Thread by @gretchemaben

My next session for tweetucation is something I’m VERY passionate about!: “Moral Injury: Don’t Just Stand There, Do Something”! #SCCM2023

First up is “Recognizing the Signs, Symptoms, and Impacts of Moral Injury” with Kimberly Ichrist (@IchristKimberly)! #SCCM2023

The concept of moral injury is from military literature and is “a wound from doing something that violated one’s own ethics, beliefs, or attachments.” #SCCM2023

Potentially morally injurious events can lead to a wide range of negative outcomes. #SCCM2023

Moral injury is not a new concept. #SCCM2023

Moral injury is not benign!!! There can be numerous negative effects! #SCCM2023

There are three scales for assessing moral injury, and this one is specifically designed for healthcare professionals. #SCCM2023

We know that moral injury contributes to burnout and job abandonment! The cost of this turnover is not just financial, but is also moral and affects other members of the healthcare team and can lead to unsafe staffing ratios. #SCCM2023

Now we have Dr. Sarah Hoehn (@sarahhoehn1) with “Addressing Individual-Level Impacts of Moral Injury”! #SCCM2023

The what and why of moral injury. #SCCM2023

Recently a lot of people were affected by witnessing the collapse of Damar Hamlin, and people can be affected and process these things differently. #SCCM2023

Examples of moral distress at the bedside. #SCCM2023

Witnessing and hearing about gun violence regularly and not seeing action taken against it also causes moral distress! #SCCM2023

ICU bed shortages and triage protocols can lead to moral distress! #SCCM2023

We also see a decrease in the ability to provide care for patients because too little reimbursement! #SCCM2023

How does repeated moral injury affect us? #SCCM2023

So what is burnout? #SCCM2023

New Zealand’s PM just resigned THIS WEEK due to burnout! (And she’s INCREDIBLE!) #SCCM2023

This study showed high levels of burnout in pediatric PCCM fellows! And I published a study in the last couple of years that showed the same in adult PCCM fellows! #SCCM2023

This study showed high burnout rates in attendings, too! #SCCM2023

Suicide in healthcare workers is also a huge problem. I personally have lost two colleagues to suicide already and they have both affected me DEEPLY. 💔 #SCCM2023

So what CAN we do?! We need to create a safe space and an environment where we can talk about these things! #SCCM2023

Let’s be honest - we suck at this! I try to share openly here on Twitter to facilitate honestly with difficult feelings, and it has personally been held against me in different ways. #SCCM2023

At least one person on this site even reported me to my boss instead of just talking to me! We have to do better at allowing people to talk openly and to be real with each other! #SCCM2023

Debriefing is helpful! #SCCM2023

Is resiliency the answer? My personal thought - let’s stop victim blaming and change the system! #SCCM2023

Let’s focus on humanism. We need to stop encouraging self-sacrifice! #SCCM2023

Potential institutional resources! #SCCM2023

We need to focus on changing systems instead of people!!! #SCCM2023

We need to learn to preserve our own hearts, it’s okay to forget, and it’s okay to remember. ❤️ #SCCM2023

The same case can affect people differently. #SCCM2023

It’s okay to cry! I will never forget the time I cried over a tough patient loss as a fellow and my resident saw me and said, “I thought you were strong.” Emotions are a strength, not a weakness! #SCCM2023

What things can we do to improve our wellness? (Come to my session on Monday to hear more about this!) #SCCM2023

Summary! #SCCM2023

What an excellent session! Thanks to #SCCM2023 for including such important content!