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Chapter 39 - Moral Distress and Moral Injury

from Section 5 - Sustaining and Caring for Staff During Emergencies

Published online by Cambridge University Press:  11 January 2024

Richard Williams
Affiliation:
University of South Wales
Verity Kemp
Affiliation:
Independent Health Emergency Planning Consultant
Keith Porter
Affiliation:
University of Birmingham
Tim Healing
Affiliation:
Worshipful Society of Apothecaries of London
John Drury
Affiliation:
University of Sussex
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Summary

This chapter explores the moral dimensions of work in emergency and pre-hospital medicine, with an emphasis on protecting the workforce and maintaining optimal functioning of teams. It explores the concepts of moral distress and moral injury from the literature and as they apply to emergency and pre-hospital medicine, but also in the light of the COVID-19 pandemic. It includes reference to the experience of one helicopter emergency medical service (HEMS) organisation attempting to make changes to its culture.

Type
Chapter
Information
Major Incidents, Pandemics and Mental Health
The Psychosocial Aspects of Health Emergencies, Incidents, Disasters and Disease Outbreaks
, pp. 287 - 292
Publisher: Cambridge University Press
Print publication year: 2024

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References

Steffens, N, Haslam, S, Kerschreiter, R, Schuh, S, van Dick, R. Leaders enhance group members’ work engagement and reduce their burnout by crafting social identity. Z Personalforsch 2014; 28: 173–94.Google Scholar
Ellemers, N, Barreto, M. Social identity and self-presentation at work: how attempts to hide a stigmatised identity affect emotional well-being, social inclusion and performance. Neth J Psychol 2006; 62: 51–7.Google Scholar
Jameton, A. Nursing Practice: The Ethical Issues. Prentice-Hall, 1984.Google Scholar
British Medical Association (BMA). Moral Distress and Moral Injury: Recognising and Tackling It for UK Doctors. BMA, 2021 (www.bma.org.uk/media/4209/bma-moral-distress-injury-survey-report-june-2021.pdf).Google Scholar
Maslach, C, Leiter, M. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 2016; 15: 103–11.Google Scholar
Murray, E, Krahé, C, Goodsman, D. Are medical students in prehospital care at risk of moral injury? Emerg Med J 2018; 35: 590–94.CrossRefGoogle ScholarPubMed
Griffin, B, Purcell, N, Burkman, K, Litz, B, Bryan, C, Schmitz, M, et al. Moral injury: an integrative review. J Trauma Stress 2019; 32: 350–62.Google Scholar
Litz, B, Stein, N, Delaney, E, Lebowitz, L, Nash, W, Silva, C, et al. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 2009; 29: 695706.Google Scholar
Shay, J. Moral injury. Psychoanal Psychol 2014; 31: 182–91.Google Scholar
Litz, B, Kerig, P. Introduction to the special issue on moral injury: conceptual challenges, methodological issues, and clinical applications. J Trauma Stress 2019; 32: 341–9.Google Scholar
McCarthy, J, Deady, R. Moral distress reconsidered. Nurs Ethics 2008; 15: 254–62.Google Scholar
Whitehead, PB, Herbertson, RK, Hamric, AB, Epstein, EG, Fisher, JM. Moral distress among healthcare professionals: report of an institution-wide survey. J Nurs Scholarsh 2015; 47: 117–25.Google Scholar
Shale, S. Moral injury and the COVID-19 pandemic: reframing what it is, who it affects and how care leaders can manage it. BMJ Leader 2020; 4: 224–7.Google Scholar
Kinman, G, Teoh, K. Looking after Doctors’ Mental Wellbeing during the COVID-19 Pandemic. BMJ, 2020 (https://blogs.bmj.com/bmj/2020/03/26/looking-after-doctors-mental-wellbeing-during-the-covid-19-pandemic/).Google Scholar
Tajfel, H, Turner, JC. An integrative theory of intergroup conflict. In The Social Psychology of Intergroup Relations (eds Austin, WG, Worchel, S): 3347. Brooks/Cole, 1979.Google Scholar
Morgan, P, Ogbonna, E. Subcultural dynamics in transformation: a multi-perspective study of healthcare professionals. Hum Relat 2008; 61: 3965.CrossRefGoogle Scholar
Williams, R. A cunning plan: integrating evidence, judgement and passion in mental health strategy. The Inaugural Lecture of Professor Richard Williams, delivered at the University of Glamorgan, November 2000.Google Scholar
Williams, R, Kemp, V, Neal, A. Compassionate care: leading and caring for staff of mental health services and the moral architecture of healthcare organisations. In Management for Psychiatrists (eds Bhugra, D, Bell, S, Burns, S): 377402. Royal College of Psychiatrists Publication, 2016.Google Scholar
Neal, A, Kemp, V, Williams, R. Caring for the carers. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al.): 289303. Cambridge University Press, 2019.Google Scholar
Warner, M, Williams, R. The nature of strategy and its application in statutory and non-statutory services. In Child and Adolescent Mental Health Services: Strategic Approaches to Commissioning and Delivering Child and Adolescent Mental Health Services (eds Williams, R, Kerfoot, M): 3962. Oxford University Press, 2005.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th ed. American Psychiatric Association, 2013 .Google Scholar

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