Published Jul 5, 2010
SlightlyMental_RN
471 Posts
I've had patients die on me during my regular med/surg days, but this was my first attempted suicide. It was a bloody mess, and I feel really guilty, like I should have seen it coming. This patient had been doing other attention-getting behaviors, but I never expected them to go to this extreme. I could use some virtual hugs and words of wisdom how any of you have moved on from finding someone that had slashed their wrists and there's blood every-freakin'-where...can't get the image out of my head. Or the guilt. I work in the detox unit in a hospital, but we tend to get a lot of the dual-diagnosis folks. Unfortunately, we're not a locked unit, nor are we a "safe" unit in regards to suicide precautions...we have call-light cords and IVs and other things floating around that people could harm themselves with if that is their intent. Anyways...you get the picture. He had the intent and the tool, and He caused himself harm. Just wish that I could mentally wrap my head around the whole thing.
Saalbunch
63 Posts
:hug:
Here are some hugs your way! I can see how this could be very traumatizing to anyone! I am surprised that you have all of this equipment knowing what type of patients you get on your floor! Patient saftey? I am sure that you did all that you could for this person and sometimes if we could just turn back time it could be a whole new story. Since we cannot do this...you have to move on and continue to push yourself and take time for yourself!!!
nrsjo60
14 Posts
Hey
Remember, you did what you could. Wondering if maybe the MD should have ordered a sitter...It happened to us once actually from the ICU...it was a busy sat night. we were all busy..the heart monitors were ringing all night. a few codes, and someone turned off the alarms because there was so much chaos that night. a pt who was suicide prec. saw that we were busy , was ablwe to take himself off the monitor. put on his clothes. walked out to the hospital chapel, and hung himself....We all felt bad. IJts about our intentions. Your intention was to give good care. If she didn't have a sitter, you couldn't be in the room constantly..You may need some debriefing from the ER social worker...God Bless.
mamamerlee, LPN
949 Posts
So sorry this happened on your shift. It is simply not always possible to know when someone's behaviour is going down the drain.
If you don't get support from your manager, please go to a counselor from your
EAP. This was not in any way your fault.
Despite what we would like to think, we are simply not in control of anyone else's actions.
Best wishes to help you get thru and past this.
Davey Do
10,608 Posts
Okay, SlightlyMental RN, here's your hug: hug hug hug
Now, let's get real: Your duo-dx patient ATTEMPTED suicide. I'm sure it was traumatic. Very traumatic. However, it could have been worse. It could have been a so-called "successful" suicide.
You didn't say, but I assume you responded to the sutuation appropriately. You know, controlled the bleeding through direct pressure, assurred his safe transport to a treatment area, made sure he was taken care of, etc. In other words, you did your duty as a nurse.
Next- you say you "should have seen it coming"? One chief sx of mental illness is UNEXPECTED behavior. If an individual has appropriate, expected behavior, then they don't meet the criteria for being mentally ill. Throw in some withdawal sx and you've got your hands full. Unless you are a psychic RN, and it's pretty obvious that you're not, you shouldn't be so hard on yourself. You can only do what is reasonably expected of any person in your position.
Things like this happen. That's why there are treatment facilities. And that's why it's called "treatment" and not "cure". Again, I reiterate: We can only do what we can do.
Perhaps this will cause a change in your facility and increase the awareness of a need for more stringent safety measures. Perhaps some "good" will come from this incident.
Take care of yourself, Slightlymental RN. It'll be okay.
Zookeeper3
1,361 Posts
Any nurse with thier first cardiac arrest feels the same way "what did I miss?". Your patient had a mental arrest, and I understand that horrible self doubt feeling. I wish I could take it away from you. Try very hard to evaluate if there was something to improve on, something to add in your daily work to enhance safety. If there is, accept it and apply it. (it's hard to swallow, but needs to be done). If not, then you have to give yourself time to accept that you don't control the actions of others. Perhaps speaking with management about looking at havnig a safety review of the unit?
This is sentinal event, a root cause analysis will take place, see if you can become a part of the process form the start. this might help you heal, the process is nonjudgemental and simply seeks to help prevent the same situation again. I'm sending a cyber hug:hug:
Cherish
876 Posts
I remember when I was 17 and in basic training I was woken up by a girl in the bathroom screaming because she just walked in and saw another trainee slicing her wrists. There was blood EVERYWHERE so I know how you feel its not a pretty site. I know this is very upsetting but this person will get help in the hospital. Not only will they be treated for any physical injuries but most importantly now they will be treated for emotional or mental injuries that they have been suffering with that had not been seen.
It's sometimes hard to hear this but you did the best that you could, do not beat yourself up wondering if you could have changed things or noticed any signs differently.
HUGS!!!:hug::hug:
bridezillatobe
34 Posts
I don't have any words on the subject, as I'm not a nurse yet, but I've read most of your posts, and you come across as someone who truly cares for their patients and takes pride in their work. I know it's a sucky situation to be in, and I don't have much to offer, aside from lots of hugs! :hug::hug::hug::hug::hug:
KinshuKiba
33 Posts
Sometimes it just happens and there's not a darn thing you could have done differently or better. And it applies to everything. There's a small 2 year old little girl that lives inside my head: she died, despite everything we did for her. I sobbed for days on end. And while I eventually came to terms with it, I have never stopped thinking about her or forgotten her name. Sometimes it's out of your hands. The best thing I think I could tell you is take this opportunity to start teaching yourself to let go, to forgive yourself, and move on. Things happen the way they happen and that's that. Do your best, which I'm sure you did, and be good to yourself. Hugs and more hugs.
phyllis59
1 Post
I've had 2 jumpers without fatalities. It is your hospitals responsibility to make a safe ward for the patients that are admitted with such a diagnosis. Finally we started a one on one ICU requirement for patients with drug and alcohol problems for at least 24 hours and an eval by a licensed professional who deals with clients frequently. I had no warninhg for either patient, or the one who stabbed himself with straws all over his body admitted from a group home. Sometimes you have no warning signs!! One patient was in a room near the hurses station and ran across the station, vaulted up and outward with a bench toward a window. Fortenately he hit the window sill not the window and he was on suicide watch. I was house sup that night, so i WAS RESPONSIBLE along with the nurse who cared for him. I had talked to mim not 2 hours before. He was rational, had talked with a counxelor and our pastor. Some times you cannot help patients anymore than will allow you to. Tjis patient went to a psych center on lockdown. sometimes with ETOH or drugs on board these centers will not accept admission until the patient is sobwer. The rules need to change, not the nurses,!!
tewdles, RN
3,156 Posts
I am so sorry....
You got good advice about the EAP...or whatever your support team is for staff. It is really helpful to speak with someone about this. And you need a few days...off work...to process this experience...get it to a place where you can work again.
7student7
60 Posts
Things happen sometimes and it's no one's fault. Even in the most secure situations with staff expecting the worst, attempts happen. We've had scares before at the psych hospital where I work. Even if you're watching them like a hawk they can always pretend to be asleep and be cutting under the covers, or try to pull something while in the shower. If someone is serious about self harm even a 1:1 observation isn't fool-proof. I'm sure you weren't at fault. You had other patients to take care of, and this patient was obviously in the wrong type of hospital. I know it sucks to not catch something you think you should have, but all you can do is move on and try to find the silver lining - maybe your experience will help you catch a similar patient sooner next time. But, don't blame yourself - that won't help anyone.