Doctor with nurse or healthcare team stress, anxiety or depression support, help, and manager advice

Symptoms of moral injury

Moral injury can affect our functions in many areas. If you are morally injured, you might experience the following symptoms.

Professional

  • Feeling less pride and satisfaction with your work
  • Feeling exhausted, burned out
  • Feeling disconnected from work and wanting to leave your profession

Emotional/psychological

  • Feeling shame, anger, guilt, despair
  • Feeling lonely and cut off from others
  • Experiencing repetitive thoughts and memories of events
  • Having difficulty concentrating
  • Self-harming behaviours like increased substance use (e.g., alcohol, recreational drugs)
  • Feeling hopeless or helpless

Social

  • Losing faith and trust in others
  • Avoiding close relationships and intimacy with others
  • Spending less time with others

Spiritual

  • Struggling to forgive people whom you consider betrayers (e.g., senior leadership in your workplace)
  • Feeling a lack of meaning and purpose (e.g., “Why am I even doing this?”)
  • Feeling alienated from your faith community (if applicable)

During the pandemic, many of these PMIEs happened outside the control of individual healthcare providers. This left many HCPs with feelings of helplessness, shame, anger, and guilt.

The good news is there are exercises and strategies to help us deal with the symptoms of moral injury. We will be discussing some of them in the coming modules.