Non c’è cura dei pazienti senza cura degli operatori: conoscere e contrastare moral distress e burnout fra prevenzione e interventi strutturali

Abstract. Caring for patients requires caring for health providers. In recent years, many academic papers have underlined the ethical and psychophysical consequences of heavy workloads, pervasive bureaucracy, chronically insufficient resources and growing expectations on part of the citizens. Moral distress and burnout episodes are increasingly reported among all health professionals, putting at risk the health of operators, the safety of treatments provided and the quality of care perceived by patients. The sustainability of National health service (Nhs) is therefore under threat. The epidemiological focus on these episodes is not followed by proportional strategies to support the healthcare professionals and simplify their work. Rather the opposite is true: an accurate research for environmental, administrative and organizational factors has been developed so that to deliver a higher amount of medical care in the same period of time, regardless of the benefits actually perceived by patients and operators. A multidisciplinary team of health professionals, trainers, nursing and policy researchers and ethicists investigated the determinants of well-being among the operators and the elderly people they care for (epidemiological-descriptive phase), in order to outline some educational and institutional interventions (political-normative phase): introducing specific educational sessions of which a preliminary experience is reported; including soft skills training in the university curricula; educating citizens’ behavior and expectations towards medicine and public health; revising the priorities of the Italian Nhs through a urgent update of Essential levels of health (Lea).