U.S. Safety-Net Providers Report Moral Distress in Early Pandemic

Moral distress emerged from being unable to provide optimal care, seeing pandemic’s effects on patients, coworkers

FRIDAY, Sept. 2, 2022 (HealthDay News) — Moral distress during the first nine months of the pandemic was reported by a majority of clinicians working in U.S. safety net practices, according to a study published online Aug. 25 in BMJ Open.

Donald E. Pathman, M.D., M.P.H., from the University of North Carolina at Chapel Hill, and colleagues examined causes and levels of moral distress experienced by clinicians caring for low-income patients in U.S. safety net practices during the COVID-19 pandemic. The survey used for the analysis included 2,073 clinician responses (20 states) from 2020.

The researchers found that 28.4 percent reported no moral distress related to work during the pandemic, 44.8 percent reported “mild” or “uncomfortable” levels, and 26.8 percent reported moral distress reaching “distressing,” “intense,” or “worst possible” levels. Patients not being able to receive the best or needed care and patients and staff risking infection in the office were the most frequently described types of morally distressing issues. Other morally distressing situations included abuse of clinic staff, suffering of patients, suffering of staff, and inequities for patients in addition to politics, inequities, and injustices within the community.

“Managers of outpatient practices should understand what moral distress means for clinicians and its importance to them, create supportive work environments, create ways for clinicians and staff to learn and talk about moral distress and safely raise morally distressing issues, identify and address any ongoing sources of moral distress, and provide clinicians with needed psychological support and time away from work,” the authors write.