Patient's Suicide

Published

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

I read something in the newspaper tonight that just makes me sick at heart........an elderly gentleman I took care of for three days last weekend was found dead at his home, apparently the victim of a self-inflicted gunshot wound.

The worst part is, I knew he was in danger, because one night he told me how he was thinking of "checking out". Then he began talking lovingly of his wife, and how proud he was of his four grown children, and about his faith in God. At the end of this conversation, we both agreed that he had a lot to live for, and that he ought to see what his upcoming lung biopsy said about his prospects. The very next day, his mood was much improved, and he practically raced me up and down the hall during our ambulation sessions, trailing grandchildren and IV tubing, and grinning the whole way.

I did make a note of this exchange in the patient's chart and a referral to the discharge planner, but he was so cheerful for the rest of the time he was in the hospital I figured he'd resolved his issues. Then last night at work, somebody mentioned that his name was in the death notices section of the newspaper........and while I immediately suspected it wasn't the cancer that got him, I prayed that he hadn't killed himself. And now, tonight's paper reports that he had "recently received a diagnosis of terminal cancer, giving him only weeks to live".

Ah, the guilt........I guess I *shouldn't* take any responsibility for this, but damn, the man TOLD me he'd been thinking about suicide, and then he went and did it. I feel like I should have done more than make a progress note and put a request in to the social worker to see him.......I knew even before the biopsy that the news would probably NOT be good.......but what else could I have done? This was an alert, oriented 80-year-old man who did things his own way, and he was determined that whatever happened to him, he was going to be in control of it.

And so he was.........I just wish I hadn't been fooled by his appearance of having worked through his feelings, and that I HAD been more aggressive about getting some help for him. I realize I'm not the only nurse who cared for him, nor am I probably the only person he shared his fears with; and who knows, maybe it was the diagnosis itself that tipped him over the edge.........or maybe what I saw the next day after our talk was just the calm before the storm, the sense of peace and relief that come when a man's mind is made up.

I guess I'll never know. :o

Up Vote Up Vote ×
And so he was.........I just wish I hadn't been fooled by his appearance of having worked through his feelings, and that I HAD been more aggressive about getting some help for him. :o [/b]

This might be hard to hear, but first - don't feel guilty... you did what you should have done. Second, he wasn't fooling you, he HAD worked through his feelings and made a decision that he was comfortable and at peace with. No one, not you, his family, a social worker, clergyman, or a psychiatrist could have changed his mind. His grandchildren will remember running around after their grandfather, laughing, loving, enjoying life. They won't remember the side effects of chemotherapy, radiation, or the wasting of cancer. It sounds very much like he wanted to spare his family the only other alternative. I think that is an indication of how much this man loved and was loved - I think that's a wonderful indication of how well lived his 80 years was.

Up Vote Up Vote ×
Specializes in LTC, assisted living, med-surg, psych.

Thanks, Lydia. I think you're right, especially about the fact that his 80 years on this earth were evidently well-lived. He loved his family passionately, and the ones I met obviously loved him right back. I only wish he hadn't met such a violent, undignified end....don't know who found him, but whoever did must be scarred for life! I know I would be, if he were my loved one. Maybe that was the only way he knew, though.....the only way he could be sure of ending it and avoiding the suffering he must have known they all would have had to endure.

I pray the Lord will forgive him and grant him the peace he sought.

Up Vote Up Vote ×

I'm sorry to hear about this. Don't blame yourself.

It does remind me though that the group at highest

risk for suicide are men in their 80s.

Your sharing this will make me more vigilant.

I hope you are doing alright!

Up Vote Up Vote ×
Specializes in LTC, assisted living, med-surg, psych.

Yeah, I'm OK, just sad is all. My younger daughter (18) just spent a good deal of time petting my hair and listening to me vent, and that helped.....I know I couldn't have changed the outcome of this. I'm old enough, and have seen enough of life, to know how little influence each of us really has on the course of history; all we can do is give what we have to give, and I did that. I'm glad I provided this gentleman with a compassionate ear when he needed one, and had a small part in his happiness the next day when he was so full of light and joy as he walked the halls with his grandchildren at his side.

Thanks, ruby360.....I appreciate your thoughtfulness.

Up Vote Up Vote ×

It sounds like you were a very compassionate and supportive I am sure he appreciated it. I agree he made his decision and noone was going to change it he was at peace with it. It seems to me he was trying to save his family a long battle watching him suffer. I sincerely hope god takes his desire to protect his family from prolonged pain into consideration. I cant imagine the God I serve holding it against him. You did your best the pt and God know that and I hope you do too. Hugs angelbear

Up Vote Up Vote ×
Specializes in Critical Care, ER.

Sounds to me like he made a conscious, self-empowered decision to end his life in the way that was most dignified *for him*. Would "helping" him linger against his will really be honoring and comforting him? I am very glad that you did the absolutely best you could which was, to comfort and take care of his physical needs, to help him reflect spiritually and emotionally, to give him the opportunity to appreciate and enjoy his many blessings during his time with you.

Watching a loved one die is never an easy thing. Maybe his relatives are proud, strong people who would have been hurt even *more* by watching him wither away gradually.

Up Vote Up Vote ×

I know just how you feel, but we had a patient a few years ago who shot himself in the room during night shift. Same thing, older male, cancer. I will not go into great detail, but suffice it to say it was a very traumatic experience for all involved and the three of us on the floor that night suffered tremendous guilts and what ifs. My thoughts are with you, I know how hard it is, but you sound like a great and caring nurse and please know there is nothing you could have done.

Up Vote Up Vote ×
Originally posted by mjlrn97

I only wish he hadn't met such a violent, undignified end....the only way he could be sure of ending it and avoiding the suffering he must have known they all would have had to endure.

I think you summed up the situation right there. He wanted to die with what dignity he had left. No doubt he didn't see maintaining his dignity as a possibility down the road say a few weeks, months, yrs, or whatever--better to die now while able to think rationally than to suffer and agonize over a period of time. It is fortunate his final days were bright and cheerful with his grandbabies. Kinda like the cliche you hear in pro sports--"going out on top". IMHO, that's exactly what he did--he went out on top of his game. God bless: you and the care you provided this gentleman, this gentleman, and his family.

Up Vote Up Vote ×
Specializes in Med-Surg.

You're a very caring nurse. You did nothing to cause his suicide. He had his mind made up and there was nothing you could have done to stop him. Don't be so hard on yourself.

We have to report suicidal thoughts and ideations to the MD. Could be a liability if the family decides to sue and they realize he mentioned it to a nurse.

Up Vote Up Vote ×

If you truly KNEW what he was thinking, you would have intervened. It is very difficult to look into someone's heart and mind to see their true intentions. You did the best you could with the knowledge you had. The rest is between him and God. I will pray for him as well.

Up Vote Up Vote ×

hi,

i have a background in psychology. it's typical for suicidal people to spring back and say they aren't suicidal anymore.

this is because such people have DECIDED to commit suicide (not attempt it, but have decided they will follow through).

they suddenly become happy because they are glad they won't have to deal with their pain anymore.

his death is NOT something you can take on yourself.

Up Vote Up Vote ×
+ Join the Discussion