Trust: is this the root of moral injury?

Rosie sound asleep (snoring) in my lap

This is my dog, Rosie, sound asleep on my lap. This is trust, something to be valued from our canines and other humans. How often can we damage a person’s trust in an individual, or for that matter, the government, medicine/science, or religion when memes, gaslighting, aggression, or violence are used to “power over” and shake the foundational beliefs of someone?

Nurses are the most trusted health professional in the world. And, as Rutherford (2014) stated: “Nursing’s trustworthiness is an intangible asset that warrants protection, as trust once lost is hard to recapture.” But, what happens when a nurse loses trust in her manager? When I was writing my dissertation, I truly wondered how trust factored into staying in the workplace after bullying. If a nurse lost trust in her/his manager, that they would protect her/him from the bully, would they leave the unit, transfer out, stay and become a bully themselves to stop from being bullied? How does trust factor into this situation?

If I were to do a survey today, would nurses trust their employer to do the right thing, keeping them safe from violence, provide adequate staffing or appropriate personal protective equipment (PPE), and assisting with psychological first aid when the CoVID pandemic overwhelms? In Social Exchange Theory, people treat each other equally; they help each other. If this exchange is perceived as unequal, unfair, or with unwarranted aggression, distress occurs (Emerson, 1976; Lazarus & Folkman, 1984, Berry, 2015 ).

Work relationships create occupational stressors or buffer against other occupational stressors influencing appraisal and coping (Berry, 2015). If trust is broken with the organization through inability to protect during a pandemic, I would surmise moral injury would occur with posttraumatic stress symptoms. Many nurses will leave the profession. And, 2020 and 2021 will be pivotal years for healthcare professionals.

These are just random thoughts as I cope with my son’s CoVID diagnosis. As a nurse mom, I am distressed by this diagnosis but I am equally concerned about the nursing profession. I know our profession has survived the Spanish Flu, Smallpox, polio, and other pandemics. But it hit home here, in my family today while others try to shake the very foundations of science and trust regarding vaccines and pandemic.

Please, give health professionals a break. Take the vaccine. Wear the mask until we reach herd immunity through vaccination. And, please, stop the trying to cast distrust on the need for vaccination. we have to be better at protecting and caring for each other for nurses to continue to care for us.

Thanks for reading.


Emerson, R. M. (1976). Social Exchange Theory. Annual Review of Sociology, 2, 335-362.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer Publishing Company

Rutherford MM. The Value of Trust to Nursing. Nurs Econ. 2014 Nov-Dec;32(6):283-8; 327; quiz 289. PMID: 26267958.

Oh yeah, my dissertation is somewhere out there to read.

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