Self-care strategies in response to nurses’ moral injury during COVID-19 pandemic

• Published in: Nursing ethics Vol. 28; no. 1; pp. 23 - 32
• Main Authors: Hossain, Fahmida, Clatty, Ariel
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2021; SAGE PUBLICATIONS, INC
• Subjects: Adaptation, Psychological; Burnout, Professional - prevention & control; Burnout, Professional - psychology; Coping; Coronaviruses; COVID-19; COVID-19 - nursing; Death & dying; Friendship; Frustration; Health care; Humans; Injuries; Medical personnel; Moral injury; Morality; Nurse led services; Nurses; Nursing Staff, Hospital - psychology; Original Manuscripts; Pandemics; Psychological distress; Psychological trauma; Psychological well being; Resilience, Psychological; SARS-CoV-2; Self Care; Shortages; Side effects; Stress Disorders, Post-Traumatic - prevention & control; Stress Disorders, Post-Traumatic - psychology; Traumatic life events; Triage; COVID-19; moral distress; pandemic; nurses; self-care; moral injury
• ISSN: 0969-7330; 1477-0989
• DOI: 10.1177/0969733020961825

These are strange and unprecedented times in the wake of the COVID-19 pandemic. Most frontline healthcare professionals have never witnessed anything like this before. As a result, staff may experience numerous and continuous traumatic events, which in many instances, will negatively affect their psychological well-being. Particularly, nurses face extraordinary challenges in response to shifting protocols, triage, shortages of resources, and the astonishing numbers of patients who require care in expedited time constraints. As most healthcare workers are passionate nursing professionals, frustration and often a sense of powerlessness occur when they find themselves unable to provide needed care to their patients. The overwhelming number of deaths, patients isolated and dying alone, and the ever-present fear of being infected and then infecting colleagues, family, friends due to the lack of protective gear or known protocols takes its toll on emotional and psychological well-being. For nurses, the experience of this significant (hopefully once-in-a-lifetime) event can inflict on-going moral injury. Nurses affected by this trauma require education, coping tools, and therapy to help avoid or alleviate the adverse effects on their well-being. Institutions must provide these resources to tend to the well-being of their healthcare staff, during and beyond the pandemic. This article aims to investigate moral distress—considering it as a moral injury—and offer tools and recommendations to support healthcare nurses as they respond to this crisis and its aftermath.