"The Power of Connection," is the theme of the National Suicide Prevention Week, which runs from September 9th -15th. Many organizations and professionals are working diligently this week to ensure that connections are in place for patients and others who struggle with depression, anxiety, or other mental health illnesses that place them at a higher risk of suicidal ideation.
But, for nurses, there's a different sort of connection we should be discussing. It seems in recent years, there's been anecdotal information connecting the risk of nurse suicide to burnout and job stress. The word anecdotal is used because if you search for current data on this connection, you will find limited information. Yet, you can see this data for other service-focused professionals, such as physicians, educators, and police.
Let's discuss available statistics, anecdotal information, and a few ways nurse leaders and healthcare systems can work to prevent this deadly occurrence from happening on your unit.
Anecdotes and Data
According to a May 2018 Medscape Nurses article, it's estimated that one physician commits suicide each day in the United States. This statistic makes physician suicide two times higher than the general population. The Ruderman Family Foundation reported earlier this year that police and firefighters are more likely to die by suicide than in the line of duty. Post Traumatic Stress Disorder and depression rates are up to 5 times higher for these civil servants - both of which are known risk factors for suicide and other forms of self-harm.
For nurses, the stressors of patient care, long shifts, and incredible professional demands can be much to bear. One study done conducted in England and discussed in a Nurse.org article contends that nurses are 23% more likely to commit suicide than women in general. But, it's difficult to find similar statistics about nurses in the U.S.
You might find stories about nurses who struggled with workplace stress and bullying who turned to self-harm. One such story, recently covered in the New York Post was about Rhian Collins, a nurse who committed suicide earlier this year. Investigators determined that the decision to end her life was related to trouble with co-workers that's been classified as "bullying." And, a recent article in Oncology Nursing News further supports the claim that nurse suicide is a silent problem, even here in the U.S.
What Can We Do To Help
Whether you are a staff nurse, manager, or hospital administrator - you can help prevent nurse suicide. Here are three things that you can do to help the nurses in your workplace.
Know the Risk Factors
As nurses, we often think that we have good instincts about these types of problems. And, while you might when it comes to your patients - when you work side by side with someone, it can be easy to overlook subtle signs of impending problems. The Suicide Prevention Lifeline provides this list of risk factors. This list includes characteristics that might put someone at a higher chance of considering, attempting, or dying from suicide.
Risk Factors for Suicide
- Mental health diseases
- Personality disorders
- Mood disorders
- Anxiety disorders
- Schizophrenia
- Hopelessness
- Hopelessness
- History of abuse or trauma
- Previous suicide attempt
- Loss of job or finances
- Family history of suicide
- Major physical illnesses
- Behaviors such as impulsivity or aggression
- Substance abuse disorders, such as alcohol, drugs, or other substances
- Ease of access to lethal means
- Feelings of isolation or true lack of social support
- Lack of access to physical and mental health services
- Exposure to other suicide victims
- Religious or cultural beliefs that hold suicide as a noble resolution
- Fear or stigma related to asking for help
- Occurrence of multiple suicides in a cluster (geography or social group)
- Loss of relationships
Along with risk factors, you must know the warning signs of suicide. Recognizing these signs in a co-worker would require a call to the Lifeline Suicide Hotline (number below) or other emergency services.
Warning Signs
- Looking for a way to kill themselves - searching online or purchasing weapons
- Talking about unbearable pain or feeling trapped
- Increasing the use of drugs or alcohol
- Sleeping too much or too little
- Exhibiting rage or attempting to seek revenge
- Severe mood swings
- Isolating or withdrawing themselves from others
- Reckless behaviors, agitation, or anxiety
- Expressing feelings of being a burden to others
- Expressing feelings of having no reason to live or feeling hopeless
- Talking about wanting to kill themselves or die
Offer Screening
As more emphasis is placed on this issue, hospitals and other facilities that employ nurses should offer screenings for suicide risks and other mental health services. Screenings should be routine and also provided after particularly stressful events, such as deaths or large tragedies. Many employers also offer employee assistance programs that allow staff to seek mental health counseling during times of need free of charge.
Suicide that occurs after stressful events is referred to as second-victim fallout. Particular attention should be given to staff who care for patients who die after a tragedy, accidents, or due to medical errors. This can place the nurse at high risk of depression, extreme sadness, and suicidal ideation or attempts.
As a nurse manager, having an open-door policy can help staff feel comfortable to express concerns or problems they may be experiencing from workplace stress. Remain open to how your staff feel, listen to their concerns and try not to judge or put down how someone might be feeling. If a staff member has a lot of stress going on either in their personal and professional life, offer resources such as a chaplain or employee assistance program, if available.
Be Prepared
With all of the violent crimes in our society these days, we rush to preparedness plans for physical safety from events. But, we must create preparedness plans for the mental health needs of our staff.
Talk about these issues openly during meetings. Publish information on your hospital blogs or in newsletters about the support offered by your facility. And most importantly, be kind to others. If you notice a change in a co-worker or staff member's behavior that is concerning according to the risk factors or warning signs listed above - talk to them. Even if they don't want to talk at that time, let them know you are there if they need to talk later and tell them that you care about them and want them to be safe.
If you or someone you know is struggling with suicidal thoughts, you can get help by calling the National Suicide Prevention Lifeline 27/7 at 1-800-273-TALK. You can also chat with a counselor online by visiting their website. They will help connect you with local resources.
