A commentary on moral injury among health care providers during the COVID-19 pandemic.

Borges, Lauren M.; Barnes, Sean M.; Farnsworth, Jacob K.; Bahraini, Nazanin H.; Brenner, Lisa A.

doi:10.1037/tra0000698

Cited by 89 publications

(96 citation statements)

References 13 publications

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“…As a result of this decision the nurse may experience feelings such as guilt, shame, or remorse, which will negatively affect all aspects of life. Although the health worker tells himself/herself that he/she is following the protocol and doing his/her best, he/ she will think that he/she has violated moral values [14,52].…”

Section: Moral Injurymentioning

confidence: 99%

Section: Moral Injurymentioning

confidence: 99%

“…All healthcare workers and all frontline workers such as emergency first responders are subject to moral injury during this time [51,52]. However, the measurement tools and studies to diagnose the painful and powerful internal struggles experienced by healthcare workers during the COVID-19 pandemic and the resulting moral injury are insufficient [52,53], although some scales have been developed to describe this process [22,26]. Moral injury negatively affects ability to COVID- 19 Pandemic and Mental Health of Nurses: Impact on International Health Security DOI: http://dx.doi.org/10.5772/intechopen.96084 function and performance; it can also lead to depression and post-traumatic stress disorder [5,52].…”

Section: Moral Injurymentioning

confidence: 99%

“…However, the measurement tools and studies to diagnose the painful and powerful internal struggles experienced by healthcare workers during the COVID-19 pandemic and the resulting moral injury are insufficient [52,53], although some scales have been developed to describe this process [22,26]. Moral injury negatively affects ability to COVID- 19 Pandemic and Mental Health of Nurses: Impact on International Health Security DOI: http://dx.doi.org/10.5772/intechopen.96084 function and performance; it can also lead to depression and post-traumatic stress disorder [5,52]. In addition, nurses are prone to quit their jobs if they feel that they are not sufficiently supported by organizations and the government [14].…”

Section: Moral Injurymentioning

confidence: 99%

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COVID-19 Pandemic and Mental Health of Nurses: Impact on International Health Security

Üstün¹

2021

Contemporary Developments and Perspectives in International Health Security - Volume 2

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COVID-19 was first detected in Wuhan, China, in December 2019 and spread rapidly in many other countries. This situation, defined now as a pandemic, has turned into a worldwide public health problem that threatens health security, especially that of healthcare professionals. Nurses, particularly those at the forefront of healthcare and directly involved in COVID-19 patient care, have been affected not only physically but also mentally. Because nurses have longer communication and interaction times with patients, they are more concerned about becoming infected or infecting others. Nurses have the highest level of occupational stress compared to other groups and are accordingly subjected to anxiety and depression. For many reasons such as intense working hours, working in a shift system, an insufficient number of personnel, severe conditions of the unit, being in constant contact with patients and their relatives and showing intense empathy for them, nurses experience primary and secondary traumatic stress, job burnout, compassion fatigue, and moral injuries. For this reason, conducting appropriate prevention activities and planning prevention strategies for future pandemic situations is important to support nurses psychologically and to protect their mental health.

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Section: Moral Injurymentioning

confidence: 99%

Section: Moral Injurymentioning

confidence: 99%

Section: Moral Injurymentioning

confidence: 99%

Section: Moral Injurymentioning

confidence: 99%

See 2 more Smart Citations

COVID-19 Pandemic and Mental Health of Nurses: Impact on International Health Security

Üstün¹

2021

Contemporary Developments and Perspectives in International Health Security - Volume 2

View full text Add to dashboard Cite

show abstract

“…Moral distress and injury may be associated with perceptions of unjust allocation of ventilators or other scarce resources, inability to provide seemingly necessary treatment (e.g., nebulized medications) due to institutional policy and/or concern for virus transmission, and inability to allow families to visit loved ones (in some cases, even at the end of life). [28,29] Elevated levels of distress might also be attributed to working conditions (e.g., PPE shortages, uncomfortable PPE, and long work hours), fears of becoming infected or transmitting the virus to others, and the stress of treating unstable patients with limited evidence to guide decision-making. [16,30] Furthermore, during the COVID-19 pandemic, HCWs are not only being exposed to novel stressors in the workplace, but also outside the workplace.…”

Section: Mental Health Concerns Of Front-line Hcws During the Pandemicmentioning

confidence: 99%

Should health care institutions provide job accommodations for health care workers with serious mental health concerns during the COVID-19 pandemic?

Villagran

Malek

Schneider

et al. 2020

JHA

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As the Coronavirus Disease 2019 pandemic continues, increased attention has been given to its mental health impacts on frontline health care workers. There is a consensus, consistent with established standards applicable to the duty to treat, that health care workers who are especially vulnerable to risk of physical harm should be provided job accommodations to reduce their risk of disease exposure, but it is unclear whether health care workers should be provided similar accommodations if their vulnerability relates specifically to mental health concerns. Especially given emerging evidence that the pandemic is taking a heavy toll on the mental health of health care workers, this issue should be included in policy conversations involving support of health care workers and provision of resources to them during the pandemic. Arguments in favor of expanding accommodations to those with mental health concerns include institutions’ ethical duty to protect vulnerable workers and not discriminate against their employees, as well as broader consideration of the consequences of not providing accommodations, both for health care workers and patients.

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What Should Clinicians Who Care for Police Officers Know About Moral Injury?

Blumberg¹

2022

AMA Journal of Ethics

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Police officers and clinicians are exposed to a broad range of moral risks in the field. When they perceive that a moral transgression has been committed by an agent responding to those risks, they are susceptible to moral injury. This article canvasses situations that can generate moral injury and describes symptom profiles of moral injury in law enforcement personnel, which tend to be more diverse than those in military personnel. This article also offers recommendations to clinicians who work with and care for police officers experiencing moral injury regarding symptom identification, recovery, and possible prevention.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Moral Injury in PolicingAccording to Litz et al, "Potentially morally injurious events, such as perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations might be deleterious in the long-term, emotionally, psychologically, behaviorally, spiritually, and socially (what we label as moral injury)." 1 Although the risk of moral injury among police officers might not be significantly different from that of members of other helping professions, the present paper focuses specifically on the circumstances that police officers face, which make them susceptible to transgressions that result in moral injury. It is important for clinicians who treat police officers and for those who work in the field of tactical medicine to understand moral injury, how it affects police officers, and how it follows from other moral risks.Somewhat surprisingly, moral injury in policing has not received much empirical attention. The term originates from work with military service members and veterans. 1 Combat situations, in which service members engage in and are exposed to violence and experience its aftermath, are commonly identified as potentially morally injurious events (PMIEs). There is some overlap between moral injury and posttraumatic stress disorder (PTSD). One criterion for the diagnosis of PTSD is exposure to actual or threatened death, actual or threatened serious injury, or actual or threatened sexual violence. 2 In law enforcement, reported incidence rates of PTSD have varied journalofethics.org 132

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A commentary on moral injury among health care providers during the COVID-19 pandemic.

Cited by 89 publications

References 13 publications

COVID-19 Pandemic and Mental Health of Nurses: Impact on International Health Security

COVID-19 Pandemic and Mental Health of Nurses: Impact on International Health Security

Should health care institutions provide job accommodations for health care workers with serious mental health concerns during the COVID-19 pandemic?

What Should Clinicians Who Care for Police Officers Know About Moral Injury?

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