In our latest piece for STAT News, Drs. Dean and Talbot examine how it is time for leaders of hospitals and health care systems to add another, deeper layer of support for their staff by speaking out publicly and collectively in defense of science, safety, and public health, even if it risks estranging patients and politicians.
What exactly is moral injury – and how do we address the continued challenges faced by healthcare workers?
Moral Injury: An erosion of a person’s moral framework that results from violation(s), often leading to one questioning their field of practice or work as trustworthy or safe. This can often be thought of as providers having highly conflicting allegiances between work demands and the Hippocratic Oath.
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Researchers are concerned that nurses working in a rapidly changing crisis like the pandemic can develop a psychological response called “moral injury.”
“Probably the biggest driver of burnout is unrecognized unintended moral injury.”
In parts of the country over the summer, nurses got some mental health respite when cases declined, said Dr. Wendy Dean.
In this episode, Chris McDonald from Nothing Left to Give interviews Moral Injury of Healthcare Associate Elizabeth Holman, PsyD who is the palliative care psychologist at a Hospital in Colorado where she also serves on the ethics consult service. She is the handler of facility dog Tootsie and her research has focused on human-animal interactions.
Elizabeth shares her journey through burnout and how she overcame it. She describes what moral injury is, when it occurs and how it impacts healthcare providers. She describes the differences between burnout and moral injury. She also discusses ways providers can move through it.
In this episode of Moral Matters, Drs. Simon Talbot and Wendy Dean discuss their own experiences with personal challenges that led them to develop the framework of moral injury.
Do you have an experience that sounds similar? We want to hear from you.
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Conversations about moral injury in healthcare and elsewhere, how it affects us all, and the growing need for change, with the authors of the STATNews article that started it all, Wendy Dean, MD and Simon G. Talbot, MD. This is Episode 1: Introducing Moral Matters.
00:00 – Introduction
0:26 – Our goals
1:00 – Who we are
3:50 – What is the essence of distress?
4:15 – Resilient, but still burned out
5:26 – What is the right diagnosis?
6:30 – The genesis of Moral Injury
7:32 – Moral Injury’s relationship to burnout
11:00 – Defining Moral Injury
12:00 – Contributing factors
15:15 – Cross-pollination for innovative, thoughtful solutions
“The pandemic arrived to a healthcare system that’s already deeply in crisis,” said Wendy Dean, a psychiatrist and president of Moral Injury of Healthcare, a group that advocates for more sustainable medical workplaces. “All of the challenges that clinicians are facing prior to the pandemic are just highlighted, exacerbated, and added to.”
In this piece with Talkspace, Dr. Dean outlines some of the basics of moral injury prevention for individuals to take.
As always, our organization has resources available for organizations and individuals experiencing moral injury due to COVID-19.
In a recent article by Pratihba Gopalakrishna, a new study is discussed that focuses on burnout and how commonplace it may be. However, Drs. Wendy Dean and Simon Talbot believe the definition of burnout needs to be reexamined.
“If we’re going to talk about the condition of burnout, then we need to be much more rigorous about applying a strict definition and measure so that everybody’s talking about the same thing using the same scale,” said Wendy Dean, a psychiatrist and the co-founder of the nonprofit organization Moral Injury of Healthcare. Dean was not involved in the new research.
Read the full article on STAT News.
In this piece entitled A Yoga Mat Won’t Fix Your Moral Injury by Ira Bedzow, PhD, moral injury is explored by Dr. Bedzow as a medical ethicist.
But people who suffer from moral injury are not slogging through endless tasks, and they are certainly not losing interest and motivation–they are hurting. And their hurt comes from their perceived inability to meet personal and professional expectations and the moral accountability they feel by their sense of failure.
Drs. Wendy Dean and Simon G. Talbot are highlighted as the experts leading the way on solutions for moral injury. As Dr. Bedzow notes, yoga mats and meditation are not longterm solutions for moral injury.
In this segment with NPR’s Here and Now, Dr. Wendy Dean is interviewed by Amanda Peacher on the toll the COVID-19 crisis is taking on front line staff in hospitals.
Some psychiatrists are even manning a hotline to help their fellow healthcare workers. Listen in via the link below.