Organizational Impact on Healthcare Workers' Moral Injury During COVID-19: A Mixed-Methods Analysis
Katie E Nelson1, Ginger C Hanson, Danielle Boyce
1Author Affiliations: PhD Candidate (Ms Nelson), Assistant Professor (Dr Hanson), Research Data Analyst (Ms Boyce), and Professor (Dr Rushton), Johns Hopkins University School of Nursing, Baltimore, Maryland; Director of Nursing Quality and Research (Dr Ley), Luminis Health, Anne Arundel Medical Center, Annapolis, Maryland; Senior Director of Clinical Inquiry and Research (Dr Swavely), Tower Health, Reading Hospital, West Reading, Pennsylvania; and Chief Trust Building Officer (Dr Reina), Reina Trust Building, Stowe, Vermont.
Objective:
The aim of this study was to explore relationships between organizational factors and moral injury among healthcare workers and the impact of perceptions of their leaders and organizations during COVID-19.
Background:
COVID-19 placed healthcare workers at risk for moral injury, which often involves feeling betrayed by people with authority and can impact workplace culture.
Methods:
Secondary data from a Web-based survey of mid-Atlantic healthcare workers were analyzed using mixed methods. Data were synthesized using the Reina Trust & Betrayal Model.
Results:
Fifty-five percent (n = 328/595) of respondents wrote comments. Forty-one percent (n = 134/328) of commenters had moral injury scores of 36 or higher. Three themes emerged: organizational infrastructure, support from leaders, and palliative care involvement. Respondents outlined organizational remedies, which were organized into 5 domains.
Conclusions:
Findings suggest healthcare workers feel trust was breached by their organizations' leaders during COVID-19. Further study is needed to understand intersections between organizational factors and moral injury to enhance trust within healthcare organizations.
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