By Jennifer Thew, RN
Suicide prevention awareness month is the time for nurse leaders to talk openly about the risk for and prevention of suicide.
September is suicide prevention awareness month, and it's a good time to shine a light on an issue that is often pushed into the shadows due to stigma.
Suicide is an uncomfortable subject for many, but to make progress in prevention, especially with your own workforce and patients, nurse leaders need to be willing to discuss the topic.
Ignoring suicide is not an option. Suicide rates are rising in almost every state, and in 2016 nearly 45,000 Americans age 10 or older died by suicide, according to the Centers for Disease Control and Prevention.
Suicide is not just a concern for patients and the public, it affects healthcare workers as well. It's estimated that between 300 to 400 physicians die from suicide in the U.S. each year. The same type of data does not exist for registered nurses but Judy E. Davidson, DNP, RN, FCCM, FAAN, a nurse scientist at UC San Diego Health says that does not mean nurse suicide isn't an issue.
"We had nurse suicides in our own workforce and when we started talking to people, we found that many knew someone who had a nurse suicide in their organization. So, it wasn’t just us," she says. "It really brings up the concrete message that we cannot hide this. The more we talk about it the more lives we can save."
To help further the conversation about suicide and suicide prevention, here are some resources.
And as always, if you or someone you know are having thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255.
1. Nurse Suicide is Real. Don't Ignore It.
Do you know the factors that put nurses a risk for suicide?
"It’s a combination of work and home stressors," Davidson says. "There is some evidence in the literature that when you combine work and home stressors you’re at higher risk of suicide than if you have just work or home stressors."
Some of the work stressors Davidson's research has uncovered include:
Fear of harming patients
Emotion burden of patient care
Home stressors include:
Many of these issues can be addressed by nurse leaders. Additionally, the Healer Education, Assessment and Referral program, known as HEAR, is one way to screen nurses for suicide risk and connect them with professional support if they need it.
2. Hospitals Help Clinicians With 'Second Victim Distress'
Second victim distress is a phenomenon that can happen to clinicians involved in errors or adverse events. Physicians, nurses, and specialists directly involved in an adverse patient event or traumatic episode can experience an emotional response that might lead to difficulty sleeping, guilt, anxiety, or reduced job satisfaction.
While a 2013 review of healthcare professionals as second victims, published in Evaluation & The Health Professions, concluded that nearly half of healthcare providers would fit this label at least once in their career, few seek help.
Thankfully, second victim syndrome is getting more attention, and support options are growing.
For example, Susan Scott, RN, PhD, CPPS, founded the forYOU University of Missouri Health Care's peer support network, which provides clinicians who have been trained in crisis support and stress management to second victims.
Nationwide Children's Hospital in Columbus, Ohio, developed its YOU Matter program to support second victims, and the University of Rochester Medical Center based its YoUR Support program on the "Demobilization, Defusing, and Debriefing" model that comes from trauma care.
3. Hospital Suicides Much Lower Than Believed
The widely cited figure of 1,500 hospital inpatient suicides per year is far lower than previously believed finds a new study published in The Joint Commission Journal on Quality and Patient Safety.
Based on the hospital inpatient suicides reported to the National Violent Death Reporting System, it was estimated that between 48.5 and 64.9 hospital inpatient suicides occur annually in the U.S., and of that total, 31 to 51.7 are expected to involve psychiatric inpatients.
While this is significantly lower than previously thought, inpatient suicide is still a sentinel event and nurses should be aware of areas where suicides are likely to occur.
The most common method of inpatient suicide in both the NVDRS and TJC Sentinel Event databases was hanging (71.7% and 70.3%, respectively). According to the Sentinel Event database, which noted the location and ligature fixation point for hangings, of sentinel event suicides:
50.8% took place in the bathroom
33.8% in the bedroom
4.1% in the closet
3.6% in the shower
7.7% in another location
A door, door handle, or door hinge was the most commonly used fixture point (53.8%).