It’s Not Just Burnout
Banding together to name and resist moral injury
By Laur Kelly (they/them), Counsellor and Educator, Care Through Chaos
I am a grief steward, social worker, community facilitator, and spiritual care practitioner who predominantly works with other social workers to support the daily realities of chronic stress, grief, and trauma on the job. A few years ago I had the honour of working with a passionate and dedicated frontline harm reduction worker who had been working within a public health agency for several years. They came to me steeped in grief, not just because of mourning over 100 friends and community members who died from overdose and drug toxicity, but also because they were weighed down by taking on the responsibility for the organizational practices that were informed by drug policies, underfunding, and other systemic failures that are causing these deaths. Their assumed guilt crushed them, and they struggled to stay connected to their service users and loved ones across an invisible border of pain, guilt, and shame. They experienced sleep and eating changes, developed a chronic illness, felt both overwhelmed and numb, struggled with their sense of identity, and lost touch with the meaning of work that they’d dedicated their life to. Part of our work together was naming the external factors that caused these changes and trying to reclaim the meaning and purpose of the work that deeply mattered to them.
I came to understand their suffering as moral injury - the traumatic impacts of being forced to act against our ethics because of policies and regulations out of our control. They didn’t immediately experience these severe impacts, it started with morally distressing ethical dilemmas that frequently went unsupported and culminated in moral injury. Before understanding this phenomenon I used language like “burnout” (overwork and exploitation), “compassion fatigue” (numbness and empathic strain), and “vicarious trauma” (being impacted by our service user’s suffering), but they all seemed to fall short of describing the devastation that social service staff felt (including management!) from carrying the burdens of the policies and regulations they were working under.
It’s not just social service staff who are experiencing moral distress and injury - it’s widespread among healthcare workers, lawyers, first responders, and progressive politicians. And I’m not immune. I often leave a session feeling like I’m applying a bandaid to a gaping wound, powerless to affect the changes needed to truly address their moral injury or contributing factors. For me, the thing that has been most supportive is developing a Solidarity Team, coined by Vikki Reynolds, to help keep me accountable to my ethics and uplift me in the hopeless moments. My Solidarity Team is made of comrades and colleagues, activists, animals, music, and plant medicines - all things that keep me centred in my purpose and able to live alongside the chronic grief of not having the far-reaching power to change what’s needed. Another form of care for moral distress and injury are Communities of Practice where we can gather with co-workers and colleagues to struggle through ethical dilemmas together and collaborate on best practices.
So where do we start? First, we can foster the vulnerability to name moral distress/injury when it shows up and stop using the catch-all phrase, “burnout”. Then we can band together with the comrades that are with us in our liberatory struggles to share the load of our moral distress through creative problem-solving, mutual support, and affirming our guiding ethics. Together we can resist the isolation of moral injury and uplift each other to keep fighting.
