This paper proposes communities of practice (CoP) as a process to build moral resilience in healthcare settings. We introduce the starting point of moral distress that arises from ethical challenges when actions of the healthcare professional are constrained. We examine how situations such as the current COVID-19 pandemic can exponentially increase moral distress in healthcare professionals. Then, we explore how moral resilience can help cope with moral distress. We propose the term collective moral resilience to capture the shared capacity arising from mutual engagement and dialogue in group settings, towards responding to individual moral distress and towards building an ethical practice environment. Finally, we look at CoPs in healthcare and explore how these group experiences can be used to build collective moral resilience.
contrary to studies of other sectors, younger age and shorter tenure were not universal risk factors for occupational injuries in the female dominated healthcare sector. Young and new workers had increased risk of cuts and punctures, but a decreased risk of musculoskeletal injuries.
Analysis from British Columbia's healthcare sector suggests variation in workers' compensation acceptance exists across sub-sectors, occupations, seniority of workers, and injury categories. The patterns observed, however, were independent of age and sex of workers. Results suggest that when using workers' compensation datasets, local adjudication regulations and factors associated with acceptance of claims should be taken into consideration.
Background: Patients with respiratory or gastrointestinal illness in emergency care settings are often not yet diagnosed but are at risk of transmitting disease. Infection control algorithms delineating a standard approach to patient management decrease risk of secondary exposure, but few articles document health care workers' (HCWs) perceptions as to their effectiveness and ease of implementation. Methods: A cross-sectional survey approach was used to explore HCWs perceptions in 2 emergency departments of the current algorithms for management of potentially infectious respiratory and gastrointestinal illnesses. Results: Surveys from 96 HCWs revealed that algorithms were perceived as invaluable in protecting staff, patients, and colleagues. Differences in self-reported compliance, clarity, and ease of implementation of the respiratory algorithm were noted between facilities, likely reflecting variation in the physical plant. Physicians scored significantly lower for compliance with the respiratory algorithm. Conclusion: Algorithms were perceived to offer a clear and consistent approach to patient management and protect HCWs in spite of environmental and resource limitations.
This paper addresses the role that communities of practice (CoP) can have within the healthcare environment when facing uncertainty and highly emotionally impactful situations, such as the current COVID-19 pandemic. The starting point is the recognition that CoPs can contribute to build resilience among their members, and particularly moral resilience. Among others, this is due to the fact that they share a reflective space from which shared knowledge is generated, which can be a source of strength and trust within the healthcare team. Specifically, in extreme situations, the CoPs can contribute to coping with moral distress, which will be crucially important not only to facing crisis situations, but to prevent the long-term adverse consequences of working in conditions of great uncertainty. The purpose of this paper is to analyze how CoP can support healthcare professionals when building moral resilience. To support that goal, we will first define CoP and describe the main characteristics of communities of practice in healthcare. Subsequently, we will clarify the concept of moral resilience, and establish the relationship between CoP and moral resilience in light of the current COVID-19 pandemic. Finally, we analyze different group experiences that we can consider as CoP which emerged in the midst of the COVID-19 pandemic to navigate moral problems that arose.
Before the COVID-19 pandemic, physician burnout was identified as reaching crisis proportions, and the pandemic is expected to worsen the already perilous state of physician wellness. It has affected physicians’ emotional health, not only by increasing workload demands, but also by eroding resilience under increasing pressures. The mental health consequences are expected to persist long after the pandemic subsides. With physician wellness increasingly recognized as a shared responsibility between individual physicians and the health care system, system-level approaches have been identified as important interventions for addressing physician well-being. In this article, we describe two evidence-guided initiatives implemented in our hospitalist network during the current pandemic: a trained peer-support team and facilitated physician online group discussions. These initiatives acknowledge the emotional strain of physicians’ work and challenge the “iron doc” culture of medicine. Our efforts build community and shift culture toward improved physician wellness. We suggest that the pandemic might be an opportunity for our profession to strengthen our support networks and for physician leaders to advance physician wellness in their work environments.
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