0131\u015fma alan\u0131nda yeterli g\u00fcvenli\u011fin sa\u011flanamamas\u0131 hekimler i\u00e7in kayg\u0131y\u0131 artt\u0131ran fakt\u00f6rler aras\u0131ndad\u0131r. Marmara \u00dcTF Acil Servisinde yap\u0131lan ve 1300 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131 ile yap\u0131lan g\u00f6r\u00fc\u015fmenin de\u011ferlendirildi\u011fi bir \u00e7al\u0131\u015fmada 1128 (%86,8) sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131n meslek hayatlar\u0131 boyunca en az 1 kez \u015fiddete u\u011frad\u0131\u011f\u0131n\u0131 bildirdi\u011fi rapor edilmi\u015ftir. 6<\/sup> \u0130htiya\u00e7lar hiyerar\u015fisinin temel basamaklar\u0131ndan olan g\u00fcvenlik gereksiniminin sa\u011flanamamas\u0131 ki\u015fiyi t\u00fckenmi\u015fli\u011fe iten \u00f6nemli bir nedendir. Asistan hekimler olarak yasal haklar\u0131m\u0131z\u0131n bilincinde olmak, meslek \u00f6rg\u00fctlerinden hukuki destek almak, \u015fiddete kar\u015f\u0131 \u00e7\u00f6z\u00fcmlerin i\u00e7inde yer almak ve g\u00fcvenlik hakk\u0131 i\u00e7in gerekli d\u00fczenlemeler a\u00e7\u0131s\u0131ndan talepte bulunmak, bizleri \u00e7\u00f6z\u00fcm noktas\u0131na bir ad\u0131m daha yakla\u015ft\u0131racakt\u0131r.<\/p>\n

Acil serviste k\u0131sa zamanda pek \u00e7ok hasta de\u011ferlendirmek zorunda olan ve kritik hastalar\u0131n tan\u0131 ve tedavisini ivedilikle s\u00fcrd\u00fcren acil hekimleri i\u00e7in \u00e7al\u0131\u015f\u0131lan yerin fiziki yetersizli\u011fi, yard\u0131mc\u0131 sa\u011fl\u0131k personelindeki eksikler, servis ve yo\u011fun bak\u0131m yat\u0131\u015f gereksinimi olan hastalar\u0131n sirk\u00fclasyonunun sa\u011flanamamas\u0131 kimi zaman olduk\u00e7a y\u0131prat\u0131c\u0131 olsa da hastalara duyulan empatiyi kaybetmemek, so\u011fukkanl\u0131 davranmak ve karamsarl\u0131k hissedilen noktada acil servis \u015fefleri ve ekiple payla\u015f\u0131mlarda bulunmak gereklidir. Etkin bir ekip \u00e7al\u0131\u015fmas\u0131yla stres duygusu payla\u015f\u0131ld\u0131\u011f\u0131 gibi, sorunlara geli\u015ftirilecek \u00e7\u00f6z\u00fcmler \u00e7o\u011falacak ve t\u0131bbi hata yapma korkusuyla olu\u015fan kayg\u0131lar minimize edilecektir.<\/p>\n

Acil t\u0131pta stresle ba\u015f etme stratejileri i\u00e7in Schmitz ve arkada\u015flar\u0131n\u0131n \u00f6nerileri 7<\/sup><\/p>\n

\n\n\n\n\n\n\n\n
Madde kullan\u0131m\u0131<\/td>\nAile ve sosyal ba\u011flar\u0131 korumak<\/p>\n

Mentor\/program direkt\u00f6r\u00fc ile y\u0131lda iki kez g\u00f6r\u00fc\u015fme yapmak<\/p>\n

Ki\u015fisel ve anonim geribildirimleri te\u015fvik etmek<\/p>\n

Profesyonel destek almak<\/p>\n

 <\/td>\n<\/tr>\n

Sirkadyen bozulma<\/td>\nSa\u011fl\u0131kl\u0131 olman\u0131n \u00f6nemini vurgulamak<\/p>\n

Egzersiz yapmak<\/p>\n

Vardiya de\u011fi\u015fimlerini ayn\u0131 d\u00f6ng\u00fcde ger\u00e7ekle\u015ftirmek<\/p>\n

 <\/td>\n<\/tr>\n

Uyku yoksunlu\u011fu<\/td>\nAlkol ve kafein t\u00fcketimini s\u0131n\u0131rlamak<\/p>\n

Dinlenmek i\u00e7in sessiz, karanl\u0131k bir alan se\u00e7mek<\/p>\n

M\u00fcmk\u00fcn oldu\u011funda \u015fekerleme yapmak<\/p>\n

Ya\u015fla birlikte gece vardiya say\u0131s\u0131n\u0131 azaltmak<\/p>\n

 <\/td>\n<\/tr>\n

Malpraktis kayg\u0131s\u0131<\/td>\nUzmanl\u0131\u011f\u0131m\u0131z\u0131n risk i\u00e7erdi\u011fini kabul etmek ve riskleri azaltmak<\/p>\n

Kay\u0131t tutmak (onam, g\u00f6zlem notlar\u0131\u2026)<\/p>\n

Hastalar\u0131 uygun takibe y\u00f6nlendirmek<\/p>\n

 <\/td>\n<\/tr>\n

Enfeksiyona maruziyet<\/td>\nGenel korunma \u00f6nlemlerini uygulamak<\/p>\n

\u0130\u015f sa\u011fl\u0131\u011f\u0131n\u0131 kaynak olarak kullanmak<\/p>\n

\u0130\u015flemler s\u0131ras\u0131nda uygun malzeme ve alan\u0131 sa\u011flamak<\/p>\n

 <\/td>\n<\/tr>\n

Beslenme ve ya\u015fam<\/td>\nHobi edinmek ya da var olan bir hobiyi uygulamak<\/p>\n

Egzersiz i\u00e7in takvim olu\u015fturmak<\/p>\n

\u0130\u015fleri e\u011flenceli tutmak ve ilgiyi korumak i\u00e7in rutininizi de\u011fi\u015ftirmek<\/p>\n

Grup aktivitelerine kat\u0131lmak<\/p>\n

\u00c7al\u0131\u015f\u0131rken sa\u011fl\u0131kl\u0131 at\u0131\u015ft\u0131rmal\u0131klar, meyve ve sebze t\u00fcketmek<\/p>\n

Enerjinizi toplamak i\u00e7in vakit olu\u015fturmak<\/p>\n

\u00c7al\u0131\u015f\u0131rken yeterli su i\u00e7ti\u011finizden emin olmak<\/p>\n

 <\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

 <\/p>\n

Akademik anlamda uzun ve k\u0131sa vadeli kariyer planlar\u0131 yap\u0131p \u00e7al\u0131\u015fma hedefleri koymak, stresle ba\u015fa \u00e7\u0131kmam\u0131z\u0131 artt\u0131raca\u011f\u0131 gibi i\u015f doyumu da sa\u011flayaca\u011f\u0131 i\u00e7in t\u00fckenmi\u015flikle m\u00fccadele etmemizde bize olduk\u00e7a yard\u0131mc\u0131 olacakt\u0131r ve bu \u00f6nerilere eklenebilir. \u00c7al\u0131\u015fma ekibiyle ya da d\u0131\u015far\u0131dan arkada\u015flar\u0131n\u0131zla ba\u015fka bir konuda e\u011fitim alma, meditasyon, spor ve sosyal etkinliklerde bulunmak da fayda sa\u011flayacak \u00f6neriler aras\u0131ndad\u0131r.<\/p>\n

\u015eayet ba\u015fa \u00e7\u0131kma mekanizmalar\u0131m\u0131z yetersiz kal\u0131yorsa profesyonel destek almay\u0131 da ak\u0131ldan \u00e7\u0131karmamak gerekir. Unutmamal\u0131y\u0131z ki kendimizi fiziksel ve psikolojik a\u00e7\u0131dan yeterli hissetti\u011fimiz s\u00fcrece kendimiz ve hastalar\u0131m\u0131z i\u00e7in verimli bir i\u015f hayat\u0131 s\u00fcrd\u00fcrece\u011fiz. Yaz\u0131m\u0131 noktalarken, Acil T\u0131p Asistan Birli\u011fi\u2019nin b\u00fct\u00fcn acil t\u0131p asistanlar\u0131na ithaf etti\u011fi bir ba\u015fucu kitap\u00e7\u0131\u011f\u0131 olan \u2018Sa\u011fl\u0131kl\u0131 Ya\u015fam Ba\u015flang\u0131\u00e7 K\u0131lavuzu\u2019na mutlaka g\u00f6z atman\u0131z\u0131 \u00f6neririm. Ger\u00e7ek amac\u0131m\u0131z\u0131n insan gibi ya\u015famak oldu\u011funu hi\u00e7bir zaman unutmay\u0131n.<\/p>\n

Sayg\u0131lar\u0131mla\u2026<\/p>\n

Dr. B\u00fc\u015fra Sapmaz<\/p>\n

E\u00dcTF Acil T\u0131p ABD, ATAB 7. YK \u00fcyesi<\/p>\n

Kaynak\u00e7a<\/p>\n

    \n
  1. Hoonpongsimanont W, Murphy M, Kim CH, Nasir D, Compton S. Emergency medicine resident well-being: stress and satisfaction. Occup Med (Lond). 2014;64(1):45-48.<\/li>\n
  2. Takayesu JK, Ramoska EA, Clark TR, et al. Factors associated with burnout during emergency medicine residency. Acad Emerg Med. 2014;21(9):1031-1035.<\/li>\n
  3. Whitley TW, Allison EJ Jr, Gallary ME, et al. Factors associated with stress among emergency medicine residents. Ann Emerg Med 1989;18:1157-1161.<\/li>\n
  4. Erdur, B et al. \u201cA Study of Depression and Anxiety among Doctors Working in Emergency Units in Denizli, Turkey.\u201d Emergency Medicine Journal\u202f: EMJ 23.10 (2006): 759\u2013763. PMC. Web. 30 June 2018.<\/li>\n
  5. Houry D, Shockley LW, Markovchick V. Wellness issues and the emergency medicine resident. Ann Emerg Med. 2000;35(4):394-397.<\/li>\n
  6. Eroglu SE, Onur O , Sagiroglu E, Denizbasi A, Akoglu H. Analysis of Violence in a Crowded Emergency Room. British Journal of Medicine & Medical Research, 3(4): 1208-1221, 2013<\/li>\n
  7. Schmitz GR, Clark M, Heron S, et al. Strategies for coping with stress in emergency medicine: Early education is vital. J Emerg Trauma Shock. 2012;5(1):64-69.<\/li>\n<\/ol>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Acil T\u0131p Asistanl\u0131\u011f\u0131 ve Burn out Sendromu Yo\u011fun bir n\u00f6bet s\u0131ras\u0131nda fiziksel yorgunlu\u011fumuzla m\u00fccadele ederken, stres ve t\u00fckenmi\u015flik hissi ile doldu\u011fumuz, i\u015fimizi…<\/p>\n","protected":false},"author":1599,"featured_media":2210,"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-2209","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\/2209","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=2209"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/posts\/2209\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/media\/2210"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/media?parent=2209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/categories?post=2209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/atab\/wp-json\/wp\/v2\/tags?post=2209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}