Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.
Clin J Am Soc Nephrol. 2021 May 8;16(5):829-837. doi: 10.2215/CJN.08400520. Epub 2021 Jan 7.
Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.
大规模灾害会导致广泛的健康问题，并使医疗服务难以开展，这在 COVID-19 大流行期间已经得到了体现。尽管 COVID-19 最初被认为是一种肺部问题，但很快就清楚地表明，还有其他各种器官受到了影响。因此，许多医疗保健提供者，包括肾脏健康护理人员，都不堪重负或出现职业倦怠。这篇综述旨在描述大规模灾害中的职业倦怠范围，并通过将先前的经验扩展到 COVID-19 大流行，为肾脏病学人员提出具体的解决方案。职业倦怠（一种对与工作相关的压力的心理反应）已经是肾脏科常规实践中常见的问题，毫不奇怪，由于工作量增加和特定条件，再加上个人因素，在大规模灾害期间，职业倦怠更为常见。避免职业倦怠对于预防人员的心理和身体健康问题以及医疗事故、人员短缺和医疗服务提供不足至关重要，所有这些都会增加灾害的医疗负担。可以通过灾害前的组织措施来预防职业倦怠，包括制定总体计划和优化医疗基础设施，以及灾害特定措施，包括组织和个人措施。组织措施包括增加安全性、减少工作量和对医疗事故的恐惧、优化医疗人员配备和物资供应、激励人员、提供心理健康支持以及使工作环境具有灵活性。个人措施包括应对压力和问题情况的培训、减少情绪困扰的耻辱感以及保持身体健康。如果这些措施不足，就必须寻求外部帮助以避免低效的灾害医疗应对。通过实施这些措施来尽量减少职业倦怠，将改善医疗服务的提供，从而尽可能挽救更多的生命。
