Viewpoint: healthcare workers face 'moral injury,' not just burnout

The term "burnout" understates the struggles of healthcare professionals — "moral injury" is a more accurate attribution, psychologist Jessica Jackson, PhD, clinical strategy manager for mental health equity at Modern Health wrote in a Dec. 3 viewpoint

Dr. Jackson served as a hospital psychologist in Houston during COVID-19 and the murder of George Floyd. These incidents "wounded" her soul, she wrote, as she could not protect her patients from the ongoing outside trauma. Such moral injuries —  caused when "we perpetrate, bear witness to or fail to prevent an act that transgresses our deeply held moral beliefs" — run deeper than burnout, and are common among healthcare workers, according to Dr. Jackson. 

Healthcare workers may experience moral injury when factors outside of their control prevent them from doing their jobs to the best of their ability. For example, "a nurse or physician during the pandemic may have been unable to deliver the care they took an oath to provide due to severe understaffing, bureaucratic red tape or systemic issues outside their control," Dr. Jackson wrote. 

Moral injury can also affect leaders who are forced to make difficult decisions, she wrote. Although they want their employees to keep their jobs, layoffs may be required to save the company. 

Leaders may not be able to eliminate moral injuries, but there are some ways they can lessen the hurt, according to Dr. Jackson. They can encourage people to use their paid time off for rest, spark workplace conversations about non-workplace issues, provide outlets for employees to voice concerns and maintain transparency. 

Common "burnout" initiatives, like yoga and wellness apps, are unlikely to be effective in treating moral injury, according to Dr. Jackson. "You can’t self-care your way out of moral injury, and sometimes individually-focused solutions to systemic problems only add an insult to injury," she wrote.

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