‘Against everything that got you into the job’: experiences of potentially morally injurious events among Canadian public safety personnel

Abstract

Background: Moral injury (MI) has become a research and organizational priority as frontline personnel have, both during and in the years preceding the COVID-19 pandemic, raised concerns about repeated expectations to make choices that transgress their deeply held morals, values, and beliefs. As awareness of MI grows, so, too, does attention on its presence and impacts in related occupations such as those in public safety, given that codes of conduct, morally and ethically complex decisions, and high-stakes situations are inherent features of such occupations. Objective: This paper shares the results of a study of the presence of potentially morally injurious events (PMIEs) in the lived experiences of 38 public safety personnel (PSP) in Ontario, Canada. Method: Through qualitative interviews, this study explored the types of events PSP identify as PMIEs, how PSP make sense of these events, and the psychological, professional, and interpersonal impacts of these events. Thematic analysis supported the interpretation of PSP descriptions of events and experiences. Results: PMIEs do arise in the context of PSP work, namely during the performance of role-specific responsibilities, within the organizational climate, and because of inadequacies in the broader healthcare system. PMIEs are as such because they violate core beliefs commonly held by PSP and compromise their ability to act in accordance with the principles that motivate them in their work. PSP associate PMIEs, in combination with traumatic experiences and routine stress, with adverse psychological, professional and personal outcomes. Conclusion: The findings provide additional empirical evidence to the growing literature on MI in PSP, offering insight into the contextual dimensions that contribute to the sources and effects of PMIEs in diverse frontline populations as well as support for the continued application and exploration of MI in the PSP context.

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021–2023

“…During the pandemic, frontline health workers including nurses and physicians (Ford et al, 2022 ), but also professionals and paraprofessionals from a wide variety of allied health fields such as respiratory therapists (D'Alessandro-Lowe et al, 2023 ), public safety personnel (Rodrigues et al, 2023 ), and social care workers (Zerach & Levi-Belz, 2021 ) were exposed to extreme hazards (e.g., viral transmission, insufficient PPE) and workplace stressors (e.g., medical crises, patients and families separated and in distress, deaths of patients and co-workers, moral dilemmas) (Adams et al, 2023 ; Berkhout et al, 2022 ; Laurent et al, 2022 ). It is important to remember that no one-size-fits-all in the experiences, adaptations, and difficulties experienced by front-line workers based on differences in the pandemic-related stressors that confronted workers of different occupational backgrounds and responsibilities, in their stress-related reactions, and their life contexts (Tekin et al, 2022 ) (Patel et al, 2023 ; Qureshi et al, 2022 ).…”

“…Qualitative interviews with public safety personnel, including paramedics and crisis hotline responders, similarly faced potentially morally injurious events in the line of duty that ‘compromise their ability to act by the principles that motivate them in their work’ and are associated with ‘adverse psychological, professional, and personal outcomes’ (Rodrigues et al, 2023 ) (p. 2205332). As early as three weeks after the initial pandemic lockdown, almost half of a self-selected sample of physicians working on both COVID-specific and general medical units who were surveyed in Romania reported having experienced potentially morally injurious events (Maftei & Holman, 2021 ).…”

“… 44. Rodrigues et al ( 2023 ). ‘Against everything that got you into the job': experiences of potentially morally injurious events among Canadian public safety personnel Qualitative analyses of interviews with Canadian public service personnel found that potentially morally injuring events in the course of their work compromise their ability to act in accordance with the principles that motivate them in their work, and, in combination with traumatic experiences and routine stress, are associated with adverse psychological, professional and personal outcomes.…”