NHS staff are suffering from ‘moral injury’, a distress usually associated with war zones

With the latest UK government figures showing that there have been nearly 150,000 deaths where COVID-19 was mentioned on the death certificate, it’s understandable why some people compare the pandemic with a war. Indeed, daily life in the NHS is now peppered with military language: the frontline, gold command calls, redeployment, buddy systems and 'moral injury'

Moral injury can be defined as the distress that arises in response to actions or inactions that violate our moral code, our set of individual beliefs about what is right or wrong. In the medical literature, moral injury has historically been associated with the mental health needs of military personnel, arising from their traumatic experiences during active service.

Moral injury is generally thought to arise in high-stakes situations so it’s no surprise that the term has gained traction in healthcare settings over the course of the pandemic, given that healthcare staff have been faced with extreme and sustained pressure at work. In many ways, working in the NHS over the past year has felt like being some sort of circus acrobat, contorting ourselves to balance various competing realities: the desire to provide high-quality care for all our patients in the context of limited resources, looking after our own health needs alongside those of our patients, trying to make peace with the responsibility we feel towards our loved ones while still upholding our duty of care to patients.

If we fail to deliver, particularly in high-stakes situations where we think things should have been done differently, it can shake us to our core. Our moral code transcends the relatively superficial responsibilities of our professional role: it gets to the heart of who we are as human beings. If we feel like our core values have been attacked, it can leave us feeling devastated and disillusioned.

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Source: The Guardian, 12 April 2021