Residue and Resilience: Understanding and Addressing Post-Traumatic Stress Disorder, Compassion Fatigue, Moral Injury, and Burnout in Emergency Medicine

IF 1.3 4区 医学 Q3 EMERGENCY MEDICINE
Joshua Lowe MD, Sean Griffiths DO
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Abstract

Background

Emergency medicine providers frequently experience psychological distress, often labeled as “burnout.” However, this term is frequently used as a catch-all, obscuring key differences between burnout, compassion fatigue, moral injury, and post-traumatic stress disorder (PTSD). These distinct conditions arise from different causes—ranging from individual trauma to organizational dysfunction—and require targeted interventions. Mislabeling them can lead to ineffective or even counterproductive solutions.

Discussion

PTSD is an acute condition stemming from identifiable traumatic events and is best addressed through individualized, evidence-based therapies. Compassion fatigue arises from chronic empathy-based stress and benefits from resilience training and self-compassion practices. Moral injury, by contrast, results from acute violations of one’s moral or ethical framework—often triggered by leadership or systemic failures—and requires organizational accountability and repair. Burnout is a chronic consequence of motivational incongruence between provider values and systemic pressures and cannot be resolved through individual-focused strategies alone. Addressing burnout and moral injury effectively requires leadership-driven changes, including ethical consistency, staffing support, and realignment of institutional priorities with provider values.

Conclusions

Properly naming and framing psychological distress is essential to developing appropriate, effective interventions. Interventions must align with the underlying causes of each condition. By distinguishing between these overlapping but distinct forms of distress, emergency medicine can move beyond one-size-fits-all wellness approaches and implement sustainable, compassionate, and systemic solutions that support provider well-being and improve patient care.
残馀与复原力:急诊医学中创伤后应激障碍、同情疲劳、道德伤害与倦怠的理解与处理
急诊医生经常经历心理困扰,通常被称为“倦怠”。然而,这个术语经常被用作包罗一切,模糊了倦怠、同情疲劳、道德伤害和创伤后应激障碍(PTSD)之间的关键区别。这些不同的情况是由不同的原因引起的——从个人创伤到组织功能障碍——需要有针对性的干预。错误的标签会导致无效甚至适得其反的解决方案。创伤后应激障碍是一种由可识别的创伤事件引起的急性疾病,最好通过个体化、循证治疗来解决。同情疲劳产生于长期的基于同理心的压力,并受益于弹性训练和自我同情练习。相反,道德伤害是严重违反个人道德或伦理框架的结果——通常是由领导或系统失败引发的——需要组织问责和修复。职业倦怠是提供者价值观和系统压力之间动机不一致的长期后果,不能仅通过以个人为中心的策略来解决。有效地解决职业倦怠和道德伤害需要领导驱动的变革,包括道德一致性、人员支持和机构优先事项与提供者价值观的重新调整。结论正确命名和界定心理困扰是制定适当、有效干预措施的关键。干预措施必须与每种疾病的根本原因保持一致。通过区分这些重叠但不同的痛苦形式,急诊医学可以超越一刀切的健康方法,并实施可持续的、富有同情心的、系统的解决方案,以支持提供者的福祉并改善患者护理。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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