Moral Distress, Mattering, and Secondary Traumatic Stress in Provider Burnout: A Call for Moral Community

AACN Adv Crit Care. 2020 Jun 15;31(2):146-157. doi: 10.4037/aacnacc2020285.


Burnout incurs significant costs to health care organizations and professionals. Mattering, moral distress, and secondary traumatic stress are personal experiences linked to burnout and are byproducts of the organizations in which we work. This article conceptualizes health care organizations as moral communities-groups of people united by a common moral purpose to promote the well-being of others. We argue that health care organizations have a fundamental obligation to mitigate and prevent the costs of caring (eg, moral distress, secondary traumatic stress) and to foster a sense of mattering. Well-functioning moral communities have strong support systems, inclusivity, fairness, open communication, and collaboration and are able to protect their members. In this article, we address mattering, moral distress, and secondary traumatic stress as they relate to burnout. We conclude that leaders of moral communities are responsible for implementing systemic changes that foster mattering among its members and attend to the problems that cause moral distress and burnout.

Keywords: burnout; mattering; moral community; moral distress; secondary traumatic stress.

MeSH terms

  • Adult
  • Burnout, Professional / prevention & control*
  • Critical Care Nursing / ethics*
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Middle Aged
  • Morals*
  • Nursing Staff, Hospital / ethics*
  • Nursing Staff, Hospital / psychology*
  • Stress, Psychological / prevention & control*
  • United States