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Writer's pictureShannon Romano

Unmasking Moral Injury: A Fresh Perspective on Staff Retention in Long-Term Care


In the world of long-term care, the well-being of our dedicated staff is of paramount importance. It's no secret that providing care in such an environment can be emotionally challenging. As we navigate the complexities of staffing in long-term care facilities, it's crucial to recognize a relatively young but significant concept in psychology: moral injury. Understanding moral injury and its distinctive features can guide us in developing effective staff retention strategies that acknowledge the unique challenges faced by healthcare workers.


Moral injury is often characterized as a violation of one's moral and ethical code and often results in feelings of guilt, shame, disgust, anxiety, sadness and anger.


Long-term care staff often find themselves in situations where they must balance their professional responsibilities with their personal, cultural and religious beliefs about death and dying. The emotional distress stemming from these moral conflicts is at the heart of moral injury and staff turnover.


Leading researcher Bill Nash, MD, and others have illuminated the intricate nuances of moral injury in caregiving roles. Their work underscores the limitations of conventional interventions in addressing the core issues of moral distress experienced by those working in long-term care.


Moral injury poses unique challenges for both long-term care staff and the facilities that employ them as it often manifests as a complex web of emotions, making it challenging to identify and address effectively.


As our understanding of moral injury in long-term care deepens, there is a growing recognition of the need for specialized staff retention strategies.


For staff members dealing with moral injury, seeking help can be daunting due to the stigma surrounding mental health issues and the profound sense of shame that often accompanies moral injury.


Facilities must create a supportive and non-judgmental environment in which staff can share their experiences and emotions.


Developing therapeutic strategies that help staff rebuild their moral compass and find meaning in their work is essential for improved staff retention in long-term care.


As our understanding of this phenomenon continues to evolve, so too must our approaches to supporting and retaining the dedicated individuals who provide crucial care to our elderly and vulnerable populations.


By addressing moral injury, we can create a more compassionate and sustainable work environment in long-term care.

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