Regina Christiansen

Background Burnout and emotional numbing—known in Scandinavian contexts as forråelse —pose critical challenges for psychiatric healthcare professionals. These phenomena are closely linked to moral distress, ethical dilemmas, and systemic pressures that complicate daily clinical practice. Understanding the interplay between organizational constraints, moral agency, and relational dynamics is essential for ethical and sustainable mental healthcare. Research aim The study aims to examine how organizational and ethical pressures contribute to burnout and emotional numbing among psychiatric healthcare professionals, and how these professionals experience and respond to moral distress and relational challenges in daily clinical practice. Research design A qualitative ethnographic design was employed, combining prolonged field observation with semi-structured interviews to capture nuanced experiences of staff in real-world clinical settings. Reflexivity and iterative analysis ensured rich, contextually grounded insights. Participants and research context Eighteen psychiatric healthcare professionals were interviewed over 6 months in inpatient psychiatric units. Participants included nurses, social workers, medical doctors, and allied staff, representing a range of clinical roles. Ethical considerations Informed consent, confidentiality, and participant well-being were prioritized. Reflexive practices were used to acknowledge researcher influence, and ethical approval was obtained from the relevant institutional review board. Results Four interrelated themes emerged: workplace dynamics, task management, patient collaboration, and emotional numbing. Systemic pressures—including understaffing, ethical strain, and limited institutional support—were central drivers of burnout. Emotional numbing appeared as an adaptive response to sustained moral distress and relational demands. Participants reported finding meaning through relational commitment, peer support, and small therapeutic successes, despite persistent ethical and organizational challenges. Conclusions Burnout and emotional numbing are systemically produced phenomena rather than individual failings. Addressing these issues requires structural reforms, reflective supervision, and supportive workplace cultures that integrate ethical deliberation. Recognizing moral distress and fostering relational engagement are critical to safeguarding staff well-being and promoting ethical, patient-centered psychiatric care.

Alcohol use has been recognized as a challenge in eldercare and social care, and some anticipate that problems related to alcohol use will increase in the future as the current adult generation has high alcohol consumption rates. Accordingly, it is suggested that care workers are at risk of becoming passive bystanders to the destructive lifestyles of vulnerable older adults and even facilitating these lifestyles. In the present paper, we suggest that alcohol exacerbates and underscores inherent difficulties in eldercare, such as finding an appropriate balance between the personal freedom of the older adult and the responsibility of the care worker to provide care. The specific focus in the paper regard the communication and interaction involving values between people in eldercare in cases of problematic alcohol‐related situations to uncover the difficulties. We found it noteworthy that the objectives and perspectives of older adults, care workers, managers and relatives have implications regarding their interactions and communications because their varying experiences involve values that are not necessarily aligned. Sometimes, care workers have no choice but to act against what, in the public sphere and to the other care workers, is ruled out by virtue of their professional ethics. It is suggested that care workers describe and judge situations where alcohol is present paradoxically by virtue of their professional ethics, yet regulate their care to preserve the dignity of older adults, even when they find the situation to be an apparent dilemma.

Alcohol use has been recognized as a challenge in eldercare and social care, and some anticipate that problems related to alcohol use will increase in the future as the current adult generation has high alcohol consumption rates. Accordingly, it is suggested that care workers are at risk of becoming passive bystanders to the destructive lifestyles of vulnerable older adults and even facilitating these lifestyles. In the present paper, we suggest that alcohol exacerbates and underscores inherent difficulties in eldercare, such as finding an appropriate balance between the personal freedom of the older adult and the responsibility of the care worker to provide care. The specific focus in the paper regard the communication and interaction involving values between people in eldercare in cases of problematic alcohol‐related situations to uncover the difficulties. We found it noteworthy that the objectives and perspectives of older adults, care workers, managers and relatives have implications regarding their interactions and communications because their varying experiences involve values that are not necessarily aligned. Sometimes, care workers have no choice but to act against what, in the public sphere and to the other care workers, is ruled out by virtue of their professional ethics. It is suggested that care workers describe and judge situations where alcohol is present paradoxically by virtue of their professional ethics, yet regulate their care to preserve the dignity of older adults, even when they find the situation to be an apparent dilemma.

The moral and epistemic significance of emotions has been increasingly emphasized in recent philosophy. The focus has been mostly on metaethical questions. We add a new perspective by considering the practical importance of gauging, reacting to, enhancing, or reducing the emotions of others and oneself. We focus particularly on the collective aspect of emotion development and regulation, how emotions are entangled with values, and how they may be used constructively for handling otherwise difficult situations. We use the case of elderly care, drawing on a qualitative study from a Danish municipality, to illustrate the complex and multifarious ways in which emotions shape the normative landscape in which attempts to maintain or improve well-being take place.