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Meat in a Seat: A Grounded Theory Study Exploring Moral Injury in Canadian Public Safety Communicators, Firefighters, and Paramedics

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  • Lorraine Smith-MacDonald

    (Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Health Sciences, Western University, London, ON N6A 2M3, Canada)

  • Liana Lentz

    (Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Health Sciences, Western University, London, ON N6A 2M3, Canada
    Faculty of Science, Thompsons River University, Kamloops, BC V2C 0C8, Canada)

  • David Malloy

    (King’s University College, Western University, London, ON N6A 2M3, Canada)

  • Suzette Brémault-Phillips

    (Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada)

  • R. Nicholas Carleton

    (Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada)

Abstract

The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews ( n = 3) and focus groups ( n = 3) were conducted with 19 participants (public safety communicators ( n = 2); paramedics ( n = 7); and firefighters ( n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.

Suggested Citation

  • Lorraine Smith-MacDonald & Liana Lentz & David Malloy & Suzette Brémault-Phillips & R. Nicholas Carleton, 2021. "Meat in a Seat: A Grounded Theory Study Exploring Moral Injury in Canadian Public Safety Communicators, Firefighters, and Paramedics," IJERPH, MDPI, vol. 18(22), pages 1-18, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12145-:d:682838
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    References listed on IDEAS

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    1. Joanna Gaitens & Marian Condon & Eseosa Fernandes & Melissa McDiarmid, 2021. "COVID-19 and Essential Workers: A Narrative Review of Health Outcomes and Moral Injury," IJERPH, MDPI, vol. 18(4), pages 1-18, February.
    2. Raganella, Anthony J. & White, Michael D., 2004. "Race, gender, and motivation for becoming a police officer: Implications for building a representative police department," Journal of Criminal Justice, Elsevier, vol. 32(6), pages 501-513.
    3. White, Michael D. & Cooper, Jonathon A. & Saunders, Jessica & Raganella, Anthony J., 2010. "Motivations for becoming a police officer: Re-assessing officer attitudes and job satisfaction after six years on the street," Journal of Criminal Justice, Elsevier, vol. 38(4), pages 520-530, July.
    4. Jane Shakespeare-Finch & Amanda Rees & Deanne Armstrong, 2015. "Social Support, Self-efficacy, Trauma and Well-Being in Emergency Medical Dispatchers," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 123(2), pages 549-565, September.
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    1. Liana Lentz & Lorraine Smith-MacDonald & David C. Malloy & Gregory S. Anderson & Shadi Beshai & Rosemary Ricciardelli & Suzette Bremault-Phillips & R. Nicholas Carleton, 2022. "A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada," IJERPH, MDPI, vol. 19(12), pages 1-19, June.

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