Injurious Memories from the COVID-19 Frontline: The Impact of Episodic Memories of Self- and Other-Potentially Morally Injurious Events on Romanian Nurses’ Burnout, Turnover Intentions and Basic Need Satisfaction

Abstract

Nurses have been frequently exposed to Potentially Morally Injurious Events (PMIEs) during the COVID-19 pandemic. Due to resource scarcity, they both perpetrated (self-PMIEs) and passively witnessed (other-PMIEs) moral transgressions toward the patients, severely violating their moral values. Our study investigated the impact of self- and other-PMIEs on work outcomes by exploring nurses’ episodic memories of these events and the basic psychological need thwarting associated with them. Using a quasi-experimental design, on a convenience sample of 463 Romanian nurses, we found that PMIEs memories were uniquely associated with burnout and turnover intentions, after controlling for socio-demographic characteristics, general basic psychological need satisfaction at work and other phenomenological characteristics. Both self- and other-PMIEs memories were need thwarting, with autonomy and competence mediating their differential impact on burnout, and with relatedness—on turnover intentions. Our findings emphasize the need for organizational moral repair practices, which should include enhancing nurses’ feelings of autonomy, relatedness and competence. Psychological counseling and psychotherapy should be provided to nurses to prevent their episodic memories of PMIEs to be (fully) integrated in autobiographical knowledge, because this integration could have severe consequences on their psycho-social function and occupational health, as well as on the organizational climate in healthcare institutions.

Moderated Role of Social Support in the Relationship between Job Strain, Burnout, and Organizational Commitment among Operating Room Nurses: A Cross-Sectional Study

“…Maslach and Leiter [ 19 ] suggested that emotional exhaustion and depersonalization must be contained in the measurement of burnout, and prolonged emotional exhaustion can lead to depersonalization. Previous research on nurses’ burnout indicated that workload [ 20 ], job strain [ 9 , 10 , 11 ], morally injurious events [ 21 ], anxiety, and depression [ 22 ] positively affected burnout. Nurses with high levels of burnout were more prone to have higher turnover intention [ 23 , 24 ], lower job satisfaction [ 25 ] and organizational commitment [ 26 ].…”

Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses’ Occupational Wellbeing: A Cross-Sectional Experimental Study

“…Thus, studies found that nurses’ episodic memories of PMIEs can have a unique negative association with their burnout, work motivation, work satisfaction, and adaptive performance several months after the event, mediated by autonomy thwarting [ 12 ]. Memories of self-PMIEs had stronger associations with burnout and turnover intentions compared to memories of other-PMIEs (i.e., enacted vs. witnessed PMIEs), mediated by the thwarting of all three basic psychological needs [ 13 ]. However, it remains unclear whether both memories of self-PMIEs and other-PMIEs would be associated with more burnout and turnover intentions when compared to a control group.…”

“…To date, protective factors against the negative effects of autobiographical episodic memories on psychological health and wellbeing have not been investigated, to the best of our knowledge. Previous findings suggest that nurses’ memories of PMIEs from the COVID-19 pandemic may not have yet been integrated in their autobiographical knowledge, an integration which might dramatically affect their work identities, behavior, and psychological health, with potential consequences on the healthcare organizational system [ 13 ]. Thus, departing from the mediating factors proposed, we set out to explore two potential moderators for the impact of memories of self- and other-PMIEs on burnout, turnover intentions, and work engagement.…”

“…In a different study, we compared nurses’ memories of self-PMIEs to their memories of other-PMIEs during the COVID-19 pandemic and found that the former had a stronger association with increased burnout and turnover intentions, mediated by all three basic psychological needs [ 13 ]. Thus, memories of self-PMIEs were more autonomy- and competence-thwarting than memories of other-PMIEs, a difference which we attributed to the omission bias [ 19 ].…”

“…To our knowledge, so far, there are no studies which compare nurses’ memories of self-PMIEs and other-PMIEs from the COVID-19 pandemic to SMTs (i.e., a control group) in terms of associations with occupational wellbeing, comprising work engagement, and burnout, and, respectively, turnover intentions. Given the mixed findings on the effects of exposure to self- and other-PMIEs [ 5 , 13 , 14 , 15 , 16 ], it could be that the impact of memories of other-PMIEs is either not different or smaller than the impact of SMTs, since the latter can be need-thwarting as well, especially in terms of competence. On the other hand, this impact could be greater, because they could be more autonomy-thwarting than memories of SMTs [ 12 , 13 ], since they constitute passive moral transgressions perpetrated under environmental constraint [ 15 , 16 ].…”