You can do everything right, follow the rules, and still carry a call that won't leave you alone. That's moral injury.
For first responders, trauma isn't always about what you witness. Sometimes it's about what you couldn't do.
Ashley Brockman, former paramedic and now counselor, shared her story of being stuck on a 9-1-1 call she couldn't leave even as another call came over the radio for a child in cardiac arrest just two blocks away. Due to laws in Texas, leaving her first call would have been classified as patient abandonment. She followed the rules, did her job by the book, and yet years later, that moment still haunted her.
That's what moral injury looks like. It's not a broken policy or a bad call; it's the inner conflict when what you had to do doesn't align with what you believe is right. And unlike physical wounds, moral injury doesn't show up on an X-ray. It shows up as guilt, shame, cynicism, emotional exhaustion, or burnout.
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