Our ProjectMoral injury has become a powerful category of analysis for healthcare professionals explaining the challenges faced in their work environment. We conducted a qualitative study to understand nurses’ experiences of moral injury and the context surrounding them. Using a subset of hospital nurses’ stories, we produced an illustrated and audio storybook.
What is Moral Injury?Moral injury is defined as “psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations" (Litz et al., 2009). It is one of the major causes of burnout, secondary trauma, compassion fatigue, and other negative effects of nursing. This concept of moral injury emphasizes system-level causes and solutions, and is distinct from the emphasis on individual resilience as a solution to the costs of caring.
From our study, we selected 23 critical incidents (CIs) of moral injury from 17 different nurses. Nurses described being unable to fulfill their professional duty to advocate for patients, with stories demonstrating betrayal, corruption, conflict around end-of-life situations, and feeling expendable. Early-career stories often centered on department- or unit-level issues, whereas later career stories tended to acknowledgethe larger forces of executive leaders and the U.S. healthcare system. |
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