Redefining Burnout: Understanding Moral Injury

We talk about burnout and self-care like hashtags, while the real injury stirs just beneath the surface.  If I hear one more wellness expert tell exhausted professionals to “just take some time off and rest,” I might actually combust—which, honestly, would at least save me the hassle of catching up on 342 unanswered emails. The truth is, most of us aren’t struggling because we forgot how to rest or because we don’t own enough candles. We’re struggling because the environments we’ve worked in, served in, and sacrificed for have demanded more of our souls than our schedules.

For years, I used the word burnout as a catch-all for everything I was feeling—fatigue, frustration, emotional depletion, spiritual dryness, irritability, and that quiet, aching sense that I was slowly fading in places where I once felt deeply called. I honestly thought I was just tired. I figured if I could somehow string together one magical week of sleep, hydration, nutrition, and sunshine, I’d snap back into the most energized version of myself. But even on the rare days when I did rest, something still felt off. I still felt hollow. I still felt disconnected from the work. It was as if something sacred inside me had been scraped out—and no amount of napping could bring it back.

Some struggle with naming this phenomenon, but so many of us in healthcare, ministry, leadership, education, and service-oriented careers live with something called moral injury. It shows up when your job keeps pushing you into choices that clash with your values. It builds slowly—moment by moment—as you tolerate dysfunction, downplay your own needs, swallow mistreatment, or keep grinding inside systems that run you ragged and then applaud you for being “strong” enough to survive it. And before you know it, you start feeling complicit in your own burnout.

Moral injury settles into your bones in a way burnout never will. Burnout comes from exhaustion; moral injury comes from betrayal—of your calling, your integrity, your purpose, and the self you’re obligated to protect. And believe it or not, moral injury isn’t even the final boss. Once your nervous system crashes and your integrity gets shoved to the back seat, you slip into a place I call existential erosion.  It’s what happens when the injury goes unaddressed for too long, slowly reshaping the way you move through life.  When this happens, your compassion grows calluses and, if you’re not careful, collapses entirely. I hate admitting it, but I let myself reach that point.

I remember the exact moment when this happened to me. I was working as a system medical director for a massive healthcare company, sitting in yet another Zoom meeting with my boss—a regional medical director and a trailblazer in her field—talking about all the ways our system kept missing the mark. She opened with praise for my work, thanking me for everything I’d taken on. And I had taken on everything. I served on clinical excellence and peer review committees. I led a major internal clinical outreach project. I covered nine clinics a week—outpatient, inpatient, call shifts, and whatever fires other providers needed me to put out. I spent 16 hours a week in my car and another 70–80 hours providing care, doing procedures, and documenting, documenting, documenting. For months, every week of my life looked like this.  Every. Single. One.

So of course I told her how overwhelmed I felt. I stayed grateful for the opportunity to lead, but I made it clear that the work, while getting done, was costing me me. I told her I couldn’t keep sprinting at this pace—and that a drowning person can’t wait for you to schedule 13 meetings and send 47 emails before you toss out a lifeline. She looked at me, completely unfazed, and said, “You know, I hear you. This company has a knack for taking our top talent and running them straight into the ground. That’s how it’s always been.”

I heard the defeat in her voice, but it didn’t stop the floor from dropping out beneath me. This was a woman who had mentored me—kind, fair, reasonable, and brilliant. I genuinely admired her. But hearing those words still hit me like a personal blow. After a long, heavy silence, I took a few steadying breaths and finally said, “The fact that you know this is true and admit this is a problem—and it’s not the number-one crisis to address on every corporate leadership meeting agenda you have—feels like a betrayal to the integrity of the practice of medicine.” 

I said it with my whole chest. I said it through tears. I said it with shock and a level of disbelief that still lives rent-free in my memory. And in that exact moment, I finally understood the real issue: my stamina wasn’t the problem. I had reached capacity. I kept pushing, kept smiling, kept trying to be grateful, because high-achieving women learn early that our value gets tied to what we produce and how well we keep everyone else’s world from collapsing. We learn to keep the optics polished while our inner world frays at the edges. And because we are competent, capable, and compassionate, people praise us for surviving conditions that should have never existed in the first place. It trains us to celebrate—and sometimes even thank—the very systems that are draining us.   

You know you’re dealing with moral injury when the work you once loved starts stealing pieces of you. You know it’s moral injury when your spirit stays heavy even after you’ve rested. And you definitely know it’s moral injury when your body sounds the alarm before your mind catches up—tight chest, clenched jaw, tension headaches, sudden irritation, and that constant sense of bracing for the next dumpster fire you’ll be expected to extinguish. Moral injury shows up when you’ve stayed too long in places that never stewarded you well. It shows up when you’ve poured more into a system than it ever poured back into you. And it shows up when you’ve silenced your own convictions just to survive or belong.

And here’s the hardest part: you can love God, love your family, love your people, and love your calling—and still feel like you’re trying to breathe underwater. It took me a long time to understand that my constant exhaustion and overwhelm didn’t come from a lack of faith. I kept thinking if I just prayed harder, pushed harder, persevered longer, or found more serenity, I’d finally feel okay. Instead, I carried guilt on top of the exhaustion, as if burnout were some kind of trophy for people who care deeply and try their best. Newsflash: even Jesus felt the weight of people’s expectations, the sting of betrayal, and the exhaustion of giving more than His body could hold. When He withdrew—and He withdrew often—it wasn’t because His faith wavered. He withdrew because His humanity needed air.

I’ve learned that leaving environments that injure you doesn’t mean you failed—it means you finally listened to your nervous system. When I turned down a high-paying job with a six-figure sign-on bonus earlier this year (see previous blog post), it wasn’t because I lacked ambition or courage. It was because the version of me who said yes to those offers was the same version who believed she could outwork her pain. Like so many high-achieving people, I genuinely believed achievement would protect me, prestige would justify the pressure, big titles would make it all worth it, and the dream salary would somehow be the crown. Instead, it pushed me deeper into a cycle where my worth lived and died by my output. Walking away became my declaration that I finally understood the difference between being called and being consumed.

Healing from moral injury takes more than rest. It takes truth. It takes the courage to name, without apology, what harmed you in the first place. It takes the strength to rebuild your life around the values that matter to you—not the expectations that drained you. And it takes the spiritual confidence to believe that God will never call you into places that destroy your sense of self just so you can look successful. Sometimes the most obedient thing you can do is leave. The holiest thing you can do is stop performing. And the most healing decision you can make is admitting you’re done repeating the same broken patterns that keep leading you into the same unfruitful seasons.

Start re-evaluating the difference between what you’re good at and what’s actually good for you. Start asking deeper questions about calling, identity, purpose, boundaries, and dignity. Remember that your soul started asking for relief long before your calendar filled up.

Moral injury isn’t burnout you fix with a weekend off, a bubble bath, a massage, or a quick vacation. It’s a more serious condition that demands deeper, more intentional healing.

If you take nothing else from this post, remember this:

• You are allowed to reclaim your integrity and stand firm in it.

• You are allowed to choose environments that honor and protect your humanity.

• You are allowed to pursue joy without apology.

• And you are allowed to affirm your capacity and demand that your boundaries be honored.

You deserve a life that aligns with who you are and who God created you to become. You deserve peace that doesn’t demand performance. You deserve work that strengthens you instead of quietly eroding the parts of you that make you whole. Enduring unnecessary pain doesn’t prove strength, resilience, or integrity. Don’t be the frog who enjoys the “hot tub” so much he forgets he’s on the menu.

Protect your peace fiercely, intentionally, and unapologetically—like your life depends on it, because it does.

Clarity is step one—the moment you stop settling and start choosing yourself on purpose.  Every decision that protects your peace begins there.