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font-family: var(--bs-font-sans-serif);">欠缺支援的憤怒與傍徨 每日提心吊膽上班</strong></p><p style="text-align: justify;">YY做了護士約4年，她指年初時未有任何心理準備，便殺來第五波疫情。「突然一日之內要清空全層，以接收急症室病人。接下來的日子，我們要硬着頭皮摸索如何處理；應該將病人轉到亞博、其他醫院還是停留？都由我們決定。」</p><p style="text-align: center; "><img src="https://cms.jcthplus.org/wp-content/uploads/2022/07/%E6%9B%BE%E7%B6%93%E8%A9%A6%E9%81%8E%E6%9C%89%E6%B2%92%E8%87%AA%E7%90%86%E8%83%BD%E5%8A%9B%E7%9A%84%E5%85%AB%E6%97%AC%E7%97%85%E4%BA%BA%EF%BC%8C%E5%93%AD%E7%9D%80%E5%93%80%E6%B1%82%E5%A5%B9%E6%8F%9B%E7%89%87%EF%BC%8C%E6%8C%87%E5%85%A8%E6%97%A5%E6%B2%92%E6%9C%89%E6%9B%B4%E6%8F%9B%E9%81%8E%EF%BC%8C%E6%8E%92%E6%B3%84%E7%89%A9%E6%BA%A2%E6%BB%BF%EF%BC%8C%E7%9A%AE%E8%86%9A%E3%80%8C%E9%86%83%E5%88%B0%E6%90%8D%E6%9B%AC%E7%88%9B%E6%9B%AC%E3%80%8D%E3%80%82-11-1.jpg" alt="" style="width: 100%; max-width: 462px; height: auto; max-height: 82px;margin:auto"></p><p>她無奈指，醫院缺乏最重要的<strong>醫療資源、配套和人手</strong>，令醫護工作量百上加斤。「我們每天也冒着危險上班—— 病房是臨時變陣，屬於過渡性質，好多裝備都不符合標準；例如我們沒有正規，有雙重房門（double door）以防止病毒傳播的病房（infection ward）、醫護人員沒有穿全副裝備才工作、甚至連過濾病毒的空氣清新機也不足夠。」</p><p style="text-align: center; "><img src="/wp-content/uploads/2022/07/曾經試過有沒自理能力的八旬病人，哭着哀求她換片，指全日沒有更換過，排泄物溢滿，皮膚「醃到損曬爛曬」。-6-1.jpg" alt="" style="width: 100%; max-width: 434px; height: auto; max-height: 110px;margin:auto"><br></p><p style="text-align: center; "><img src="/wp-content/uploads/2022/07/（相片來源：PETER-PARKSAFP-via-Getty-Images）.webp" alt="Hong Kong Covid"><br></p><p>（相片來源：PETER PARKS/AFP via Getty Images）</p><p><br></p><p style="text-align: left; font-size: 20px;"><strong>見證病人被綁手綁腳 沒選擇權利</strong> </p><p>「變化太快太大，我們沒時間了解病人的真正需要，只能維持基本支援如一日三餐和換片。有些公公婆婆進了院，未能清楚發生什麼事，堅持要落床離開。我們只能依循醫院規則，使用安全背心或約束手帶，以防他們落床時跌倒。」</p><p>YY回憶指，高峰期一個病格塞滿八張床，三分二也是綁手綁腳、動彈不得的老人家，其實自己<strong>內心充滿驚恐和不安</strong>。「因為不夠人手看護病人，而要綁住他們，回想還是<strong>失落比憤怒佔據得多，因為每一更（shift）也有病人離世</strong><strong>，是我從未遇過的狀況，回想還是好心悒。</strong>所以信念是盡力做，救得幾多得幾多，讓他們健康出院，是當時唯一的心願。工作分秒必爭，我總是提醒自己上班要處於最佳狀態。往往都是放工時才突然覺得好攰好攰。」</p><p><br></p><p style="text-align: left; font-size: 20px;"><strong>病人受苦卻無能為力 僅完成最基本職責</strong></p><p>和YY不同，Sylvia是主動請纓加入北大嶼山醫院香港感染控制中心（HKICC）。為什麼要「偏向虎山行」？「在同一個崗位做了很久，想尋找新的挑戰，跳出comfort zone。」</p><p>做了8年護士，Sylvia相信第五波是她人生所經歷最惡劣的情況。臨時過渡醫院的設計是供有自理能力的患者隔離，原本每兩位姑娘負責72個外來輸入確診個案，如入境外國人、機組人員、外籍女傭，患者有自理能力；第五波時，卻一日內轉型，接收整間老人院的老人家，變成<strong>兩位姑娘處理近百名沒有自理能力的長者</strong>。</p><p><img src="/wp-content/uploads/2022/07/CREDIT-PETER-PARKSAFP-via-Getty-Images.jpeg" alt="Hong Kong Covid"><br></p><p style="text-align: justify;">（相片來源：PETER PARKS/AFP via Getty Images）</p><p style="text-align: justify;">Sylvia形容情況十分「地獄」—— 嚴重欠缺人手，護理質素急轉直下。「<strong>如果當天病人還生存，沒有去世，已經是好叻了</strong>。資源基本上是『要乜冇乜』，連尿片和聞氧氣的面罩也不足夠，要自己土炮製作，在紙杯剪窿，當作面罩。」</p><p style="text-align: center; "><img src="https://cms.jcthplus.org/wp-content/uploads/2022/07/%E6%9B%BE%E7%B6%93%E8%A9%A6%E9%81%8E%E6%9C%89%E6%B2%92%E8%87%AA%E7%90%86%E8%83%BD%E5%8A%9B%E7%9A%84%E5%85%AB%E6%97%AC%E7%97%85%E4%BA%BA%EF%BC%8C%E5%93%AD%E7%9D%80%E5%93%80%E6%B1%82%E5%A5%B9%E6%8F%9B%E7%89%87%EF%BC%8C%E6%8C%87%E5%85%A8%E6%97%A5%E6%B2%92%E6%9C%89%E6%9B%B4%E6%8F%9B%E9%81%8E%EF%BC%8C%E6%8E%92%E6%B3%84%E7%89%A9%E6%BA%A2%E6%BB%BF%EF%BC%8C%E7%9A%AE%E8%86%9A%E3%80%8C%E9%86%83%E5%88%B0%E6%90%8D%E6%9B%AC%E7%88%9B%E6%9B%AC%E3%80%8D%E3%80%82-7-1.jpg" alt="" style="font-family: var(--bs-font-sans-serif); font-size: 1rem; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); width: 425px; max-width: 425px; max-height: 122px;margin:auto"></p><p>Sylvia指大家忙到崩潰：「返工完全冇時間食飯、去廁所是奢侈、不敢請假。每日都唔想返工，收工會打給同事和家人喊，真正『返到想死』。」</p><p><img src="/wp-content/uploads/2022/07/CREDIT：Marc-Fernandes-Getty-Image-.webp" alt="Hong Kong Covid" style="width: 100%; max-width: 904px; height: auto; max-height: 603px;"><br></p><p>（相片來源：Marc Fernandes / NurPhoto via Getty Images）</p><p><br></p><p style="text-align: left; font-size: 20px;"><strong>什麼是悲憫心疲勞（compassion fatigue）？</strong></p><p>對於提供支援服務的職業而言，長期運用自身資源（包括體力及心理資源）去支援他人，或是<strong>承載他人的情緒及苦難</strong>，都可造成情緒上的超載，導致悲憫心疲勞。</p><p style="text-align: center; "><img src="/wp-content/uploads/2022/07/曾經試過有沒自理能力的八旬病人，哭着哀求她換片，指全日沒有更換過，排泄物溢滿，皮膚「醃到損曬爛曬」。-10-1.jpg" alt="" style="width: 100%; max-width: 430px; height: auto; max-height: 130px;margin:auto"><br></p><p>悲憫心疲勞的症狀和<strong>工作過勞相似</strong>，包括身心感到疲累、焦慮或麻木、情感上的疏遠和失去滿足感等。不同之處是，悲憫心疲勞是由長期感受和理解他人的情緒所造成。</p><p>有研究歸納出醫療人員的主要壓力來源：</p><p style="text-align: center;"><img src="https://cms.jcthplus.org/wp-content/uploads/2022/07/%E6%9B%BE%E7%B6%93%E8%A9%A6%E9%81%8E%E6%9C%89%E6%B2%92%E8%87%AA%E7%90%86%E8%83%BD%E5%8A%9B%E7%9A%84%E5%85%AB%E6%97%AC%E7%97%85%E4%BA%BA%EF%BC%8C%E5%93%AD%E7%9D%80%E5%93%80%E6%B1%82%E5%A5%B9%E6%8F%9B%E7%89%87%EF%BC%8C%E6%8C%87%E5%85%A8%E6%97%A5%E6%B2%92%E6%9C%89%E6%9B%B4%E6%8F%9B%E9%81%8E%EF%BC%8C%E6%8E%92%E6%B3%84%E7%89%A9%E6%BA%A2%E6%BB%BF%EF%BC%8C%E7%9A%AE%E8%86%9A%E3%80%8C%E9%86%83%E5%88%B0%E6%90%8D%E6%9B%AC%E7%88%9B%E6%9B%AC%E3%80%8D%E3%80%82-12-3.jpg" alt="" style="max-width: 419px; font-family: var(--bs-font-sans-serif); font-size: 1rem; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); width: 419px; max-height: 206px;margin:auto"><br></p><p>另外，亦有研究指出，<strong>職場行政因素</strong>是減低悲憫心疲勞的關鍵：<br></p><ol><li>一個理想的工作環境（清晰的溝通、充足的專業自主權、心理支援和日常支持，都能提升護士士氣）、<br></li><li>適切的工作量、<br></li><li>提高員工的工作滿意度。<br></li></ol><p>面對病人的痛苦，Sylvia的態度是「做得幾多得幾多，已經盡力；做不到會好心悒，但也沒有辦法。」問到她可曾見過悲憫心疲勞？Sylvia指「唔多唔少都見過，太忙碌下要對病人的要求視而不見。」她認為<strong>難以應付的工作量和個人心態</strong>是悲憫心疲勞的來源。</p><p style="text-align: center; "><img src="https://cms.jcthplus.org/wp-content/uploads/2022/07/%E6%9B%BE%E7%B6%93%E8%A9%A6%E9%81%8E%E6%9C%89%E6%B2%92%E8%87%AA%E7%90%86%E8%83%BD%E5%8A%9B%E7%9A%84%E5%85%AB%E6%97%AC%E7%97%85%E4%BA%BA%EF%BC%8C%E5%93%AD%E7%9D%80%E5%93%80%E6%B1%82%E5%A5%B9%E6%8F%9B%E7%89%87%EF%BC%8C%E6%8C%87%E5%85%A8%E6%97%A5%E6%B2%92%E6%9C%89%E6%9B%B4%E6%8F%9B%E9%81%8E%EF%BC%8C%E6%8E%92%E6%B3%84%E7%89%A9%E6%BA%A2%E6%BB%BF%EF%BC%8C%E7%9A%AE%E8%86%9A%E3%80%8C%E9%86%83%E5%88%B0%E6%90%8D%E6%9B%AC%E7%88%9B%E6%9B%AC%E3%80%8D%E3%80%82-5-1.jpg" alt="" style="font-family: var(--bs-font-sans-serif); font-size: 1rem; max-width: 424px;margin:auto caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); width: 424px; max-height: 126px;margin:auto"></p><p style="text-align: justify;">而<strong>「追更文化」</strong>，亦是護士身心靈疲憊的主要原因。追更指，例如今天的更表是0700-1500，下一更是同日2100-翌日0700，回家梳洗短睡四五小時便要上班，影響睡眠質素及精神狀況。</p><p style="text-align: center;"><img src="https://cms.jcthplus.org/wp-content/uploads/2022/07/%E6%9B%BE%E7%B6%93%E8%A9%A6%E9%81%8E%E6%9C%89%E6%B2%92%E8%87%AA%E7%90%86%E8%83%BD%E5%8A%9B%E7%9A%84%E5%85%AB%E6%97%AC%E7%97%85%E4%BA%BA%EF%BC%8C%E5%93%AD%E7%9D%80%E5%93%80%E6%B1%82%E5%A5%B9%E6%8F%9B%E7%89%87%EF%BC%8C%E6%8C%87%E5%85%A8%E6%97%A5%E6%B2%92%E6%9C%89%E6%9B%B4%E6%8F%9B%E9%81%8E%EF%BC%8C%E6%8E%92%E6%B3%84%E7%89%A9%E6%BA%A2%E6%BB%BF%EF%BC%8C%E7%9A%AE%E8%86%9A%E3%80%8C%E9%86%83%E5%88%B0%E6%90%8D%E6%9B%AC%E7%88%9B%E6%9B%AC%E3%80%8D%E3%80%82-9-1.jpg" alt="" style="width: 100%; max-width: 419px; height: auto; max-height: 134px;margin:auto"><br></p><p>有研究發現，所有受訪者都認為悲憫心疲勞是有跡可尋的，<strong>先兆是在休閒時失去活力</strong>，演化至工作時也失去能量，只能在體力上而非情緒上照顧病人。悲憫心疲勞不只令護士在工作時身心筋疲力盡，這份麻木更會不自覺帶到<strong>個人生活和自我價值</strong>等層面；除了工作時對病人產生冷漠和不誠懇的態度，也可能會將不耐煩、恐懼、自我批評和惱怒的情緒帶到個人生活，如對待家人和伴侶。</p><p>名作《旁觀他人之苦》有句：「悲憫心是一個浮動的情緒，需要被轉化成行動才不會枯萎。」（“Compassion is an unstable emotion. It needs to be translated into action, or it withers.）但當感受和減輕他人之苦，成了你工作的一部分，在長年累月下，如何能避免麻木不枯萎？</p><p>然而危中有機，悲憫心疲勞亦能轉化成<strong>自我察覺</strong>的良機，提醒服務提供者以自我關懷，照顧悲憫心疲勞的自己，專注靈魂的虛耗。有興趣了解更多排解悲憫心疲勞的方法，請密切留意我們的文章和<a href="https://www.jcthplus.org/event/public-webinar-on-compassion-fatigue_all-members">講座</a>，學習以自我慈心和<a href="https://www.jcthplus.org/article/what-is-mindfulness-2">其他方法</a>照顧自己。 </p><p>願一眾服務提供者們，在照顧別人時，亦有空間讓自己的心靈喘息。</p><p><br></p><p><strong>參考資料：</strong></p> <p class="apa"> Strauss, C., Lever Taylor, B., Gu, J., Kuyken, W., Baer, R., Jones, F., & Cavanagh, K. (2016). What is compassion and how can we measure it? A review of definitions and measures. Clinical psychology review, 47, 15–27. <a class="reference" href="https://doi.org/10.1016/j.cpr.2016.05.004">https://doi.org/10.1016/j.cpr.2016.05.004</a> </p> <p class="apa"> Turgoose, D., & Maddox, L. (2017). Predictors of compassion fatigue in mental health professionals: A narrative review. Traumatology, 23(2), 172. <a class="reference" href="https://psycnet.apa.org/record/2017-09426-001">https://psycnet.apa.org/record/2017-09426-001</a> </p> <p class="apa"> Gustafsson, T., & Hemberg, J. (2022). Compassion fatigue as bruises in the soul: A qualitative study on nurses. Nursing ethics, 29(1), 157–170. <a class="reference" href="https://doi.org/10.1177/09697330211003215">https://doi.org/10.1177/09697330211003215</a></p><p><br></p><p><br></p><p><br></p><p><br></p> </div> <div class="flex flex-row flex-wrap justify-start my-6 gap-3 mt-5 overflow-x-scroll no-scrollbar"> <div class="rounded-full h-7 flex items-center justify-center px-3 border border-primary text-primary font-medium leading-tight">人物專題</div> <div class="rounded-full h-7 flex items-center justify-center px-3 border border-primary text-primary font-medium leading-tight">從社會看心理健康</div> <div class="rounded-full h-7 flex items-center justify-center px-3 border border-primary text-primary font-medium leading-tight">有關職場</div> </div> <div class="bg-primary-lightest rounded-3xl p-6 flex flex-row"> <img src="/wp-content/uploads/2024/09/emoji_calm-96x96.webp" class="h-12 w-12 sm:h-16 sm:w-16 rounded-full mr-4 md:mr-8 flex-shrink-0" alt="author profile pic"> <div class="flex-grow"> <p class="text-primary-dark text-base font-medium">Ruby Liu MY</p> <p class="text-primary-dark text-sm mt-2">「賽馬會心導遊+計劃」心理健康推廣主任</p> </div> </div> </div> <div class="hidden lg:flex relative w-88 flex-shrink-0 flex-col justify-start"> <div class="sticky top-20 flex flex-col items-stretch pl-16 xl:pl-24 pt-8 overflow-visible"> <div class="w-full h-44 overflow-hidden"> <img class="w-32 h-auto mx-auto" src="https://www.jcthplus.org/wp-content/themes/1.0/assets/images/tour-guide-boon-zh.png" alt="Boon tour guide image"> </div> <div class="w-full bg-avatar-light rounded-xl flex flex-col p-5 items-center shadow"> <h4 class="text-primary-darker font-jinxuanlatte text-2xl leading-tight">免費登記</h4> <p class="text-primary-darker my-4 text-13 text-center">一站式心理自療平台，紓解情緒，照顧心理健康</p> <a href="/register" class="auth-url bg-primary w-full rounded-full text-white font-bold h-8 flex items-center justify-center px-5 mt-3 hover:bg-primary-dark">開始旅程</a> </div> <div class="flex flex-row items-center justify-center space-x-4 mt-7"> <button class="rounded-full w-8 h-8 flex items-center justify-center border" :class="is_favorited ? 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