Kapoor Sumit, Morgan Christopher K, Siddique Muhammad Asim, Guntupalli Kalpalatha K
1 Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
Am J Hosp Palliat Care. 2018 Oct;35(10):1337-1341. doi: 10.1177/1049909118768247. Epub 2018 Apr 4.
Increased exposure to deaths in the intensive care unit (ICU) generate grief among ICU staff, which remains unresolved most of the time. Unresolved grief becomes cumulative and presents a risk factor for burnout. "sacred pause" is a ritual performed at patient's death to honor the lost life and recognize the efforts of the health-care team.
To study the impact of the ritual of sacred pause on the attitudes and behaviors of the ICU physicians and nurses.
Ten-question online anonymous survey was sent to ICU physicians and nurses in the medical ICU of a tertiary care hospital in July 2017.
Thirty-four ICU team members completed the survey including 12 physicians and 22 nurses. Seventy sacred pause rituals were performed from July 2016 to June 2017. Seventy-nine percent respondents believed that the ritual brought closure and helped them overcome the feelings of disappointment, grief, distress, and failure after the death of their patient in ICU. Seventy-three percent agreed that the ritual has instilled and encouraged a sense of team effort. Eighty-two percent responded that the ritual makes their efforts feel appreciated. Many felt that the ritual should be a universal phenomenon in all ICUs. Only 55% respondents felt that the practice has a potential to decrease ICU burnout, many of them (42%) were undecided.
Sacred pause brings closure, prevents cumulative grief and distress, builds resilience, promotes team effort, and improves professional satisfaction of ICU team. It may lower burnout syndrome in ICU, but further studies are warranted.
重症监护病房（ICU）内死亡病例的增加会使ICU医护人员产生悲伤情绪，而这种情绪大多时候得不到缓解。未缓解的悲伤情绪会不断累积，成为职业倦怠的一个风险因素。“神圣的停顿”是在患者死亡时举行的一种仪式，用以缅怀逝去的生命并认可医护团队的努力。
研究“神圣的停顿”仪式对ICU医生和护士态度及行为的影响。
2017年7月，向一家三级护理医院内科ICU的医生和护士发送了一份包含10个问题的在线匿名调查问卷。
34名ICU团队成员完成了调查，其中包括12名医生和22名护士。2016年7月至2017年6月期间共举行了70次“神圣的停顿”仪式。79%的受访者认为该仪式带来了结束感，并帮助他们克服了患者在ICU死亡后的失望、悲伤、痛苦和挫败感。73%的受访者同意该仪式灌输并鼓励了团队协作意识。82%的受访者表示该仪式让他们觉得自己的努力得到了认可。许多人认为该仪式应该在所有ICU成为普遍现象。只有55%的受访者认为这种做法有可能减少ICU的职业倦怠，其中许多人（42%）不确定。
“神圣的停顿”带来结束感，防止悲伤和痛苦情绪的累积，增强恢复力，促进团队协作，并提高ICU团队的职业满意度。它可能会降低ICU的职业倦怠综合征，但仍需进一步研究。
