Help! Suicide vs. Unmanaged diabetes

[jxoxo]

Which would be the priority nursing diagnosis ? Risk for suicide or ineffective health maintenance? I currently have a psych pt who has a history of previous suicide attempts and was admitted when he posted suicidal suggestive comments on fb, but denies any SI. His other main issue is non compliance with meds. He has diabetes and when at home did nothing to manage it. DId not take his insulin, did not manage his diet. Was admitted to ER on one ocassion with bg of 600. In my eyes, either one could kill him... so which would take priority ? thanks in advance

[RKpianoman, APRN]

I would pick the one most likely to kill him while he's under your care. That would be suicide, in my opinion. Curtains, clothing, bathtub, sink, toilet with a lot of water, string on blinds, shoe laces, hording drugs, metal eating-utensils, open window, and many other things can be used to attempt suicide in a hospital or treatment center. When choosing between two diagnoses like that, though, it's pretty subjective...they're both pretty important.

[NCRNMDM, ASN, RN]

Risk for suicide is always your first nursing diagnoses unless there is something else that will definitely kill them faster than that. Basically, risk for suicide trumps nearly every other nursing diagnoses out there.

[JBudd, MSN]

His non-compliance despite education is a slow form of suicide. In some it is just denial, but in his case? You have two worries here, but both deal with self harm.

One is suicide by neglect, the other by intent.

[Hygiene Queen]

He may not die on you from ineffective health maintenance, but he sure as heck could die on you when your back is turned when he decides to steal a trash can liner and wrap it around his head.

Suicide risk trumps.