Nurses take an oath to act in the best interest of their patients, but the corporatization of health care and the focus on profits have made it increasingly challenging to keep that vow.

Dr. Wendy Dean, the keynote speaker at the Federation of Nurses/UFT’s annual Professional Issues Conference on Nov. 15, described this phenomenon and gave it a name. Clinicians who do not have enough staff, equipment or training to provide the care patients deserve can suffer “moral injury,” she said.

Dean, the CEO and co-founder of the nonprofit Moral Injury of Healthcare, said the injury can be repaired by developing a responsive work culture or seeing the workforce as a solution and not a problem. By belonging to a union, Federation of Nurses/UFT members can advocate for change at the bargaining table, she said.

“What I loved hearing is you have folks who have your back,” she said, referring to UFT President Michael Mulgrew and UFT Vice President Anne Goldman, who heads the Federation of Nurses/UFT.

Mulgrew thanked the roughly 185 nurses who attended the conference at union headquarters in Manhattan for using their voices to advocate for both their patients and themselves. Members of the UFT’s NYU Langone Hospital–Brooklyn Chapter, he noted, filed thousands of grievances to force the hospital to comply with the union contract and a 2021 state law that established safe staff-patient ratios. As a result of a groundbreaking arbitration settlement in 2022, the hospital must now compensate nurses who work understaffed shifts.

Mulgrew said the union’s goal was to make sure that hospital CEOs paid attention to and feared the staffing law. “Now they’re afraid,” he said.

Goldman called Federation of Nurses/UFT members “fierce warriors” who make a difference when they bargain with the employer and when they advocate for patients in the workplace. With the strength of the union behind them, she said, they “challenge a system that is in many ways improper, not equitable and certainly doesn’t meet people where they are.”

At the daylong conference, members could attend two of four 90-minute continuing education workshops on wound care, medical emergencies, assessing anxiety and mood disorders, and legal and professional requirements for nursing documentation.

Ruth Caballero, a per diem charge nurse at a rehabilitation center who recently retired from VNS Health, said she learned how to ask open-ended questions at the workshops on wound care and evaluating patients for depression and anxiety.

“A lot of times patients will just say ‘Yes’ or ‘No’ or ‘I don’t know,’ but now that I have the ability to use what I’ve learned to help them expand on that, I won’t get that one-word answer from a patient, or a family member if a patient can’t respond,” she said.

The Professional Issues Conference is an annual “time out” that allows nurses to socialize and talk about issues of interest to the profession, said Blessing Ijeoma, a former school nurse who now works for the state Office for People with Developmental Disabilities. “We encourage each other,” Ijeoma said. “Once we know that we all experience similar situations, we get that camaraderie.”

Members including Olga Rios, a charge nurse at NYU Langone–Brooklyn, said the keynote address on moral injury rang true and described what nurses have been experiencing.

Rios said she first heard the term “moral injury” in a recent online class. “It’s a new thing, and it stuck with me and really made an impact, which she just cemented more today,” she said of Dean.

Rios and Katherine Finkelstein, who retired from Staten Island University Hospital–South in June, said framing the problem as moral injury is more accurate and a spur to action.

“It was very enlightening,” Finkelstein said. “Everyone thinks ‘burnout, burnout, burnout’ or post-traumatic stress. I didn’t even know this syndrome existed.”