A guide to supporting staff with post-pandemic moral loss

26 Sep 23 168 0 0

A guide to supporting staff with post-pandemic moral loss

Cool Story - A guide to supporting staff with post-pandemic moral loss

Regeneration, transformation, and systemic change are demanded in rallying calls to draw lessons from the COVID catastrophe. Such language is aspirational and ambitious, and it is primarily addressed to decision-makers, organizations, and healthcare systems.

For healthcare workers to fully recover, structural changes that reduce their workload and prevent them from going through the specific traumas of the COVID-19 pandemic are crucial. However, post-COVID regeneration also needs to acknowledge, take seriously, and respond to the moral dimensions of frontline health workers' experiences during the pandemic.

Methods like guided ethics talks should be a crucial component of COVID recovery efforts since they can aid doctors in acknowledging and processing their difficulties.

Moral implications of the pandemic

When a clinician's agency is restricted or undermined, as it was during the epidemic, moral disorientation results from a breakdown in the moral coherence between their sense of moral identity and the demands of the workplace.

Clinicians had to deal with an excessive number of patients in the early stages of the pandemic, difficult triage decisions, and worry about their own and their families health.

Clinicians had to change their ethical focus from patient-centered care for the individual to preserving the health and safety of the population across all facets of clinical practice.

Personal protective equipment, visiting limitations for inpatients, and alterations to established and evidence-based clinical care pathways are just a few of the restrictions that governments and hospital administrators have imposed in the name of infection control.

It was stressful for clinicians to provide patient care in a way that went against fundamental health ethics principles of patient-centered care, as doing so resulted in emotions of guilt and humiliation as well as a loss of moral identity.

This causes a person's confidence in themselves and their leadership to decline, as well as their sense of professional helplessness and ability to carry out their duties by their ideals.

Strategies to repair the moral loss

For example, identifying the norms that have been broken and listening to and validating feelings of guilt, shame, and resentment are some techniques for responding to moral injury.

Educational therapies, 30- to 60-minute facilitated dialogues, specialized consulting services, multidisciplinary rounds, and other healthcare practices have all been reported to reduce moral discomfort.

Evidence is mounting that links assisted ethical dialogues in the workplace to greater moral agency and professional integrity for certain practitioners. As a result, they are better equipped to offer feedback and advocate for change within their clinical community as well as at the systems and health policy levels.

Clinicians have the chance to name and process their reactions and experiences, to hear from others and thereby situate and make sense of their own experiences, and to make connections between their feelings of moral distress and potential causes during facilitated clinical ethics discussion and debriefing.

It validates clinicians' experiences of moral loss and distress, normalizes their responses and feelings, and creates a safe space for fostering the understanding and fostering resilience needed for professional growth and repair to occur despite persistent adversity. Clinicians' ability to name the ethical values they believe were being promoted, balanced, or traded off and identify the constraints placed on them as decision-makers.

Such talks demand a facilitator with particular knowledge of clinical ethics who is aware of the scope and limitations of their position as well as the potential advantages and disadvantages of the facilitation technique.

Not all healthcare organizations have easy access to this knowledge. Additionally, these conversations require time, which is limited in healthcare settings.

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