Moral Injury and Healthcare Providers

Many of us have heard of healthcare fatigue. The “burnout”, “overwhelmed” feelings that nurses, doctors, and healthcare staff experience from long shifts and stressful circumstances. Healthcare fatigue is a common term that has long been plaguing the halls of our hospitals as patient populations and disease processes increase. Some medical facilities have implemented wellness programs that promote healthy lifestyle activities and offer employee discounts at various gyms. However, the COVID-19 time period is beyond healthcare fatigue.

COVID-19 has taken healthcare fatigue and turned it upside down. The frontline workers who are facing some of the illest patients that they have encountered are left questioning their medical knowledge and skill. To make the situation worse, our healthcare workers are often met with dwindling supplies of protective equipment. This leaves our heroes not only fearing for their patient’s safety but also for themselves and their own families.

A term that was coined for our Vietnam Veterans returning home in the 1970’s has been recently applied to the mental and emotional toll that our current day healthcare teams are experiencing, MORAL INJURY. “Moral injury occurs when we perpetrate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs. In the health care context, that deeply held moral belief is the oath each of us took when embarking on our paths as health care providers: Put the needs of patients first” (Dean, Talbot, & Dean, 2019). Moral Injury is happening all through our hospitals as workers are challenged with an unfamiliar disease. There is no protocol for COVID-19 patients that has been tested and approved to be the benchmark of treatment modality. Our healthcare workers are doing the best that they know how, and yet they see the ongoing death toll of their patients. This internal battle of facing death day in and day out creates the Moral Injury that can distress anyone’s mental and emotional stability.

So healthcare fatigue may be the term that you are more familiar with but I urge you to become aware of Moral Injury. Left unattended, mental health distress can overwhelm and overtake individuals. Let’s start now by offering a listening ear or a kind gesture towards our strong healthcare heroes, embracing them as humans as well.

Dean, W., Talbot, S., & Dean, A. (2019). Reframing Clinician Distress: Moral Injury Not Burnout. Federal practitioner : for the health care professionals of the VA, DoD, and PHS36(9), 400–402.

For more information about Moral Injury check out this article:

About Jessica Ulmer, LPC, NCC

Licensed Professional Counselor for Morning Star Counseling, LLC in Lancaster, Pa. Office locations are East Petersburg and Quarryville.
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