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PACEs in Pediatrics

How Integrity Can Heal Burnout (


Struggling to make an organizational decision that could adversely impact employees, or feeling unable to provide your children with care and attention while balancing the demands of work and your own need for rest, represent situations where moral suffering could arise. Whatever the exact nature of the decisions and dilemmas we face, the feeling of being too pressured or undersupported to act in alignment with our values has real effects on our mental health, and on whether we reach a point of burnout.

A Prescription for Resilience

It’s a problem for which Dr. Rushton has helped us, literally, to find new words. Rushton coined the term moral resilience: the capacity to sustain integrity in response to morally difficult circumstances. (Integrity is defined by Rushton as a sense of wholeness and being in alignment with your values, personally as well as in relationships). In response to the crisis of burnout in healthcareβ€”a 2021 study in JAMA: The Journal of the American Medical Association showed that among nurses who reported leaving their current job, 31.5% reported leaving because of burnout in 2018β€”Rushton developed an educational program for nurses called Mindful Ethical Practice and Resilience Academy, or MEPRA, launched in 2016. Research on the program’s efficacy showed significantly increased levels of mindfulness, ethical competence, confidence, work engagement, and resilience for the nurses who participated, as well as lower levels of depression, anger, and intent to leave their jobs.

A March 2021 survey of US employees found that 52% of respondents feel burned out, and more than two-thirds (67%) report the feeling has worsened over the course of the pandemic. If moral resilience training can reduce burnout among frontline nurses, can it help the general, non-healthcare population?

To read more of Caren Osten Gerszberg's article, please click here.

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