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Moral Injury and COVID-19


Are you hearing the same stories I am?

  • Doctors in Italy removing ventilators from the living to give them to those who have a better chance of living a fuller life.

  • Hospitals in New York struggling to develop new protocols about which patients will be given lifesaving treatments when there are not enough resources.

  • EMTs and firefighters in New York ordered to preserve hospital and ambulance resources by not transporting cardiac arrest patients who can’t be resuscitated in the field.

  • In our own state and elsewhere, fire crews no longer dispatched on medical calls that aren’t lifesaving events, leaving medical calls to the already stretched EMS crews who may now have longer response times.

  • Let's not forget, every time a firefighter or EMT does CPR or another lifesaving intervention, they do so with the knowledge that this person may have COVID-19. Those first responder may be taken off calls until medically cleared to serve again.

First responders train for mass casualty incidents, but few of us have ever had to work one in real life. We have not had to make the hard decision about who will live and who will die based on the resources we have at hand. But this can happen. It is a dark part of our job that we really don't like to think about. After all, we are there to protect and preserve life. We do all we can to save a life, sometimes even to the point of giving our own life. That is the way of emergency services. And to be told not to do everything possible to save a life in front of you can crush your own spirit. It’s what they call a moral injury.

The modern understanding of moral injury is rooted in the experience of soldiers and nurses who have had to do (or not do) something or witness something so traumatic that it violated the very core (or moral center) of who they are as a person. Those experiences sometimes produce emotional guilt and shame, a sense of betrayal and anger, and moral disorientation. And sometimes they are is hardest on those of us whose deeply held religious beliefs say that all life is precious and is honored by God.

The truth is, sometimes this world is downright ugly. Sometimes first responders are caught in “damned if you do, damned if you don’t” situations. And now COVID-19 may put many at risk for moral injury, from 911 telecommunications to hospital staff and everyone in-between. The healing of the soul will be more important than ever. Chaplains, even if you don’t face moral injury yourself, you serve people who do. This is your realm. You are needed now more than ever.

Here are six things that can help you, or help you help someone else who suffers moral injury.

  1. Find space to exercise your spiritual life. When and where do you connect with God? Where do you experience God’s love in your life? With churches closed we are now forced to walk with God in new ways. Find what works for you.

  2. Figure out your theology of suffering and death. Find the answer in your heart and mind why bad things happen in the world. Question: Does your theology show a loving God that cares or a judgmental God who condemns or is distant and doesn’t care? Where do grace, mercy and forgiveness fit in?

  3. Seek grace and forgiveness. You may not be able to get grace and forgiveness from victims/patients or their family, but I have found that you can still get it from God.

  4. Focus on the good things in life. Yes, what happened was bad, but please put it into perspective with the rest of your life and your walk with God.

  5. Find ways to reduce your stress. There are many ways out there, and you probably know what works best for you. For me, it is worship.

  6. Take time to spend with accountability partners. Now is not the time to keep a moral injury to yourself. Find good, trusted people who can speak into your life things of faith and truth.

Chaplain Chris M. Wade

President

South Carolina Public Safety Chaplains Association

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