in china, for example, makeshift hospitals were built to make room for more beds at the same time that physicians had to turn away non-covid patients. in italy, doctors were forced to withhold limited ventilators from the elderly for use by younger, healthier patients. now, parts of the united states face completely full icus.
other frontline workers may feel efforts to limit the risk of infection from covid-19 is letting patients down — personal support workers (psws) in long-term care facilities with inadequate protective gear to cover typical care; physicians forced to delay non-essential medical procedures; therapists discontinuing face-to-face appointments.
moral stressors also go well beyond the traditional hospital setting. sarah beanlands, a nurse at a supervised consumption site in ottawa, says lack of touch, maintaining a two metre distance, and wearing full ppe — gowns, goggles, face shields and face masks — has made it hard to help clients feel accepted and welcomed, especially those who already feel judged or stigmatized and are at risk of overdose.
experts on post-traumatic stress disorder (ptsd) say that racialized frontline workers are especially at risk of moral injury.
“members of racial minorities working in healthcare often have to deal with discrimination from their patients, and when colleagues who are not people of colour ignore such occurrences this can lead to a sense of betrayal, which compounds moral distress.” says fardous hosseiny, vice president of research and policy at the
centre of excellence on post-traumatic stress disorder
at the royal ottawa hospital. “given that people of colour are disproportionately affected by the virus, healthcare workers may also struggle with distress stemming from a sense of identification with patients, who may remind them of loved ones.”
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