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15Организация учебно-воспитательного совета в воспитательных колониях является характерной особенностью данного вида исправительного учреждения. Законодатель, таким образом, подчеркивает педагогическую сущность воспитательных колоний, а также единство учебного и воспитательного процессов. Анализировалось состояние работы учебно-воспитательного совета. С этой целью по специально подготовленным методикам проводилось анкетирование председателей учебно-воспитательного совета, анализировались планы работы Советов. Членство представителей общественных и религиозных организаций, а также местных органов исполнительной власти в учебно-воспитательном совете Инструкцией не предусмотрено. Однако, осознавая важность их участия в работе с осужденными, а также то, что принцип комплексного подхода в процессе исправления и воспитания осужденных, отбывающих наказание в воспитательных колониях, реализуется в работе учебно-воспитательного совета, организованного в соответствии с УИК Российской Федерации и разделом 9 Инструкции.
Исследования ученых (И.И. Купцов, А.В. Митькина (Вилкова), и др.) показывают, что для несовершеннолетних осужденных характерны интеллектуальное отставание, закрытость, нездоровые нравственные начала и асоциальная направленность личности [2; 4].
Комплексный подход в воспитательных колониях реализуется в работе учебно-воспитательного
совета. Учебно-воспитательный совет - это высший коллегиальный орган, который действует постоянно, состоящий из сотрудников различных отделов и служб, администрации учреждения, а также представителей школы и профессионального училища, с целью рассмотрения различных вопросов организации деятельности воспитательных колоний.
Список литературы
1. Деев, В.Г. Характеристика направленности личности несовершеннолетних правонарушителей: учебно-практическое пособие / В.Г. Деев, А.И. Ушатиков: под ред. А.И. Высоцкого. - Рязань, 1978. - 97 с.
2. Купцов, И.И. Психологическая характеристика преодоления подростками недостатков собственного поведения: дис. ... канд. психол. наук / Купцов Иван Иванович. - Рязань, 1964. - 198 с.
3. Караковский, В.А. Школа будущего - это школа воспитания / В.А. Караковский // Народное образование. - 2007. - № 1. С. 205-206.
4. Митькина, А.В. Условия духовно-нравственного воспитания несовершеннолетних правонарушителей / А.В. Митькина // Философско-педа-гогические основания образования в России: история и современность: пятые Покровские образовательные чтения. - Рязань: Ряз. гос. ун-т им. С.А. Есенина, 2007. - С. 204-206.
5. Макаренко А.С. Соч. в семи томах. T.V. С.
177.
FEATURES OF EMOTIONAL BURNOUT OF DOCTORS AND NURSES IN INTENSIVE CARE
UNITS
Filshtinskaya E.,
Samara State Medical University senior lecturer of the Department of General psychology and health psychology
Aborina M.
Samara State Medical University assistant lecturer of the Department of General psychology and health psychology
Abstract
Doctors and nurses of intensive care units occupy a special position among medical specialties, which is due to the specifics of their activities, including regular emotional overload. In addition to the stress caused by professional activities, the mental state of resuscitators is affected by social factors and personal problems. The consequences of emotional overload affect both the work activity and the personality of the specialist. Most employees in intensive care units are characterized by certain symptoms of emotional burnout of varying degrees of severity.
Keywords: Resuscitation department employees, attitude to death, emotional burnout, emotional deficit, emotional detachment, depersonalization, psychosomatic disorders.
The work of medical stuff in intensive care units is one of the most difficult, both physically and emotionally, due to the following reasons [2]:
- intensive care unit patients are the most severe, often on the verge of life and death;
- the resuscitator «leads» the patient either to improve his condition and transfer to another Department, or to death, which is a strong psychotraumaticfactor;
- the resuscitator is forced to constantly scroll through the various options for the prognosis of each patient in his head, and therefore by the end of the duty,
emotional, intellectual and physical stress often leads to complete devastation;
- often the choice of the only correct solution is limited to an extremely short time interval, so the work of resuscitators in its intensity can be compared with the work of air traffic controllers;
- it is the staff of the intensive care unit that more often than doctors of any other profile have to witness the grief of relatives and friends of the deceased or accept their claims.
I.V. Zaseeva and co-authors conducted a comparative analysis of professional deformities of doctors
and nurses in intensive care units. The study found that doctors have a high level of emotional burnout more often than nurses, which may be associated with a high degree of responsibility for the patient's life. Doctors, in comparison with nurses, have higher indicators of activity, self-confidence and adventurism. The severity of the hermit reflects professional distancing. The emotional sensitivity of doctors is higher than that of nurses, they are more aggressive, which is considered by the authors as a discharge in response to difficulties in work. Among nurses, the indicators of drama, sensitivity, dedication to the profession, conscientiousness, altruism, seriousness and vigilance are higher. Complex that integrates altruism, seriousness, alertness, and conscientiousness is more pronounced in nurses, who also tend to have low values of adventurism. These qualities, on the one hand, are professionally significant, but on the other hand, they contribute to the development of burnout syndrome in nurses [3].
As a result of the study, A.N. Mamas and T.S. Kosarevskaya established a direct relationship between the severity of emotional burnout and professional experience, which indicates the undoubted destructive influence of this profession on the employee's personality. There is also a link with gender: women show symptoms of burnout significantly more clearly than men. The risk of developing emotional burnout of the resuscitator may increase in the following cases [4]:
- significant personal involvement in the work with insufficient positive assessment and recognition;
- conflict and tense situation in the team, weak support and frequent criticism from colleagues;
- lack of conditions for self-expression;
- dissatisfaction with the profession due to the error of its choice or inconsistency of professionally important qualities with the requirements of the profession.
If the doctor feels that he is not able to change anything, the probability of developing emotional burnout increases.
A.A. Baiturin notes that among the risk factors for maladaptation of resuscitators, the most common was psychoemotional stress, which leads to the development of health problems. About a third of the subjects complained of a variety of pain, chronic fatigue, decreased performance and activity, they were found to have a high level of anxiety, and about half suffered from sleep disorders that require medical correction [1].
The study was conducted based on the Department of General resuscitation and intensive care of the Samara regional clinical Oncology dispensary. The study sample consisted of 50 doctors and nurses of the Department. The experience of working in departments of this profile varied from 3 to 18 years. The study was carried out using the method «Profile of attitudes towards death» (P.T.P. Wong, G.T. Reker, G. Gesser) and the method of diagnostics of emotional burnout By V.V. Boyko. Mathematical analysis of the data was performed using the Mann-Whitney U-test and Spearman's rank correlation coefficient.
According to the results, the leading symptom of the stress phase in doctors is the indicator of self - dissatisfaction, which is at the stage of formation (14,8
points), and in nurses-the experience of psychotrau-matic situations (15,2 points), which is also only developing. Self-dissatisfaction develops as a result of failures in professional activities or the inability to change certain circumstances. In severe cases, the energy of negative emotions is directed towards yourself rather than outside. The experience of psychotraumatic situations is manifested in the subject's awareness of difficult psychotraumatic factors of the profession. There is an accumulation of despair and resentment.
The symptom of inadequate selective emotional response is at the stage of formation and is the leading resistance factor in both doctors (14,5 points) and nurses (15 points) of the intensive care unit. This symptom is expressed in the fact that the employee inadequately «saves» on emotions, limits the return of emotions due to selective emotional response in various professional contacts. Despite the unacceptability of this style of emotional behavior in professions of the socionomic type, the subject believes that he behaves in an acceptable way. This restriction of the intensity and range of emotions displayed by the subject is seen by the communication partners as disrespectful to their personality. Patients may consider the doctor or nurse rude, indifferent, indifferent to their pain and problems, without understanding the essence of the emotional changes taking place.
The leading symptom of the exhaustion phase in doctors is emotional detachment (13 points), which is at the stage of formation, and in nurses - a symptom of emotional deficit (16 points), which is at the stage of an established symptom. The severity of the symptom of emotional deficit in nurses is significantly higher than in doctors (p<0,05).
The symptom of» emotional detachment « in doctors is that the specialist consciously almost completely excludes emotions from the field of his professional activity and begins to work like an automaton. In other areas of his life, he continues to live with vivid emotions.
The symptom of «emotional deficit» in nurses is manifested in the feeling that they can no longer emotionally support patients, are not able to empathize, participate, and enter into their situation. There is irritability, resentment, rudeness, harshness towards patients.
The results of the study of emotional burnout were compared with the identified types of attitude of medical workers to death. This type of acceptance of death consists in the belief that death frees a person from physical or psychological pain and suffering. It reflects obvious or hidden suicidal tendencies. Values of this type are inversely correlated with emotional disorientation (rs=-0,327, with p<0,05), emotional deficit (rs=-0,283, with p<0,.01), and the presence of psychosomatic disorders in the structure of burnout syndrome (rs=-0,362, with p<0,01).
An emotionally disoriented employee not only realizes that they are not showing proper emotional attitude to patients, they also justify themselves by reducing their emotional involvement. He admits that he is not able to enter into their situation, participate and empathize, and does not try to do so. The very idea of serious patients causes deterioration of physical health,
relapses of chronic diseases. According to the data obtained, accepting death to get rid of suffering and problems is typical for those health workers who take the pain of patients to heart.
It is necessary to pay attention to work on prevention and correction of emotional burnout of employees of intensive care units. Prevention of burnout can be achieved by training medical professionals in communication, interaction, and self-regulation techniques. A significant role in the prevention of burnout syndrome is played by experience exchange groups that allow participants to expand their field of view on a particular problem, change their approach, and develop new behavioral patterns.
References
1. Bajturin A.A. The psychosomatic state of the resuscitator as a risk factor in the provision of resuscitation care [Psihosomaticheskoe sostoyanie reanima-tologa kak factor riska pri okazanii reanimacionnoj
pomoshchi] // Medicinskij zhurnal Zapadnogo Kazah-stana. - 2012. - №4(36). - P. 115-116.
2. Dubovik P.L., Vartanov V.YA., Hlebnikov B.A. et al. Burnout syndrome in anesthesiology-resus-citation [Sindrom emocional'nogo vygoraniya v anesteziologii-reanimatologii] // Tol'yattinskij medicinskij konsilium. - 2011. - № 3. - P. 55-60.
3. Zaseeva I.V., Tatrov A.S. Comparative analysis of burnout syndrome in doctors and nurses of the department of anesthesiology and intensive care in the region [Sravnitel'nyj analiz sindroma emocional'nogo vygoraniya u vrachej I medicinskih sester otdeleniya anesteziologii i reanimacii v usloviyah regiona] // Fun-damental'nye issledovaniya. - 2013. - № 6. - P. 184189.
4. Mamas' A.N., Kosarevskaya T.E. Investigation of burnout syndrome in anesthesiologists-resusci-tators [Issledovanie sindroma emocional'nogo vygoraniya u vrachej anesteziologov-reanimatologov] // Novosti hirurgii. - 2010. - № 6. - P. 76-83.
