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BrainWaves: The Neuroscience Graduate Program Newsletter

Healthcare Workers, Burnout, and Moral Injury: The Aftermath of COVID-19

Author: Vanessa Parise

It has come to the attention of many Canadians that our healthcare systems and the employees within them are currently facing a dire situation. Many recent reports suggest that during and after the COVID-19 pandemic, healthcare professionals at various levels (e.g., nurses, physicians, personal support workers) have already or plan to leave their profession in the coming years. In a report titled “Addressing Canada’s Health Workforce Crisis” by the House of Commons Standing Committee on Health (March 2023), data projected that Canada anticipates a shortfall of 78,000 physicians by 2031 and 117,600 nurses by 2030.2 Additionally, in a labor survey performed in the same year by Statistics Canada, 11.2% percent of surveyed healthcare workers (HCW) (excluding physicians) intended on leaving their profession within the next year.1

What Could be Causing This?

There are two main reasons as to why this may be occurring: Burnout and Moral Injury.


Job burnout refers to the emotional and physical stress that is directly correlated to conditions at one’s job. This could be due to a variety of reasons such as a toxic work environment, working excessive overtime, and/or not maintaining a healthy work-life balance etc. In the case of healthcare workers, the COVID-19 pandemic stretched their means to, and sometimes over their emotional and physical limits. In one study, healthcare workers logged more overtime in the second year of the COVID-19 pandemic than they have at any time during the past decade.3 Additionally, 49% of family doctors reported high or severe work-related burnout related to working beyond their desired capacity.3 If such burnout is not resolved, it can lead to adverse mental and physical health outcomes and lead individuals to behave/act in a way that may not be in line with their own moral code.


Moral Injury/Overall Mental Health

As mentioned above, experiencing burnout on the job can lead to a variety of adverse health outcomes, which in turn could lead individuals to make decisions outside their typical moral conduct. Such changes can be more apparent in HCWs as they come face-to-face with life and death situations far more than a civilian might be. These types of situations can lead to morally injurious events. Moral injury is defined as a negative psychological response that may arise when one transgresses or witnesses another transgress, deeply held moral values, or when one feels like an individual or institution that has a duty to provide care has not done so.2 Many times, during the pandemic HCWs were put in situations, whether voluntary or not, where they had to choose between patient safety, their own safety and their families’ safety. Often, these individuals were forced to isolate themselves away from family to take care of those in the ICU with severe/fatal COVID-19. Many times, HCWs were in positions where there were not enough resources to properly take care of their patients putting them in situations where they were reusing personal protective equipment or working overtime many days in a row. In a small number of cases, they even had to make the decision of which patient received resources and which did not. Actions like these have led to a substantial rise in moral injury within the healthcare population.

All in all, the COVID-19 pandemic had a profound effect on both the physical and mental wellbeing of thousands of HCW employed within Canada and beyond, highlighting the importance of researching ways to alleviate the burden that currently exists within the healthcare system.

Excitingly, research in moral injury and burnout in both healthcare workers and public safety personnel is happening right here at McMaster University. Dr. Margaret Mckinnon and The Trauma and Recovery Research Lab recently launched a landing page with events, resources, and factsheets to help those in these professions who have felt the effects of the COVID-19 Pandemic. For more information, visit:

 1.  Blackwell, A. J. (2023, August 10). Quality of employment and labour market dynamics of health care workers during the COVID-19 pandemic. Statistics Canada .

2.  D'Alessandro, A. M., Ritchie, K., McCabe, R. E., Lanius, R. A., Heber, A., Smith, P., Malain, A., Schielke, H., O'Connor, C., Hosseiny, F., Rodrigues, S., & McKinnon, M. C. (2022). Healthcare Workers and COVID-19-Related Moral Injury: An Interpersonally-Focused Approach Informed by PTSD. Frontiers in psychiatry, 12, 784523.

3.  Duong, D., & Vogel, L. (2023). Overworked health workers are "past the point of exhaustion". CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 195(8), E309–E310.

4.  Standing Committee on Health, & Casey, S. [Report], Addressing Canada’s Health Workforce Crisis: Report of the Standing Committee on Health March (2023).