COVID-19 and Moral Distress/Moral Anguish Therapeutic Support for Healthcare Workers in Acute Care: Our Voice

Cerone, Victoria L.

In the midst of the novel coronavirus (COVID-19) pandemic, acute care healthcare workers (HWs) on the front lines are balancing fear and bravery to prioritize lifesaving efficiency for their patients and themselves. Given the complexity of their work, in particular its constant proximity to patients encountering life-altering events, HWs are at high risk for traumatic, stressful workplace experiences, including the phenomena known in tandem as moral distress/moral anguish (MDA). This chapter offers guidance on therapeutic practice skills needed by social workers (SWs) to help HWs identify and address their experiences of MDA. Case-based vignettes demonstrate how situations encountered within acute care settings challenge personal values and trigger personal memories, heightening the experience of MDA. The vignettes illustrate how two therapeutic approaches can be used to address MDA: reflective cycle (Gibbs, Learning by Doing: A Guide to Teaching and Learning Methods. Further Educational Unit, Oxford Polytechnic, Oxford, 1988) and transformative learning (Mezirow, Fostering Critical Reflection in Adulthood. Jossey-Bass, San Francisco, 1990). Given a medical culture that prioritizes efficiency and often imposes strict time restraints on workers, it is challenging for HWs to reflect on and treat symptoms that indicate MDA. The opportunity for HWs to voice their distress and build self-care strategies represents their path toward healing from the extraordinary pressure and hardship the COVID-19 crisis has brought and toward strengthening their resilience in order to continue their profoundly benevolent work.