Moral injury can happen when a fire fighter experiences or witnesses something that conflicts with their core values or sense of what is right. Unlike PTSD, which Jamie Epting describes as rooted in a sense of threat or danger, moral injury can challenge how someone sees themselves, other people, or the systems around them. For fire fighters, it may come from a difficult call, an outcome they wish they could have changed, repeated encounters with situations they cannot fix, or even policies and systems that prevent them from helping in the way they believe they should.
Jamie Epting and Lt. Bill Hartung emphasize that these experiences can linger long after a call is over, particularly in a profession where people are trained to solve problems and continually evaluate their own performance. Talking about these experiences, recognizing what is and is not within your control, and creating a culture where crews can openly acknowledge difficult calls can help. Most importantly, experiencing moral injury does not mean a fire fighter has failed. These feelings are a normal response to difficult circumstances, and support is available.
5 Key Takeaways
- Moral injury challenges your sense of what is right. It can occur when something you experience, witness, or are unable to change conflicts with your core values.
- It is different from PTSD, but the two can overlap. PTSD is associated with a sense of threat or survival, while moral injury more directly affects your sense of self, values, trust, and how you believe the world should work.
- The inability to “fix it” can weigh heavily on fire fighters. Difficult outcomes, repeat calls, systemic problems, or barriers outside a fire fighter’s control can create frustration, guilt, anger, or a sense of betrayal.
- Talking about it matters. Conversations with crew members, officers, peer support, the union, Station 2 Clinic, or another trusted resource can help keep difficult experiences from being carried alone.
- Normalization starts with the crew. Simply acknowledging, “That was a rough one,” can open the door for others to talk. When leaders and crew members are willing to name difficult experiences, it reinforces that these reactions are understandable and okay.
Transcript
Listen Up L27: Moral Injury in the Fire Service
Jamie Epting: I think it changes how you see yourself and others. I think fire fighters particularly work in a world where morals and judgment are part of code. Every action, every situation I recall, there’s a moral complexity in that it’s different than other jobs. And so there’s a lot more processing and reflecting on how things happen, especially when it sticks or didn’t go a certain way. But then there’s also can be more harm because you have to work in a system that requires you to be a good person.
Jen Pennington (Host): Hey, Seattle Fire Fighters, welcome to Listen Up L27.
Today we’re going to be talking about when something doesn’t feel right. We’re going to be talking about moral injury in the fire service. It’s not just stress, it’s not just trauma. It can show up when something about a call goes against your sense of what’s right, whether you were directly involved or simply there to witness it. We’re going to get into a little bit more of the explanation of moral injury. But today we are joined by Jamie Epting From Station and Lt. Bill Hartung, who is a Seattle fire fighter and the lead peer support coordinator who also serves on the peer support team. So thank you very much for joining us today.
Jamie Epting: Thank you for having us.
Jen Pennington (Host): So before we get into it, Jamie, why don’t you set us up? Why don’t you set us up and tell us a little bit more in sort of simplified terms what we mean when we talk about moral injury.
Jamie Epting: I just want to note that there are a lot of different definitions for moral injury. So in the context, just the generalized definition, it’s something that happens when an experience goes against your core values and it stays with you because it challenges how you see yourself, others, and the world.
So something that you experience that sticks with you, that goes against your morals. In plain English, although I’d like to hear your definition.
Lt. Bill Hartung: Yeah, I think about it in many different aspects. It can be a situation that something happened that you couldn’t control and you feel bad about it later about wishing you could have done more, wishing the outcome could have been different. It could be something that you see that’s unethical, whether that’s somebody that you work with or somebody that you work for.
It could be political in nature. It could be policy-based. There can be many different things that go against who you are and what you stand for and what you fully believe in. And that can bring upon many different aspects of distress.
Jen Pennington (Host): And sometimes it’s not even about, you know, we often talk about, you want to say something in the moment but it doesn’t even hit you until afterwards. It’s like, oh, you know, maybe I should have said this, or maybe I should have done this, or maybe I shouldn’t have done something.
So, you know, I think we’re talking about something that can stay with a person for quite a while because you’re thinking about it.
Jamie Epting: Yeah, definitely this. It sticks to you, and I think it changes how you see yourself and others. And going back to that definition, the world. Yeah. I think fire fighters, particularly, you know, fire fighters work in a world where morals and judgment are part of code. Every action, every situation I recall, there’s a moral complexity in that. Right. And so it’s different than other jobs. And so there’s a lot more, you know, processing and reflecting on how things happen, especially when it sticks or didn’t go a certain way. But then there’s also can be more harm because you have to work in a system that requires you to be a good person.
Lt. Bill Hartung: Yeah, I would agree. And the nature of being a fire fighter, we are constantly analyzing ourselves and our performance.
And so when you have a situation that occurs, whether it’s a call, like an aid call or a fire call, and things don’t turn out the way that you expected, we will often rehash them in our minds over and over and over again.
And those are those times when we’re sitting awake in the middle of the night. It could be on shift after a call, or we wake up at home and you’re staring at the ceiling and rehashing those incidents and wondering what you could have done differently, or if things had happened differently, how would the outcome have changed?
And especially when that involves somebody’s life, and it really sticks with you, thinking, what could I have done differently? How could I have done better?
And it’s almost a preseveration.
Jen Pennington (Host): And I think, you know, there’s also things that are external factors. Right. So we. There are always. Always.
But I mean, you might be in a very, you know, I mean, fire fighters, you go into situations that can be really intimate. You’re right there with a person.
You might be on repeat with the same person.
You know, you’ve seen something happen, like a, you know, a drug overdose or something like that, and you’re helping the person.
But you might be saying to yourself, there are some factors here that could be done better by maybe the forces around you in terms of, like, a policy, what’s going on with maybe a homeless situation or something. So how do you think about that?
Jamie Epting: I want Bill to answer that. First, because I, obviously as a therapist, you know, I.
I get the stories secondhand, and so I’m not there on the scene, but I can imagine the scene very well, and I get the perspective of the fire fighter. And it’s a very layered thing because there’s the difficulty with not being able to fix a situation and what that can over time feel like. And then there’s the layer of this is your job and this is the expectation. And fire fighters are very performance-based, as Bill said, and also professional like. There’s an excellence of professionalism, if that makes sense. And so going to a scene that feels like a moral injury or even later, moral injury coming up, there’s a lot of emotion that can be attached to that because of the different calls that fire fighters go on.
Lt. Bill Hartung: In some ways, you talked about performance-based and professionalism. Sometimes we hear an address and we know that address, and so going into it, you’re like, oh, gosh, here we go again.
But then the second you step off the rig, everything drops and your professionalism takes over and you go do the job the best that you can.
And sometimes that’s constrained by other things, you know, environments, policies, procedures, whatever. But we do the best we can with what we have in that moment. moment. And that professionalism, it’s like a switch. And we go and do everything that we can to help that person, but that’s where that stuff comes out. Later, when we get back to the rig, we’re driving back to the station or whatever else we’re doing, and maybe some of the guys start talking about it. You know, they have something to vent, or maybe the coworkers that you’re with don’t talk about it at all.
And that’s the stuff I think that can be troubling is when nobody talks about it and everybody’s wondering, does he feel that way? Does she feel the same as I do?
I don’t know.
And maybe I’m afraid to speak up, you know, because I don’t want to be the one person that says something that’s negative or different than what everybody
Jamie Epting: else thinks or complaining or being viewed as a certain way.
Lt. Bill Hartung: Right. But at the same time, you’re sitting there thinking it after. It’s not really during the moment.
We don’t think about those things during the moment. All that stuff goes out the window, so to speak. You know, we focus on the task at hand, we get the job done, we’re professional, do what we need to do. It’s always after.
Jen Pennington (Host): It’s the hindsight, yes. Yeah. And something that you said before, and I had a conversation earlier today with Laura Takacs and Captain Matt Lujan, and one of the things that he was talking about is like, hey, fire fighters, we like to fix things. We like to. You know, it’s sort of encoded in who we are.
Jamie Epting: They’re problem solvers. Yeah, they’re problem solvers.
Jen Pennington (Host): And when you see something that you can’t fix or it stays with you, like we’re talking about, or you look back in hindsight and you’re like, ah, is there anything that it has brought forward for you that you’re like, you know what? I think we can fix some of these things, but we don’t. You know, has it pushed you to move some things forward that you weren’t able to before? Or maybe you. I don’t know.
Lt. Bill Hartung: I think that goes with some of that moral injury. Right. Like, every fire fighter’s got a lot of great ideas.
They all want to fix something, and they all have their idea on how they’re going to solve the situation.
But the difference is, is whether you have that ability, Right. And that could be those policies or procedures that are in place, whether that’s our own administration or citywide or statewide or countrywide. There could be any numerous roadblocks in front of you that aren’t necessarily going to allow you to enact what you think will fix the situation. Those are some conversations that happen around the beanery table often, you know, if I was in charge, this is how I would do things.
But that doesn’t mean that that’s what can’t actually be put in place. I think we do everything we can at the time with the information we have and the ability we have.
I think that’s what goes into that professionalism. Like Jamie talked about, we are going to give everything we have at that moment to fix the situation.
And I’ve seen some fire fighters go through some massive efforts to try to fix things for just one person. And I know I’ve been a part of all kinds of different things like that, but the difference is, you know, when it doesn’t work and you see that person again, or you’re going to the same address, and those things can add up on you a lot. You know, you put in so much effort to try to help somebody, and it doesn’t work.
Jen Pennington (Host): And you’re a peer support counselor as well, Right?
Lt. Bill Hartung: So, yes, I wouldn’t call us counselors, but I’m a member of the peer support team, and I’m also the lead
Jen Pennington (Host): coordinator and as a peer support person, you are, I’m sure you’re hearing this, you know, as people are talking through, you know, they might be having a conversation with you or you know, one of their coordinators or something. So.
Lt. Bill Hartung: Absolutely, there’s a lot of different ways that we talk to people. You know, in peer support world, we come to some of the more difficult instance, whether it’s an aid call or a fire call or whatever it is that can be more impactful. You know, we might do some work with them immediately after the call or as soon as we possibly can with people that are on shift, or we might work with individuals one on one. And sometimes that might be somebody was recommended to us and we try to connect them with the right peer or they reach out to us.
So there’s a lot of different ways that can happen, but there can be one on one or group type work that happens.
Jen Pennington (Host): How do you see this show up in people that you work with? We’ve been talking a little bit about it, but has, you know, have you seen behavior changes or things like that? Can you recognize it right away?
Lt. Bill Hartung: I think our, our different fields, like as me as being an officer and a fire fighter versus Jamie being counselor, I think we see it in vastly different ways.
Jamie Epting: Would you agree with that?
Lt. Bill Hartung: I think for me, I see it, you know, when I see someone on the call, has a bad reaction to something, or we get back to the station or back to the rig and somebody might bring it up, you know, especially as an officer, I’m going to try to talk with them and help them work through it or in my peer support capacity. People come to me in that aspect, but I feel like those are instances that are way more short term. Like it hasn’t been a long period of time. I mean, we do have stuff that people come to us like way down the road, but I think it’s more like in the immediate. Or I think Jamie would probably have different.
Jamie Epting: I think, well, I see the spectrum of it. Obviously, I’m only working with the fire fighter, so I see it show up in layers. Again, back to the layer piece.
So individual interpersonal meaning between fire fighter, between fire fighter and fire fighter, fire fighter and station, fire fighter and administration.
I think one of the more glaring experiences that I see is the. There’s a betrayal with moral injury, the betrayal trauma as I call it.
Because moral injury on a systems level can feel like betrayal to a fire fighter, especially when they’re going through a crisis and there’s an expectation that they will be taken care of. In the same way that they take care of others. And so that doesn’t happen. It’s an added layer of, you know, emotion and pain.
Yeah.
Jen Pennington (Host): Honestly, how do you differentiate that between, you know, something that somebody’s experiencing as a moral injury and maybe something like PTSD?
Jamie Epting: Yeah, they’re not mutually exclusive or mutually inclusive.
So PTSD is a threat to survival. It’s a survival threat. So your body. There’s a biological component to this, where your body is in an active state of survival and threat to your life. Even though the outside external world may not technically be threatening your life, your body feels as if your life is threatened. Whereas moral injury is more of a less threat to your life, but more a threat to your sense of self and to your sense of how the world should be, if that makes sense.
Lt. Bill Hartung: Like a threat to your core values.
Jamie Epting: Yes, exactly. Yes. And then both of those can also be layered on top of each other. So you can have PTSD and moral injury, and you can have moral injury and not have PTSD.
Jen Pennington (Host): Well, let’s talk about what helps.
So if someone is recognizing this in themselves, I mean, obviously they can speak to you or, you know, either of
Jamie Epting: you, and hopefully you go to Bill first.
Jen Pennington (Host): Yeah, I know, absolutely. But. But, you know, let’s talk about first steps and follow-ups and things like that.
Lt. Bill Hartung: I think talking is the very first important step.
And for a lot of people, it could be the ego or bravado. You know, fire fighters definitely don’t like to feel like they’re the ones that are hurt or in crisis or having issues. I think a lot of us feel like we should have Superman or Superwoman suits, and that’s who we are, and nothing can crack us.
But the reality is, is that something cracks all of us eventually. We’re human beings. Right.
So to me, talking is the first step. And it doesn’t matter to me who that is. You know, we have so many different options with the Seattle Fire Department. We have the peer support team. We have our union. We have the Station 2 Clinic now.
And on top of that, each one of us, one of those different areas, has all kinds of other resources that we could tap into to help people.
And to me, it doesn’t matter where anybody goes. You know, it’s not a competition to see who can help whom first.
It’s about that person getting the help that they need.
Jamie Epting: So to add to that, yes, name it, talk about it. I think, Bill, you brought this up when we were talking, kind of prepping for this, but the. What can you control is really important, like, what are things within your control?
What are things outside of your control? Being able to identify that distinction so that you know how to move forward, whatever that looks like. Being mindful about how much venting and negativity can kind of make the.
The feeling in you worse. So, you know, I’ve been. I was told this when I first started this job of. There can, like the culture of the station you’re in can really exacerbate feelings of negativity if there’s already some negativity at that station. Leadership is really important, too. So having conversations with your lieutenant or captain, and if those aren’t people that you feel like you can really talk to, then find definitely identifying people that you can.
Jen Pennington (Host): Well, let me ask you this. You know, how can, like, the departments or leadership better support fire fighters around this? And especially, like, calling it. Calling it out. This is, you know, what you’re experiencing might be moral injury, and here’s what it is and that kind of thing.
Lt. Bill Hartung: I feel like as far as our leadership and administration, when it’s time for me to activate some peer support help, I don’t ever receive any pushback. It’s more of them saying, what can we do? How can we help you? What do you need?
And I feel like that provides a great background for us to be able to get people the help that they need. So I haven’t felt that there’s ever been any kind of pushback ever. They’re always very open to whenever some type of peer support work needs to be done or what needs to be done to help somebody or a group of people, like a station or a crew. They’re always supportive of us being able to do some kind of intervening help.
Jen Pennington (Host): And I wasn’t. Maybe I should be clear because I wasn’t necessarily looking at it in terms of that leadership is not there. But I think I was looking at it more as, like, an educational piece of, you know, that. That what you might be experiencing is, you know, moral injury from the standpoint of talking about it as.
Jen Pennington (Host): Have you recognized that normalizing it as part of the job, having conversation around it, helps?
Lt. Bill Hartung: Yeah, I do feel that normalization is powerful, helping people understand that you’re not the only person that is feeling this way or is going to feel this way.
It’s likely going to happen to us all. And at some point in your career, you’re going to experience something like this. It’s kind of a job hazard.
So that normalization, talking about it, putting it out there, you know, I feel like as officers, we can be aware of that when it happens. And knowing that, hey, that was a rough one.
Let’s talk about it.
And that creates an open forum for everyone on the crew to be able to start talking about it. And it makes it so that, oh, okay.
If my officer is talking about how bad this was or how rough this was or how frustrated they are with that situation or however things are going, it’s huge, then it’s okay for the rest of us to feel that way, too.
And I think that shouldn’t just be the officer, really. Anybody on the crew can bring that up and help normalize that for everyone.
Jamie Epting: It’s a leadership role. Yeah, for sure.
I’d say not everyone will always feel comfortable, especially if they’re newer to firefighting. But I agree with you, definitely.
It’s a team effort to talk about it and also to have the courage to bring that up, too.
Jen Pennington (Host): But that’s what I think. You’re finding a way to work it into a conversation like we’ve talked about, normalizing it and whatnot. If there’s one thing you’d like fire fighters to take away from this conversation, what would you like them to know?
Jamie Epting: You’re not alone.
Yeah, I think just. I think about the fire fighters that I’ve had to sit with who really have gone through a level of betrayal that is unfortunate. And while it does happen when you work in a system and the Seattle Fire Department is a part of a larger system, I just want to say that there’s support for that, and it is something that happens, unfortunately, but that there is support on the other side of that.
Lt. Bill Hartung: Yeah. Like you said, you’re not alone. And I think my saying would be, it’s okay.
It’s okay to feel that way. It’s okay to have those emotions. It’s okay to be upset or feel betrayed or feel like you could have done something different or wishing you could have done something different. Whatever that layered piece of moral injury is that you’re experiencing, it’s okay. And it is normal, and all of us feel it at one point or another.
And like Jamie said, there’s a ton of resources we have available and a lot of things we can do to help anyone work through that.
Jen Pennington (Host): Great. Well, I want to thank you both. It’s been a really great conversation.
I appreciate you taking time out of your busy day.
If you’re listening and you need some resources, we definitely have a bunch on the SFFHealthCareTrust.org website, and you can find how to get in touch with Jamie and how to get in touch with Bill on peer support. So use the resources you have. So thank you both so much for being here.
Jamie Epting: Thank you.
Lt. Bill Hartung: Thank you for having me.
Jen Pennington (Host): Thanks for joining us. Listen Up L27 is a Seattle fire fighter healthcare trust production. Our music is Hagadate Line by Blue Dot Sessions. This podcast is produced by the Rhizome Collaborative. I’m your host, Jen Pennington. And until next time, stay safe and stay healthy.
