When I served as a Chaplain at the VA we spent a lot of time discussing moral injury and PTSD. Many of the veterans we worked with, especially those with combat experience, carried these titles with them. If you’re unfamiliar, moral injury first started appearing in literature following the Vietnam war to describe patients who loosely fit criteria for PTSD, but weren’t responding well to traditional treatments. It occurs when a person perpetrates, bears witness to, or fails to prevent an act that transgresses his or her deeply held moral belief. In other words, there is a split in our souls.
In the last several years many healthcare professionals have been reading about moral injury and realizing that there is a lot of overlap between their experiences and those of combat vets. This has led to some great articles arguing that clinician distress ought be reframed in these terms rather than “burnout.” I can go into that some other time.
Right now I want to address what we are currently facing. And this is not about masks or how we choose to proceed with our social response. We can go into that another time as well.
In my role I have the privilege of working with the frontline. Their job has always been hard. I have sat with nurses whose scrubs were stained with a mother’s tears and the blood of her deceased son. I have listened to doctors lament over treatments that stopped working. I have prayed with front liners of all faiths and traditions over what goes on in those buildings every day.
But something is different with this. I can hear it in the cracking, shaking voices of the most skilled, experienced, and stoic team members. I can see it in their eyes. It looks all too familiar. It reminds me of the soldiers I used to see at the VA.
I am concerned about the human cost; the most valuable resource we have. We cannot ask these teams to pull these shifts, take these risks, and injure their souls indefinitely. There is tremendous wear from long days full of moral and ethical dilemmas one after another and repeated exposure to high levels of stress. Let me be clear: The frontline is resilient as hell. And they are powerful beyond measure, but they are not immortal.
They need us. They need our prayers. They need our solutions. They need to know the community has their backs. The onus is on us to assure them that we are indeed for them.
Here are some basic ways we can help:
- Stop posting crap research and bunk science
- Receive their laments. Believe them when they share their stories
- Partner with your local facility or foundation to get them resources
- Lobby, vote, and hold officials accountable for a better, stronger approach to healthcare
- Don’t blame, shame, and try to sue everyone when there is an unfavorable outcome