When Suicide Occurs on the Unit

Specialties Psychiatric

Published

Specializes in Too many to list.

It has been a difficult week on my unit. I am trying to be mindful of

privacy concerns and legal issues as I type this. I have removed

my state of residence from my profile.

Though this forum seems to be about the mental and emotional issues

of our patients, a suicide, and in this case more than one just a few days

apart, impacts not only the patients and their families but caregivers as

well. Flashbacks of the death I witnessed, and crying over the loss of the

second patient, someone who had been with us for several weeks, I am

most definitely struggling to deal with my own feelings.

I know that I could not have prevented either death, and was not present

for the second one. What I feel is anger, and frustration, and sadness.

I dread hearing more bad news. As the hospital tries to keep costs

down, I know that all of the additional staffing that is being provided for

additional surveillance as a result of these deaths will eventually be

withdrawn, but there will soon be cameras in patient rooms and common

areas.

I am wishing that I could explain more fully everything that happened

in the milieu the night prior to the first death, because I believe all of

those additional stressors and events made everything so much worse.

We were fully staffed the night of the first death though staffing is not

always about the census. It can look good on paper, but the type of

patients, the occurrence of other medical emergencies, as well as a

significant environmental disruption can negatively impact everything.

One of our staff having worked both nights of these events is on

emergency leave for PTSS with remedial therapy provided by the hospital.

We are all in shock but functioning with the additional staffing, though the

stress level is very high.

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{{{indigo}}}

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Specializes in Nephrology, Cardiology, ER, ICU.

I am so sorry for what you are going thru - please know you are in my thoughts and prayers.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Indigo girl, you have my heart. Suicide is never easy. In a very great way, it becomes a selfish act (despite the hopelessness) because everyone surrounding that person dies in a small or large way with him/her....forever changed. I have been thru 10 suicides in my professional life...some very nasty. Please read my bio, go half way down into it. I totally understand your pain. https://allnurses.com/forums/f282/thunderwolf-s-bio-262427.html

You have my great big hug, my friend.

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Specializes in LTC, assisted living, med-surg, psych.

((((((((indigo girl)))))))))

I can't even imagine what you must be feeling. You are an incredibly strong and brave caregiver, and I hope you are taking extra-special care of yourself right now. Just know that we are here for you and will support you as you work through this.:icon_hug:

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Specializes in Family Nurse Practitioner.

I am so sorry. Hugs, Jules

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Expect a state of fugue or numbness (alternating with high states of emotion...similar to what you are feeling now) among staff after such an event. It is a normal state when folks are in shock. Impacted staff will most likely not be as observant and/or on the ball...which places patients at risk. Staff that have not been a part of the incident need to be present on the unit and/or highly visible/accessible to help refocus staff at the task at hand. I would also recommend, if it hasn't been done yet or proposed, management providing a debriefing group for staff present/surrounding this event in order to process this appropriately. I would also recommend the facility EAP to be present and to provide additional follow up in the way of 1:1's if needed by impacted staff. As evidenced by your colleague, there is going to be fall out from this....more than she, I would imagine.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

PTSD is a very real phenomenon among health care providers...often undiagnosed and left untreated...and we as providers often suffer in our silence. Depression is not uncommon afterward. It is time to take care of yourself, Indigo. Explaining your situation here today and how it has impacted you already was a good first step.

Another big hug...and a tissue for your tears.

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Specializes in LTC, MDS, Education.

Back in Feb. one of our residents asked for and took her sleeper, then took the plastic liner from her trash can, laid down and tied it around her neck. The CNA was traumatized.(as were the LPN and others). The DON was upset because she "had to drive in after she had taken her Ambien CR". The administrator was worried(understandably) what the state wouldl say or do. (Nothing-- we were not at fault) BUT when the ADON and Psych APN offered counselling, it didn't happen per corporate. It probably happens more in LTC then we think. Just covered up. ANYWAY my heart goes out to you and staff.:crying2:

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Specializes in Too many to list.

Thanks for all of the kind words. It was helpful to read

the previous links on suicide, and I am grateful for your

sharing of your story, Thunderwolf.

This still a new speciality area for me. I have been doing this for

less than 4 months at this very busy receiving facility.

I went to the debriefing they told me to go to. It was for me almost

as upsetting as witnessing the first hanging. I looked at that big conference

table with all the boxes of kleenex, saw that the debriefing was being

chaired by three male chaplains, and wished that I was anywhere

but there. It didn't help that I am uncomfortable around clergy though

it may have been helpful to staff that knew the chaplains personally.

I am not clear about what a debriefing is for as this is the first

time that I ever attended one. I guess, I thought a mental health

counselor would have chaired such a meeting.

An assistant nurse manager said to me after the meeting that

maybe I was having a delayed reaction as she said that I was

very cool that night after the event, but there was alot that had to be

done, and no time to react. Now, I ask myself why I am crying though

intellectually, I know why.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Delayed reactions or responses after the event are as well very common. This too happened to myself. The tough nurse in me dealt with the situation at hand (as I had done in many past events)...in all its gorey glory. Right now you will be feeling alot of things previously suppressed. This is normal, if not expected. Debriefing allows this to occur or starts the ball rolling for you in order to heal. Unfortunately, your debriefing was handled by clergy...not against them...but truly this is out of their league. Some how, management may think this sufficient in practice, but it can often fall way short for many people. Clergy are there for spiritual concerns for members of their faith...not issues that have psychiatric bearing. A psychologist or licensed mental health counselor should have chaired your debriefing. In that, I am truly sorry. Again, EAP counseling may be an option for you and/or for your colleagues...or contact a local mental health professional in your area. The thing about PTSD is to not put it off...it will bite you in the end if you do.

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Specializes in Too many to list.

I am having a reaction to my reaction, and I am tired of me already!

Yes, it does looks like I'll have to seek some help with all of this.

Thanks for your insight.

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