Operational stressors, psychological distress, and turnover intentions: The impact of potentially morally injurious experiences

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

“…Drawing from Self-Determination Theory (SDT), recent research on moral memories [ 11 ] and moral injury [ 5 ], our study aims to investigate how memories of work-related PMIEs influence nurses’ burnout and turnover intentions after at least six months from exposure. We distinguish between self- and other-PMIEs, in line with recent recommendations [ 5 , 12 , 13 ], and explore the phenomenological characteristics of the resulting memories. Using a quasi-experimental design, we also investigate the differential impact of nurses’ exposure to the two types of PMIEs on the two outcomes, to test whether the basic psychological need-thwarting experienced during recall can have a unique impact on nurses’ current burnout and turnover intentions.…”

“…Initially studied in war veterans, PMIEs are events which entail “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations” [ 14 ] (p. 697). While moral injury is always caused by exposure to PMIEs, not all PMIE experiences lead (only) to moral injury, which is why research needs to better differentiate between the two [ 12 , 13 ].…”

“…Another conceptual differentiation insufficiently investigated distinguishes between perpetration- and betrayal-based PMIEs (i.e., self- and other-PMIEs) [ 12 , 13 ]. Self-PMIEs are moral violations perpetrated by the person under perceived environmental constraint, whereas other-PMIEs are moral violations perpetrated by others and passively witnessed by the person.…”

“…Thus, the effects they found could be attributed to memories of PMIEs rather than exposure to them. However, the instruments they employed (i.e., scales measuring whether exposure had occurred) and the differences in the amount of time having passed from exposure to data collection prevent us from drawing precise conclusions concerning the role of their episodic memories in the respective outcomes [ 5 , 10 , 12 , 13 ], since episodic memories from the same time period have to be recalled in detail during data collection to explore this topic [ 11 , 25 , 26 , 27 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

“…In contrast, nurses’ need for relatedness could be more thwarted in memories of other-PMIEs, because they depict instances of organizational betrayal, perpetrated by their superiors [ 5 , 12 , 13 ]. Following the same rationale, their autonomy could be more thwarted in memories of other-PMIEs, which are accompanied by disrespect towards nurses’ autonomy and their exclusion from medical decision-making processes by their peers [ 43 , 44 , 45 ].…”