questions about suicide

You certainly have a moral obligation to report if someone makes a suicidal statement, especially with a plan.

Why wouldn't you report it? That's not intended confrontationally, I am just wondering if you have extra concerns i.e.. you promised you wouldn't etc. I'd let the nurse in charge of the shift and the responsible MD know and send an urgent psych referral. Are these options?

Ah, just read the "off-duty" bit. Do you mean a friend/relative/acquaintance or a patient? You can always ask their permission to tell someone. If they say yes, that makes it all simpler.

Great question.....I hope someone more knowledgeable than me answers. I assume by report it you mean....?.....who exactly. I'm guessing 911 or the police would ask if you or they were in imminent danger , were they holding a gun or standing on a ledge, etc. if not what could they do? Give you the number of the local mental health clinic or suicide hot line?

You could tell this person you were going to have to tell someone. Depends on the situation, if you know or trust this persons family, minister, therapist, Doctor, teacher, someone who, maybe along with you, can get this person some help? You could tell them you are going to take them to the ER but you couldn't force them into your car or even force them to enter the ER?

As a mental health professional one has a duty to warn if knowing of a clear and imminent danger to client or others. I suspect the duty is similar in healthcare but don't know for sure.

If you have concerns about someone in your personal life you can always try to help them through be it speaking to them directly and asking permission to bring in other supports ranging from family and therapists to driving them to the ED for a psych evaluation. If you aren't sure how to have that conversation or can't have it but still want to know what you can do you can call a suicide/mental health crisis line. You do NOT have to be the one in crisis to call. My experience is these lines are great resources for helping someone else and connecting to community supports. If you believe danger is imminent call 911.

There is no federal law that requires reporting of suicidal thoughts or intent, but you should check your state's mandatory reporting requirements. In Oregon it's not required. We've got a laundry list of things we report on, but suicide isn't one.

Now, should you? If you believe the person is an imminent risk, and you're not qualified to help them, then the answer is always yes. The manner in which you go about it is up to you - whether you talk with the person and report it with them, or talk them into seeking treatment, or just call 911 - but the ethical obligation is always to report. If you believe that there is a serious and imminent threat it meets the requirements for the emergency exclusion to HIPAA. If the person is not a patient then HIPAA doesn't apply and you can report.

Is this homework? Sounds like it could be.

You didn't give us any of your opinions.

There is no federal law, and no law in any state that I know about requiring anyone to be a "good samaritan" and punishing for not doing so, whether the person in question had knowledge and capability to do that or not. A licensed health care worker who is not on duty is essentially a "good samaritan" in such case.

Just like you are not obliged to stop near a car parked on a shoulder and see if help is needed, or to offer your own medication to another person who might need it more at that moment, nobody is required to report another person suicidal behavior. Regarding "should you", it is another story. I just can't see which agency a potential suicide can be reported to except police, and I kind of doubt that in quite a few places policemen will act STAT unless the question is clearly about safety of others. There were more than one case when relatives/coworkers called mental health help lines and such due to what they perceived as acute issues like suicidal ideations; the person in question might or might not get help of some kind but in the process things like history of mental health problems, addictions, abuse, etc. were exposed. The results were not good for anyone, as patients were fired, divorced, etc., and the "good samaritans" were slapped with lawsuits for their good deeds.

Why wouldn't you? What does on duty/off duty have to do with it?

What do you think, OP?

Like PPs I don't know that you are obligated to report someone who is suicidal but I don't understand why you wouldn't. Especially if it is someone you know personally.

I don't have anything to report, really. But it may be happening and I just want to be on the safe side - so I guess that kind of answers something.

But are there any bad consquences regarding a nursing licence if the off-duty nurse doesn't do anything? That's really all I want to know. It's sounding like there's no laws about it but are nurses, even off-duty ones, morally obligated to? And would they risk their job if they don't do anything about it?

thanks for all the replies.

also, the off duty part has to do with the fact that if the nurse is on duty, I know that they should report someone suicidal - no matter what.

To answer "the only question you want to know" - your license is safe in any case. As it was said, there is no legal obligation on you as a nurse to report to anyone some other person's suicidal thoughts.

The moral obligations are totally up to you.