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.
“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.
In this most recent article from Drs. Dean and Talbot, they explore the concept of mindfulness as a diagnostic, rather than treatment for moral injury.
What would happen if clinicians flipped the script on mindfulness, and instead of using it to tolerate a broken system, used it to sharpen awareness of the challenges?
Explore this with the doctors in their latest piece published on KevinMD below.
During this pandemic, most people have been grateful for the courage of medical workers. We have heard about the physical demands and emotional burnout they have suffered; but far less about moral injury.
In this episode, Dr. Keith Corl, an emergency and critical care physician offers a personal and professional understanding of moral injury of physicians, both before and during COVID-19. Listen to Voice America: Beyond Burnout: The Moral Injury of Doctors below!
Clinicians wade into the breach of COVID-19 without sufficient protection, even as their pay is cut, their protests gagged, their employment threatened, and as they watch their colleagues and friends fall ill.
We mustn’t lose sight of how moral injury is in the fabric of this pandemic.