UC Irvine

Occupational burnout and moral injury are related, but distinct, processes with operational and relational drivers. This scoping literature review examines one key relational driver of burnout and moral injury: values conflicts between nurses and their organizational leadership. This review included a five-database search, which produced 346 citations for full-text review. Preliminary results have identified 11 relevant citations: 8 journal articles, 2 journal-published expert opinions, and 1 qualitative dissertation study. All references examined some aspect of leadership in relation to burnout and discussed values conflicts; only one investigated moral injury in relation to leadership structures and values conflicts. Six sources explicitly found that perceived differences in values between administrators and clinicians may contribute to burnout. One article discussed the betrayal of nurses' moral values by leadership in connection with moral injury. Implications suggest a potential for organizational leadership and administration interventions that address values conflicts to combat burnout, moral injury, and their myriad negative downstream consequences. These results also implicate a need for further research to better understand how nurses come to experience values conflicts in relation to their organizational leaders and administrators.