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.

[Penelope_Pitstop, BSN, RN]

Thanks everyone. I'm not blaming anyone, myself included, for this.

I visited him during his last psych hospitalization and he said, "I like these meds. I don't feel like killing myself for once." He hadn't been compliant with his meds prior to that.

His case manager agrees that in spite of his chronic intermittent suicidal ideation he really DID want to die this time. He made it very hard to be found. Other attempts - well, he would call us and we'd call 911.

This time he had his cell turned off so he wasn't discoverable by tower location.

This time he didn't call us in a panic after taking pills.

He had made some comments suggestive of suicidal ideation on Monday afternoon. He was vague as to his location, or his plans and wouldn't say outright that he was suicidal, it had to be inferred. My boss, who has known him for many years, contacted police and then when they turned up nothing set out himself looking for him on Tuesday afternoon/evening. He drove all around the county, stopping at places the patient liked or had ties to. He had me calling all the hospitals all day to see if he had ended up there. His parole officer was involved.

Then around 11PM, a State Police Sergeant called my boss and told him that his body was found, manner of death suspected suicide. I think he may have actually ID'd the body but I'm not sure. He is keeping a lot of this inside. He did express to me on Thursday, "He was more than a client to me." But then clammed up. His phone number being written on the deceased's arm must have really affected him, too.

Another one of my patients recently lost her son to an OD and she is friends with the patient who died. I'm not sure if she knows - his obituary hasn't been published or anything. But we're afraid this might set her off again...she had to be hospitalized after her son died and his death happened about two weeks after she got out of the hospital for a different setback.

I'm rambling now...Sorry.

[broomg]

I am so sorry you are suffering with the loss of your Patient. I too had a Patient that suicided by hanging. As a Crisis Outpatient Rn, he would come in periodically to be assessed and evaluated by the Psychiatrist. What I most remembered was that he just would not open up beyond a few words. As a fairly new Rn at the time I remember how devasted I was and what could I have done differently. Finally, I seen a counselor myself and that in itself helped tremendously. Thank you so much for your transparency and sharing.

[BCgradnurse, MSN, RN, NP]

I'm so sorry. Sending you hugs.

[alluneedislove]

Suicide is tough in personal life but tougher as a psych nurse. I once taught a crisis planning psychoeducation group on a Friday only to learn that an outpatient in that group went home and killed himself. When I lost people in my personal life to suicide I self nurtured... I went to bereavement/suicide support groups, I went to therapy. And reading your post has made me realize I've done none of this as a 'professional' who looses a patient they are trying to help. Thanks for posting, I am going to do some self nurturing and you should too!

[adebola]

Sorry about the loss! At times it is beyond the control of the patient because the delusion of guilt and unworthiness to live are fixed in their brain and no matter the interventions of the psych nurses with their team the patient still commit suicide. It happens some other time when you least expect it, when patient seems to be getting over the acute stage of suicidal thoughts and behaviors.

[NurseNotforLong]

Wow that's really tragic. I hope that the people in your office are going for grief counseling.

When I was really young in my career, I had a nurse manager who had a sick child to die in route

to the ER. The staff were torn up about it. It was horrible for us being that many had small kids at

home. Plus our unit was like a small family and families share in one another's loss.

Another occasion was when a sitter was on a 1:1, the patient almost took him along for the jump out

of the window. The patient ended up on the canopy of the hospital main entrance where the ER

physicians climbed out of the 2 nd floor window to code him. Although it (near death) didn't happen on my floor,

I remember being traumatized. The thing about tragic events is that they cause a set backs.

Hopefully your boss is getting grief counseling with someone since

many hospitals don't employ Champlains anymore.

Be well!

[blackberry74]

how tragic for all involved. Terribly sorry for your loss. It moves me greatly for you all to come here and share these stories with us, I am in my first year of nursing school and after studying, I treat myself to real life nurse stories here in AN...

We have been taught about psych patients, went to a behavioral health facility and met people there, and its just such an intimate job working with people with hurt minds. I don't think I could ever be a psych nurse but it seems that we utilize some of that teaching in every nursing position.

[SleeperHold]

I'm sorry to hear this. Psych nurses are amazing, hang in there.

[Farawyn]

DLHW, how is it going?

[Penelope_Pitstop, BSN, RN]

DLHW, how is it going?

It's okay. We all want to go to his service but his obit hasn't been published. We're thinking his family might just be doing something privately without a public announcement because of legal and social issues that went on.

I know this sounds awful, but we have 100 patients and he wasn't around all that often, so he doesn't really come to mind (at least my mind) too much when I'm actually at work. I do come home and check for his obituary every day, though.

As for my boss, he does have a support system at home and seems to be doing all right. He is working a lot and I think it's therapeutic to him.

[Penelope_Pitstop, BSN, RN]

Update...

his family isn't having a service at all.

They're raising money to cremate him, and that's it.

I know he was a jerk, but dannnng.

I guess it could be worse - he could end up in the potter's field at the state hospital like all of the "unclaimed remains."

[Graduatenurse14]

(((((DeLanaHarvickWannabe)))))

I am sorry for your loss. I'm glad to hear that you and your boss have a good support system.