Читать книгу Mitarbeitersicherheit ist Patientensicherheit - Группа авторов - Страница 6
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Dr. med. Ruth Hecker
Wir hören immer von Personalmangel und belastetem Personal in den deutschen Krankenhäusern. Es ist ein ewiger Kreislauf, der sich selbst unterhält. Das Thema des Second Victim / des Zweiten Opfers ist nicht neu. Es ist nicht neu, dass Mitarbeitende im Gesundheitswesen im Rahmen der Patientenbehandlungen selbst traumatisiert werden.
Die COVID-19 Pandemie hat das Dilemma nochmal deutlich verschärft.
Die wirklichen Ursachen und Bedingungen, die zu Second Victims führen, und die Möglichkeiten, daraus einen Ausweg zu finden, sind nur wenigen bewusst.
Das Buch »Mitarbeitersicherheit ist Patientensicherheit – Psychosoziale Unterstützung von Behandelnden im Krankenhaus« bringt dieses Thema in den richtigen Rahmen, klärt auf und bietet vor allem Lösungsansätze – auch aus der Schweiz und Österreich.
Es spricht jede Führungskraft im Gesundheitswesen – von der Teamleitung bis zum Top Management – an und zeigt die Verantwortlichkeiten auf. Mitarbeitende, die es lesen, verstehen sich und ihre Kollegen besser und können anschließend in Eigeninitiative besser agieren.
Mitarbeitende müssen sich sicher fühlen mit dem, was sie tun, sie benötigen sichere Rahmenbedingungen und ein unterstützendes Umfeld, nur dann können sie eine sichere Versorgung der Patienten gewährleisten.
In anderen Berufsfeldern ist es völlig normal, dass Teams und einzelne Mitarbeiter Unterstützung bekommen, z. B. durch regelmäßige Supervision oder andere Methoden der Stressbewältigung, die der Arbeitgeber anbietet. Für die Gesundheitsberufe sind derartige Angebote noch neu und die Kultur, Angebote anzunehmen, ist noch unterentwickelt.
Das Aktionsbündnis Patientensicherheit hofft, dass das Buch in den Krankenhäusern diskutiert und das Thema Second Victim aus der Tabuzone geholt wird. Die Inhalte machen Mut und könnten den Kreislauf unterbrechen! Nur Mitarbeitende und Teams, auf die seitens der Führungskräfte geachtet wird und die auf sich selbst achten, können auch auf Patienten achten.
| Dr. med. Ruth Hecker Berlin,Vorsitzende Aktionsbündnis Patientensicherheit e. V. | im März 2021 |
Prof. Dr. Albert Wu
Twenty years ago, when I first wrote about the »second victim«, I was not describing something new. Instead, I was calling attention to an experience that is familiar to virtually every clinician – the agonizing realization that you have made a serious mistake. Personally, I can recall with great clarity a specific incident in which I gave a patient an overdose of medication during a code. Humans have a limited repertoire of responses to traumatic events. When a patient is harmed, health care workers react with shock and grief, fear and guilt, shame and feelings of inadequacy. This is precisely what I felt.
Organized medicine has never done a good job of handling this issue. The first reaction has generally been to blame the individual closest to the incident. Healthcare would really like to distance itself from the possibility of error in medicine. The public, which would like to hope for the best, has been happy to join the conspiracy. But mistakes are inevitable, and when a patient is seriously harmed by health care, there will always be workers who are harmed psychologically. These are the second victims.
Prior to 2000, little had been written about this experience that is so familiar to providers and so central to medical practice. But naming is a tool that helps us think. In the ensuing decades, there has been growing acceptance of the phenomenon. The term has come into common use in health care – a Google search on »second victim« yields over a million results.
Our understanding of the problem has also expanded. We now know that is the system that creates safety and risk, and workers can be harmed by the same flaws in the system that contribute to harming patients. Research has shown that involvement in an error can have an adverse impact on a provider’s emotional well-being. This may lead to impaired functioning and burnout, and may increase the risk for additional errors. Some workers never recover entirely, and go on to develop post-traumatic stress disorder, or leave their job or profession.
It is now apparent that healthcare is a high-risk environment for health workers, virtually all of whom are at risk for emotional trauma. This includes not just physicians and nurses, but also other, less visible frontline workers, such as those in security, nutrition, and environmental services.
Importantly, we have learned that workers can be harmed by a broad range of stressful events in their work – not just by medical errors. These events include patient deaths and adverse outcomes that occur despite excellent care. They also include incidents in which there is no patient harm like near-misses, workplace violence, disagreements about decisions, and conflicts with others.
There has been some pushback against the term »second victim«. But it remains crucial to draw public attention to the importance of supporting health care workers. Organized health care has largely resisted the idea that healthy, happy workers will take better care of patients. Nevertheless, some institutions have developed innovative programs, many of them based on peer support and psychological first aid. These programs have gained momentum during the Covid-19 pandemic, which exposed the vulnerability of health workers and the vital need of supporting them.
I believe that this is the first book in German devoted to the second victim experience and strategies to deal with it. This timely volume, by Reinhard Strametz and colleagues, comes on the heels of the theme for WHO’s 2020 World Patient Safety Day, »Health Worker Safety: a Priority for Patient Safety«, and at the kickoff of the European Researchers’ Network on Second Victims (ERNST). The book provides a boost to the growing global initiative to reduce harm to health professionals. It is time for health care institutions to accept their obligation to support the well-being of their workers. Doing so will improve both worker resilience and their ability to deliver the quality of care their patients deserve.
| Albert W. Wu, MD, MPHProfessor, Johns Hopkins University Baltimore, Maryland, USA awu@jhu.edu | April 2021 |
