The covid-19 pandemic has placed unprecedented pressure on healthcare workers, forcing them to make difficult decisions under extreme conditions. These challenges can lead to moral injury, a psychological distress caused by actions or inactions that violate one's ethical code. Unlike formal mental health conditions, moral injury is not a mental illness but can lead to symptoms such as guilt, shame, and depression. Some individuals may experience post-traumatic growth, but this depends on the support they receive. Healthcare workers may face situations where they cannot assure grieving relatives that they did all they could, leading to moral injury. To mitigate this, healthcare managers should prepare staff for the moral dilemmas they will face, provide frank assessments, and avoid false reassurance. Team leaders should facilitate discussions to help staff process difficult decisions, using methods like Schwarz rounds. Avoidance of these discussions is harmful, so team leaders should reach out to staff who are too busy or not available. Support from colleagues and managers is crucial for mental health. Staff who show signs of distress should receive sensitive support. Routine support processes should include information on moral injuries and mental health. Supervisors should monitor staff after the crisis to ensure they receive appropriate care. Once the crisis is over, supervisors should help staff reflect on their experiences to create a meaningful narrative. Active monitoring is essential to identify and support those who may develop mental health issues. Healthcare managers must acknowledge the challenges faced by staff and minimize psychological risks. The article emphasizes the importance of proactive support to protect the mental health of healthcare workers during the pandemic.The covid-19 pandemic has placed unprecedented pressure on healthcare workers, forcing them to make difficult decisions under extreme conditions. These challenges can lead to moral injury, a psychological distress caused by actions or inactions that violate one's ethical code. Unlike formal mental health conditions, moral injury is not a mental illness but can lead to symptoms such as guilt, shame, and depression. Some individuals may experience post-traumatic growth, but this depends on the support they receive. Healthcare workers may face situations where they cannot assure grieving relatives that they did all they could, leading to moral injury. To mitigate this, healthcare managers should prepare staff for the moral dilemmas they will face, provide frank assessments, and avoid false reassurance. Team leaders should facilitate discussions to help staff process difficult decisions, using methods like Schwarz rounds. Avoidance of these discussions is harmful, so team leaders should reach out to staff who are too busy or not available. Support from colleagues and managers is crucial for mental health. Staff who show signs of distress should receive sensitive support. Routine support processes should include information on moral injuries and mental health. Supervisors should monitor staff after the crisis to ensure they receive appropriate care. Once the crisis is over, supervisors should help staff reflect on their experiences to create a meaningful narrative. Active monitoring is essential to identify and support those who may develop mental health issues. Healthcare managers must acknowledge the challenges faced by staff and minimize psychological risks. The article emphasizes the importance of proactive support to protect the mental health of healthcare workers during the pandemic.