Do you feel prepared for a suicide threat?

xtxrn, ASN, RN · Aug 31, 2011

I work for a out pt clinic and the policy for a caller threatening suicide is to get the nearest RN or MD and have them talk to the pt. I start nursing school in the fall, so it got me wondering. RN's, Do you really feel as though you should be the one talking these pts down? I am sure this topic is covered in nursing school, but is it covered to the point where you would be confident taking the call? Medical emergencies, i think i can handle. Psych emergencies, i am terrified!
Have you ever had this happen?
Thanks for sharing!

Yes....I was the weekend (so no intake staff around) day charge nurse, and I was called to the reception area of the drug/alcohol rehab facility I worked at when the receptionist picked up a call that was a suicidal individual. I talked to them while she rounded up one of the counselors...but it was my problem for about 20 minutes.... you listen, don't minimize their pain, ask questions, and follow their lead. In the meantime, get as much info as you can about a ready method- any actual plans (date/time), previous attempts, and look for ANYthing that can be turned into a positive- without implying that they are being nuts!!

Most people do not want to die- they just want to not hurt any more, for whatever reasons (those reasons are very intense and real to them- so never tell them they're being silly- or they can perceive that as not even being able to be suicidal good enough- sounds crazy- but someone in that situation really feels that their life is meaningless, people would be better without them, etc..... Let them know you care, and would love to find some way to help them get through the really hard times they're having. But don't bring up any sort of "locked up" situation - to a lot of people, being hospitalized for mental health issues is worse than dying...

You want to buy time. If they're not drunk, hostile, or psychotic, look for things that mean something to them... And, something that is controversial (but can help in the right situation) is tell someone that they can always decided to kill themselves some other time- but they can never take that decision back... You don't want them to do that, but want them to hold out for help... WHATEVER it takes to keep them from acting on their impulses.... that CAN help them hang on long enough to get help to them (if you get an address, have someone else call 911 to send the police- but don't tell the person you're talking to that they're coming- you don't know what else is going on= if they have legal issues, the police are the last people they want). :eek:

You'll get more info in psych rotation....and you can take classes through most crisis hotline places. :)

grownuprosie · Aug 31, 2011

Thanks for the thorough response! I guess my impression of this policy was that the RN was supposed to save the day and then everybody goes to get ice cream. (Dramatization... obviously :)) But, it is not so much ninja mind tricks as listening and keeping the conversation going until more help arrives.

I would like to see more done for this policy at my office though. Like a list of ways to help the RN while they are on the phone. Numbers to call/ page, etc.

Thanks again!

Gently.me · Aug 31, 2011

Most people who are actually calling to admit to suicidal ideation, do not really want to do it. Never underestimate the power of hopelessness/helplessness.

I worked in a doctors office and have had a few calls where patients had suicidal thoughts. You need to cover your own butt and treat every single case seriously, even though some of them you know are calling to get attention.

The biggest thing you can do is listen, gether all the information you can (Exactly what xtxrn has mentioned) and have someone else in the facility call 911. Keep them on the line for as long as possible and be the loving, tenderhearted nurse who actually cares about this individual.

grownuprosie · Aug 31, 2011

I just want to add: I cannot figure out how to edit my origional post. I re-read it and it sounded a little condescending. i just want everybody to know that it was NOT AT ALL meant to sound like that. lesson in proof reading. :)

xtxrn, ASN, RN · Aug 31, 2011

I just want to add: I cannot figure out how to edit my origional post. I re-read it and it sounded a little condescending. i just want everybody to know that it was NOT AT ALL meant to sound like that. lesson in proof reading. :)

You sounded find :)

ear · Sep 1, 2011

Yes, I am prepared.... but I work in a psychiatric crisis unit

We get where they are located at the time. Sometimes people dont want to say, so it makes it a little difficuclt. Most business phone lines have some sort of caller ID. I ususally grab that number, then search for a reverse look up to see if I can find the number. If the caller actually gives a name, I can look up their medical record. All while talking to the caller and assessing what is going on.

I work nights, so sometimes there are only a couple of other people working with me. I ususally somehow get their attention, and they are on standby to contact police. The police go out and pick up the caller and take them to an ER for evaluation.

It is really hard to ask a suicidal caller to hold on, and have them talk to someone else. That first contact, and who they are talking to makes a difference. If they have developed a relationship with who ever picks up the phone, then get transferred, it might (or might not) upset them. I know on our unit, they secretaries are not allowed to answer the phones because of this reason.

You may want to ask the local crisis unit to come out and give an inservice on how to handle these calls. They may be able to give you (and the staff there) a little more knowledge to make you guys more comfortable with handling these types of calls. (not that it is EVER comfortable!!)