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What is 'moral injury' at work?

Tired medical staff
If an employer doesn't give you the resources you need to do your job properly – for instance if a nurse can't spend enough time with each patient – that's moral injury. (SEAN GLADWELL via Getty Images)

If you’ve ever been asked to do something you’re not comfortable with at work, you’re not alone. Workers across a range of professions – from healthcare to office managers and sales – are often asked to compromise their morals for their jobs. So much so, that a phrase is used to describe the detrimental impact it has on people: Moral injury.

Moral injury is a response to seeing – or participating in – behaviours that go against your moral beliefs. If you’re a manager, this might mean pushing employees to work longer hours to finish a project, even though you know it’s taking its toll on their physical and mental health. If you work in healthcare, experiencing moral injury might be the result of spending less time with a patient than you’d like – because time and resources are so stretched.

The term moral injury was first coined by American military psychiatrist Jonathan Shay to describe how the horrors of war had impacted Vietnam veterans. However, the phrase has since been expanded to different contexts, including the workplace.

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Read more: How work changed in 2022

Research suggests moral injury can be experienced by people in many different job roles. It may be the result of something you did or something you witnessed – or something that you experienced personally. For example, a colleague’s humiliation, manipulation by a manager, or a company’s failure to act upon a harassment claim. A 2020 study by Duke University found moral injury to be a particular issue among nurses, doctors and other medical professionals who often worked long hours and experienced exhaustion from the pressures placed on them by healthcare systems.

Recently, researchers from the Imperial College London, the University of Sheffield and the consultancies Affinity Health and Softer Success, found moral injury was contributing to workplace burnout. They found it was triggering a “more intense type of burnout in people across many business sectors” which can be challenging to overcome.

The impact of moral injury can be far-reaching, leading to guilt, stress, shame, self-criticism, anger or grief. The symptoms can also be similar to workplace burnout, such as disengagement, anxiety and emotional, mental and physical exhaustion.

Read more: Employers also need to embrace right to request flexible working

Moral injury is costly for employers

Moral injury is also costly for employers, too. Since the Covid-19 pandemic began, a record number of people have quit their jobs to seek out better pay, satisfaction and balance. In fact, two-thirds of those who said they planned to leave their jobs in 2022 said they were seeking more fulfilment in the workplace, according to a survey of more than 50,000 people. For many people, a fulfilling job is one that doesn’t compromise their ethics.

Of course, it’s not always possible to leave your job. Finding a new role isn’t easy and the rising cost of living means many people are trapped in jobs they don’t enjoy because they need the money. So what can you do if you’re struggling with moral injury at work – and what can employers do to ensure their workplaces and practices are ethical?

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Coping with moral injury at work

If you’re experiencing moral injury at work, it can be difficult to know what to do. Often, it’s the result of a structural issue within an organisation, so it’s not an easy fix. And as humans, we are hardwired to try and find meaning in what we do – so trying to mentally detach from work can be difficult.

Cara de Lange, founder & CEO of Softer Success, which carried out the study into moral injury and burnout, advised taking several steps if you’re struggling at work. First, it can help to look for support within the organisation – a trusted manager or colleague, for example – or from friends or family. Counselling can help you process difficult emotions too. It’s also important to look after yourself and invest time in self-care.

For employers, prevention is key when it comes to moral injury. It’s essential to gauge how employees are feeling without trying to influence them in any way. This will help you track satisfaction and engagement, which can be a good indication of stress levels. It’s also crucial to provide ways in which workers can voice concerns safely and openly – and issues that arise should be followed up transparently.

Companies should also make sure managers are able to acknowledge mistakes and take responsibility for their actions. Honest, open communication can help reduce stress and reduce the likelihood of burnout – while creating a healthy, happy working environment.

Watch: Why do we still have a gender pay gap?