Moral Distress, Mattering, and Secondary Traumatic Stress in Provider Burnout: A Call for Moral Community

Author:

Epstein Elizabeth G.1,Haizlip Julie2,Liaschenko Joan3,Zhao David4,Bennett Rachel5,Marshall Mary Faith6

Affiliation:

1. Elizabeth G. Epstein is Associate Professor and Department Chair, University of Virginia School of Nursing; and Associate Professor, School of Medicine Center for Health Humanities and Ethics, 202 Jeanette Lancaster Way, Charlottesville, VA 22903 (meg4u@virginia.edu).

2. Julie Haizlip is Clinical Professor of Nursing and Associate Professor of Pediatrics, University of Virginia, Charlottesville, Virginia.

3. Joan Liaschenko is Professor, University of Minnesota Center for Bioethics and School of Nursing, Minneapolis, Minnesota.

4. David Zhao is an undergraduate student at the University of Chicago, Chicago, Illinois.

5. Rachel Bennett is a doctoral student at University of Virginia School of Nursing, Charlottesville, Virginia.

6. Mary Faith Marshall is Emily Davie and Joseph S. Kornfeld Professor of Biomedical Ethics, University of Virginia School of Medicine Center for Health Humanities and Ethics; and Professor of Nursing, University of Virginia School of Nursing, Charlottesville, Virginia.

Abstract

Burnout incurs significant costs to health care organizations and professionals. Mattering, moral distress, and secondary traumatic stress are personal experiences linked to burnout and are byproducts of the organizations in which we work. This article conceptualizes health care organizations as moral communities—groups of people united by a common moral purpose to promote the well-being of others. We argue that health care organizations have a fundamental obligation to mitigate and prevent the costs of caring (eg, moral distress, secondary traumatic stress) and to foster a sense of mattering. Well-functioning moral communities have strong support systems, inclusivity, fairness, open communication, and collaboration and are able to protect their members. In this article, we address mattering, moral distress, and secondary traumatic stress as they relate to burnout. We conclude that leaders of moral communities are responsible for implementing systemic changes that foster mattering among its members and attend to the problems that cause moral distress and burnout.

Publisher

AACN Publishing

Subject

Critical Care Nursing,Emergency Medicine,General Medicine

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