The issue of burnout has been of concern within a variety of professions, including health care. There have been changes made in the training of young physicians to restrict the number of hours they can work at a time. More time off has also been added. Efforts to manage work-life balance have been more considered for physicians, nurses and other staff.
Then came COVID. It was a frightening time for everyone. Many in healthcare stepped up and people responded by thanking them and supporting them. Then it suddenly became political and things changed. This was an incredibly difficult time for those in the health system. Then, though we are back to more normal life again, I don’t know that we have returned to our already challenged baseline. We now have increased costs, supply shortages, staffing shortages, people leaving the profession. In some cases it has become more than what some can live with. Somehow things feel more unsettled, fragmented and challenging than every before. I can only describe the environment as feeling sort of “foul”. Patients are angry and impatient, staff sometimes seem frustrated and disconnected.
There is a story in the news right now. It is an unbelievable tragedy. A young beautiful nurse who took her own life. Thought we cannot know everything that was in her heart and mind, she did seem to be struggling within her speciality. This is not my area of expertise but like most, I care a lot and find this to be an unfathomable loss. This young woman is not the first and she won’t be the last unless we can begin to get our arms around what is happening.
Along with the obvious issues of staffing, stress, frustrated patients, people questioning good science, among other things…. there is discussion about moral distress. The idea that people are being required to do things that conflict with some of their most dearly held values. If you are working in an Emergency Department and the waiting room is full of very sick older people and you recognize that some of the zones are closed because we don’t seem willing to staff these areas it can begin to weigh on you. When you are asked to send people home that you believe need to be admitted because they don’t have insurance, that can make you feel that you are violating an oath you took when you entered medicine. There is a wonderful article from the NY TImes here.
I wish I had more answers here, but as we work things out let’s be sure to watch out for each other.
| Moral injury, a relatively new concept in healthcare, refers to the deep psychological distress experienced when an individual’s moral and ethical beliefs are violated. For healthcare providers, this may occur when they are unable to provide the level of care they believe their patients deserve due to system constraints, resource shortages or other factors beyond their control. The impact of moral injury is profound, leading to feelings of guilt, shame, and disillusionment. Many healthcare professionals experience a sense of betrayal by their organizations and struggle with the resulting emotional turmoil. The consequences of moral injury among healthcare providers are far-reaching. It can lead to burnout, decreased job satisfaction, and even early retirement from the profession. Furthermore, it can erode trust in the healthcare system and impede effective patient care. Addressing moral injury requires systemic changes within healthcare institutions to ensure that providers are not put in morally compromising situations. By acknowledging and addressing this issue, we can support our caregivers in delivering compassionate care while preserving their own well-being. |