My patient committed suicide last night

[Penelope_Pitstop]

Hey everyone.

I work in outpatient psych at a case management agency. I'm a nurse there but do case management stuff in an office setting with some home and community visits - just for background. We have about four hundred patients who receive service from our office - about one hundred on my personal team.

Last night my boss received a call from the police that one of our patients had been found dead - manner of death suicide.

This is the fourth patient in a week from our office who has died. (The others weren't my patients but still).

I don't even know why I'm posting. I just need to talk about it, I guess.

I didn't even LIKE this patient. He was inappropriate and rude. I think that's part of the reason why I'm so upset.

My boss is really torn up - he actually went out looking for the patient yesterday into the evening. He knew his kids...in fact his (my boss's) cell phone number was scrawled on the patient's arm according to the cops. We made him go home this morning.

[Julius Seizure]

I'm sorry

[Alex Egan, LPN, EMT-B]

I have come to view suicide in this chronic mental health situation in a similar fashion to death from other conditions. Modern medicine can't save them all, we save so many that we have it in our head that we can. We have all seen the diabetic who just couldn't get control, for a variety of reasons, or the CHF patent who just keeps filling with fluid dispite best efforts. Some of these folks die, and it's not a failure, we don't blame ourselves. We say we tried everything, and it just didn't work.

This is my personal view. It's how I come to peace with my mothers often uncontrolled Bipolar disorder. When the meds, inpatient therapy, ECT, everything just seems to not work. If/when she kills herself it was not from lack of effort from anyone, it's the disease winning.

[Hartsheila]

As a psych NP, I appreciate the comment that we can't save them all. I want to add that we can't like them all either. Many of our patients are unlikable. We are seeing some at their worst. Try to focus on your care...was your treatment the same for him as it would have been for your other patients? I bet the answer is 'yes' and that says a lot for you as his nurse. Your expenditure to care for the unlikeable outweighs the energy you expend on the likeable patients. It's still within the patient's power to choose what they will do with their lives. My bet is he didn't like himself or his life and that is sad.

[OCNRN63, RN]

Thanks.

The thing is, I *was* an ICU nurse and a self-described "code junkie." I guess most of the codes were somewhat expected so they didn't really bother me and there was that adrenaline rush...not so much when a patient is found alone and dead in the rain, in the woods...

I'm not saying suicides/attempted suicides give people a rush. It's just that, like patients who code, some won't make it, no matter how hard we try t help them.

I had a psych patient who died during her hospitalization from a completely preventable medical issue. That was close to 30 years ago, and that patient still haunts me.

[Here.I.Stand, BSN, RN]

Hugs!!! I am so sorry. I hope you are able to take some time for self-care today.

[GenSurgRNFA, BSN]

Its good to talk it out in a professional environment. Psych is a hard specialty to work in so i give you alot of credit for that!! It is ok to reflect on the suicide, possibly learn from it somehow?

[Penelope_Pitstop, BSN, RN]

I'm not saying suicides/attempted suicides give people a rush. It's just that, like patients who code, some won't make it, no matter how hard we try t help them..

Oh, I know, I know! What I meant was that as a "code junkie," I DID get a rush from a code blue regardless of outcome...but in this case there was no adrenaline rush to help me get through...make sense?

[SuzanneP54]

I am sorry for you and all involved. (((hugs)))

[Psychtrish39, BSN, RN]

Big AL you are right and my son was bipolar and committed suicide. The hardest thing for me is as his Mom I helped so many people find the light but couldn't help my own son. The disease won. He was just newly diagnosed when it happened. I appreciate how you put it.

[LadysSolo]

From one who was suicidal many years ago, it truly is a dark place, and you (or at least I) believe the world will be better off without you. I am now past that place, but the mind plays tricks on people, and the depression is like a deep hole that is EXTREMELY difficult to crawl out of (and I DO mean crawl, it is a very slow process.) Sometimes it is unsuccessful for people. We truly cannot save them all, we just do the best we can. But it is NEVER someone else's fault, it is within the person who does the act.

[alaskansunbeam]

Remember all of the patients you help every single day. You do good all of the time. This person's actions are not your responsibility, and no one can help everyone all of the time. I have been in your position. One thing that really helped was participating in the smudge ceremony that our hospital had for the staff. If you have any sort of grief groups for the staff I recommend attending. I also spoke to my own counsellors about it. I am still quick to confront the lies I tell myself. I do good in this world and so do you.

[VivaLasViejas, ASN, RN]

From one who was suicidal many years ago, it truly is a dark place, and you (or at least I) believe the world will be better off without you. I am now past that place, but the mind plays tricks on people, and the depression is like a deep hole that is EXTREMELY difficult to crawl out of (and I DO mean crawl, it is a very slow process.) Sometimes it is unsuccessful for people. We truly cannot save them all, we just do the best we can. But it is NEVER someone else's fault, it is within the person who does the act.

This. ^^