1 in 5 American health care workers have left the profession since the pandemic hit. The pandemic has pushed what was already a tough situation into crisis mode. And as psychiatrist Wendy Dean sees it, this is more than just burnout.

Burnout and the burden of life-and-death decisions have driven some exhausted front-line staff to the edge. In this long-form piece by Financial Times writer India Ross, Dr. Wendy Dean lends her expertise as a psychiatrist and the framework of moral injury to contextualize the deep trauma facing healthcare workers today.

The country of the United States is experiencing complex trauma. That trauma is silently influencing how we think, how we make decisions, and how we act in powerful ways that are predictable to experts in psychological trauma, but often obscure to those in the midst of it.

Originally used to describe what soldiers experience in wartime, moral injury in health care began to be applied to health care even before the pandemic, says Wendy Dean, MD, a psychiatrist and the president and co-founder of Moral Injury of Healthcare, a nonprofit devoted to reframe clinician distress as moral injury — and to work to improve the source of it, which she and others say is the health care system itself.

Burnout and depression are still serious problems among physicians, especially amid COVID-19. More than 12,000 physicians told us how burnout has affected their relationships, career, and happiness. Dr. Wendy Dean helps frame this conversation with moral injury.

Wendy Dean, M.D., a psychiatrist and president and co-founder of Moral Injury of Healthcare, says that following the long period of rigorous training, focusing on independent, critical thinking with strict adherence to algorithms based on reimbursement policies can be grating.

In advance of a white paper collaboration with Moral Injury of Healthcare and Array Architects and Design, this article highlights a pivot in design and architecture to clinician centered design.

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.