Some experts call it "secondary PTSD" or "vicarious traumatization"; others prefer "compassion fatigue." The Army's term is "provider fatigue." Although it's not listed as an illness in the standard diagnostic manual, it can be seriously debilitating. Symptoms range from nightmares and "invasive thoughts" to anxiety, insomnia and hypervigilance. Case studies often mention a dread of work, including failure to keep appointments and carry out necessary follow-up with patients; in addition to absenteeism, effects often include errors in judgment, difficulty in concentrating, emotional numbness and religious doubts. The symptoms are part of everyday life to many Department of Veterans Affairs caregivers and to staff at military hospitals like the Walter Reed Army Medical Center.
The military is looking for solutions to the provider-fatigue problem. A 2006 internal advisory on health care for troops in Iraq reported that 33 percent of behavioral-health personnel (counselors and psychiatrists) and 45 percent of primary-care specialists (doctors and nurses) complained of high or very high burnout. The rate among chaplains was 27 percent. Last summer the Army launched a pilot "provider resiliency" program to help cope with secondary PTSD, and Maj. Edward A. Brusher of the U.S. Army Medical Command says the plan is to take the program worldwide. Landstuhl Regional Medical Center in Germany—usually the first stop for wounded troops coming out of Iraq—set up some of the first provider-fatigue workshops after the war began. Similar therapy groups are scheduled for May at Walter Reed.
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