Hello. Welcome. In this video we will tell you which are the alert signs which tell us a provider is being affected by his job. Providers, as everybody, suffer different kinds of stress. There's the normal stress of doing a job, a kind of job in an emergency situation, this adrenaline that activates us and helps us working properly and being aware. Then there's the healthy stress which would help us working. Then there's the work stress type, the one which involves those small tensions with our boss or such as we don't agree with our salary or our work conditions. Then we have the accumulative stress type, the fact that we will carry all these interventions we have made, all this stress we have lived. And finally, the emergency's own stress. As people are living the stressful situation, the participant also suffers it just for being there. And what do we see in the participant? What can happen to him? We have the image of a provider who doesn't know the meaning of "give up", with a shield that makes him totally immune to other people's emotions, to the catastrophic situation around him, but is it really this way? Are participants really not affected by everything happening around them? Well, a good provider knows how to take care of himself and what to do so that all this doesn't affect him in his daily life or work. As we have seen in previous videos, some self-care techniques and guidelines, but sometimes these techniques aren't enough or aren't applied, and then aid providers might develop some kind of symptomatology. What can be a signal that something isn't fine? Well, we can see signals during the assistance or during the assistance. It's possible that when we are assisting in the emergency we realize we have symptoms similar to the ones we have explained during the acute stress disorder, maybe physical such as fatigue, enervation, stomachache, headache, nausea; cognitive symptoms such as not being able to focus, having memory problems, finding difficult to make simple tasks we usually do without big efforts in our job, such as organizing things or taking quick decisions. Also emotional symptoms, which we have divided in two blocks: a block which is those feelings of invulnerability, of euphoria for being alive, for being helping, assisting in an emergency to save people, to help people, what we would call Superman's syndrome, and then we have other symptoms which would be more related to exhaustion due to compassion, which are all those symptoms in which there is a deep empathy with victims. We can see emotional symptoms such as irritability, sadness, dejection, alienation, failure, all these symptoms we can also see in victims. After the emergency there's a series of alert signs both coordinators and partners can detect to help the person who's feeling bad. To begin, any use or abuse either of alcohol and addictive substances, which some people usually use to calm down the memory of the experience, these symptoms we had talked about, of avoiding places and locations, in assistants and sometimes in persons and victims we tend to turn to alcohol or substances which make they forget or ease them deleting the lived experience from their memories. We can also see, in this post-assistance, boredom, having to face ordinary tasks and jobs. Once assistance providers aren't always in the emergency and even more if they are volunteers which usually have a job which has nothing to do with the emergency job itself. So the fact of having to go back to these ordinary jobs, let's call them office jobs, find them boring, don't feel like doing them, there's a strong sadness and melancholy feeling, somehow they aren't comfortable and they would prefer being in the emergency. If we talk about assistance providers and assistance groups in emergencies, sometimes you have the feeling that they are superior. People who has assisted have a superiority feeling with those who haven't assisted because it wasn't their turn, because we always do it by turns. We have talked on exhaustion produced by compassion, this exhaustion would be the burn out, the emergency providers' burning syndrome and it would be analogous to the secondary post-traumatic stress disorder, that disorder we get from being in contact with someone who has really been traumatized and who has lived this traumatic experience. As we said, people who suffer this exhaustion due to compassion experience the same symptoms as the people they have assisted. We would have both physical symptoms as malaise and emotional symptoms such as anxiety, fear, hyperactivity, all these symptoms we had explained for acute stress disorder and post-traumatic stress disorder with people who have lived an emergency or a crisis. Here assistance providers would be living it without having suffered this emergency directly. Finally it's important to remember, as in previous cases, that these alert signs will be so when there is really an effect on this person. If we detect one of those alert signs we must be aware of whether the different areas of this person's life are affected. The work, social and familiar area. There's a lot of people, a lot of assistance providers who have problems at home because sometimes the need of repeating the story once and again, and repeating this can generate tension between the couple. See if it doesn't only affect it but also his normal job and if he is also avoiding his friends, avoiding social situations. Also in the temporal point, remember, whenever it's more than four weeks. Most of these symptoms would be normal after a traumatic event even for an assistance provider. That's why the defusing and debriefing techniques we have explained in previous videos are so important.