同情疲劳(CF),或者对自己关心的其他人失去同情或同情的能力,是急诊医生(EP)日益关注的问题。EP,根据他们工作的性质,在不可预测的条件下工作,在奇数小时,高水平的创伤事件暴露。他们被置于实质性的心理之下,物理,和认知压力,几乎没有机会恢复或反思。当这种工作场所的压力导致被压倒的感觉时,就会发生CF,无助,不支持,无法应付。此外,来自工作场所暴力威胁的主要创伤压力和来自目睹他人痛苦的次要创伤压力(STS)增加了发展CF的可能性。未选中,这种向CF的进展导致患者护理质量下降,患者满意度降低,EP抑郁和焦虑水平升高,EP物质使用水平增加,增加了专业人员的减员。为了真正提高CF,个人和组织应该意识到CF的贡献者:即,情绪疲惫,去个性化,主要和STS,和个人成就。EP应该通过使用认知行为技术和正念来最大限度地提高他们对CF的韧性,照顾他们的身体健康,在工作中寻求意义和发展,发展工作之外的爱好,在工作和家庭之间建立界限。组织应积极解决已知的医生职业倦怠的驱动因素:工作量和工作需求,效率和资源,在工作中的意义,文化和价值观,控制和灵活性,工作社区,工作与生活的融合。组织还应在设施内提供足够的安全性,以减少原发性创伤的威胁,并应为患有STS的EP的创伤后症状提供足够的支持和污名化。
Compassion fatigue (CF), or loss of ability to empathize or feel compassion for others for whom one cares, is a growing concern for emergency physicians (EP). EPs, by the nature of their jobs, work under unpredictable conditions at odd hours with high levels of exposure to traumatic events. They are placed under substantial psychological, physical, and cognitive pressure, with little opportunity to recover or reflect. CF occurs when this workplace stress leads to feelings of being overwhelmed, helpless, unsupported, and unable to cope. Additionally, primary traumatic stress from threats of workplace violence and secondary traumatic stress (STS) from witnessing the suffering of others increase the likelihood of developing CF. Unchecked, this progression to CF causes reduction in quality of care to patients, reduction in patient satisfaction, increased levels of EP depression and anxiety, increased levels of EP substance use, and increased attrition from the specialty. To truly improve CF, individuals and organizations should be aware of the contributors to CF: namely, emotional exhaustion, depersonalization, primary and STS, and personal achievement. EPs should maximize their resilience to CF by using cognitive behavioral techniques and mindfulness, taking care of their physical health, seeking meaning and development within their work, developing hobbies outside of work, and creating boundaries between work and home. Organizations should actively address the known drivers of physician burnout: workload and job demands, efficiency and resources, meaning in work, culture and values, control and flexibility, work community, and work-life integration. Organizations should also provide adequate safety within facilities to reduce the threat of primary trauma and should supply adequate support and destigmatization for post-traumatic symptoms for EPs suffering from STS.