Moral distress in healthcare providers working in safety net practices during COVID-19

Editor's Note

This study led by researchers at the University of North Carolina School of Medicine, Chapel Hill, finds that nearly 72% of healthcare providers in US safety net practices experienced either mild or intense levels of moral distress during the first year of COVID-19 because of issues with patient care and their workplaces.

Using data from a survey of 2,073 office-based clinicians in 20 states who worked with low income patients, the researchers found that:

• 28.4% reported no moral distress
• 44.8% reported mild or uncomfortable levels of moral distress
• 26.8% described their moral distress as distressing, intense, or worst possible.

Some of the most commonly mentioned issues that clinicians found morally distressing were:

• when their patients were not receiving the best and/or all needed care
• infection risks faced by both patients and staff
• when their coworkers’ health was jeopardized or they lost their jobs
• politics in the community that affected clinicians’ work and families
• how the pandemic impacted their patients and patients’ families and feeling powerless to make changes.

Future studies should assess whether other clinician groups, including those working in other types of outpatient practices and in hospitals, can also be morally distressed at work by staff mistreatment and witnessing injustices, the authors say.