Exploring Experiences of Moral Injury and Distress Amongst Healthcare Workers During the Covid-19 Pandemic

Objective Healthcare workers have been exposed to a variety of practical and emotional challenges because of the Covid-19 pandemic, leaving them vulnerable to experiencing moral injury and distress. However, there is currently sparse research which directly explores such experiences. This study aimed to explore and characterise the experiences and impacts of moral injury and distress amongst healthcare workers during the pandemic.

Methods Twenty semi-structured interviews were conducted with healthcare workers employed across both mental and physical healthcare services. Interviews were analysed from a critical realist perspective using thematic analysis.

Results Three key themes were identified: attitudes towards moral injury, experiences of moral injury, and consequences of moral injury. Participants appeared to identify with the idea of acting against their morals to varying extents based on their job roles. Participants experienced a range of potentially morally injurious and distressing events throughout the pandemic and many ultimately felt that they provided sub-standard levels of care due to extreme pressures on services. Detrimental impacts upon wellbeing were commonly reported, including high levels of emotional distress and feelings of guilt and shame. Some reported a loss of enthusiasm for their job and a desire to leave the profession entirely.

Conclusion Moral injury and distress presents a real concern for staff wellbeing and retention within the profession. During and beyond the Covid-19 pandemic, there is an urgent need for healthcare providers to implement wider strategies to target moral injury and distress, and support staff within healthcare settings.