Traumatized by pt's attempted suicide

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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.

Specializes in psych, addictions, hospice, education.

First of all...BIG hugs. I know this is a terrible experience to have gone through, and I'm sure you did all you could.

When someone is intent on self-harm, where there's a will there's a way. However, I believe your facility needs a wake-up call and maybe this was it. Call light cords need to begone. IV tubing needs to be used in the milieu or with a staff member present.

I've worked at places where the binding off of gowns, slats from aluminum mini-blinds, and plastic liners from trash bins have been used by patients to hang themselves, off of bathroom door hooks, shower heads, and the grab bar beside toilets. Patients have cut themselves with pens, plastic silverware, parts of lamps, and the aerator screens from faucets. You can only do so much, and you have to be ever-vigilant. It's blind of your facility to think someone there for detox doesn't have a reason underneath the drug/alcohol use that might be connected with some real emotional blackness. Take away the substance they use and there's the life-chaos glaring at them in full high definition. Add possibly miserable withdrawal symptoms and it's pretty awful. I hope your facility looks at this long and hard. I hope your facility has a staff debriefing too. Maybe they have a Critical Incident Stress Debriefing team?

But, I send you even more hugs. I've been in your shoes and know how I felt. Please find a trusted friend or professional to help you sort through this. It will be with you awhile. It will become less awful as it gets into distant memory, but it will still be there. Take care of you. I think this would qualify for a day or two off as mental health days too.

MORE hugs (and a plate of cookies) to you!!

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Specializes in chemical dependency detox/psych.
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.

Very true.

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.

Yep, applied pressure and arranged transport to ED w/final destination being the locked psych ward.

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.

:lol2:Thanks for the laugh. No, you're right, I'm not a "psychic RN."

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.

God, it would be nice to have more stringent safety measures put in place. I swear, sometimes our hospital is of the mind "Live and don't Learn, that's us!"

Take care of yourself, Slightlymental RN. It'll be okay.

Thanks, everyone for the hugs and well-wishes. I'm doing better, today. It helped to talk to a friend, as her brother had committed suicide, so she know first-hand what goes through your mind. It's a rather difficult area to work in, as you get the dual-diagnosis and the quote unquote normal people going detox, and we aren't set up for the true "psych" patients. He hadn't voiced any suicidal ideation, so this was just a shocker...no 1:1 set up. We already had 2 1:1's going since they were detoxing hard off of ETOH and were having hallucinations. Not to mention we've been working short-staffed for weeks, including that shift. He had been there for days w/out significant S/S of withdrawal, so was going to be sent home the next day...I think he just didn't want to go home, and did this as a cry for help. Thankfully, got some peaceful sleep last night--that helped a lot. The night before, every time I tried to sleep, I would end up with a nightmare about work. Thanks again, everyone for the responses. It really does help.

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Specializes in M/S, ICU, ICP.

{{{{{hug hug hug}}}}} i am so sorry and i understand how difficult it can be to close your eyes and "see it all over again." the best way to get rid of such a negative image is find a real friend and talk it out of your system. get out and watch a sunset or go for a drive in the country, find a zoo filled with new baby animals or go to the animal shelter and play with some puppies and kittens. put some new images in your memory bank. good luck.

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Specializes in chemical dependency detox/psych.

Thank goodness for my little girl. I think MDs should write prescriptions that read, "Take 1 long cuddle with little girl, PRN, anxiety and stress."

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Specializes in Critical Care.

I'm a bit late to the party in adding my support to you but you're gonna get it! :) I know it sounds a bit trite, saying you did all you could do but there is really a lot of power in that statement. We don't know the future and the past, hindsight is a real bugger to deal with. In hindsight, we see all kinds of things we didn't "see" before the problem and as good nurses we then promptly beat ourselves up. The problem with hindsight is you have PLENTY of TIME to reflect, you didn't have that luxury going thru the events. And from what you related, with all you had to deal with, you did AWESOME! Don't beat yourself up, keep that little girl close and use that as a form of therapy. Reach out to friends, colleagues, counselors, everyone you can use to keep yourself healthy. If the nightmares start coming back, it may be a bit of PTSD and you can talk to someone about that. I know first hand what you're going through, I lost my husband to suicide and it's a nasty, nasty disease. Keep reaching out to your supports and lean on them. Kudos to you for all you do!

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Specializes in Acute Care, CM, School Nursing.

:hug::hug::hug:

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Specializes in Psych (25 years), Medical (15 years).

SlightlyMental RN:

Often times, we allow our emotions to drive our behavior. When emotions are involved, logic usually goes out the window.

Your ability to see and own the logic in your approach to dealing with this emotionally traumatic event is an indication of your abilities as a nurse.

In your reply, you systematically responded in a succinct way. To be able to see past your pain and logically approach a response speaks volumes.

My hat is off to you, SlightlyMental RN.

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Specializes in chemical dependency detox/psych.

:tku:

If I could give you numerous kudos for that psychological cheerleading, I would. I'm feeling so much better this evening. Yesterday, I just hibernated and licked my wounds, and tonight, I had my hubby take me out for filet mignon and drinks. It felt really good getting out "among the living". I think I'm back to baseline, now. Thank you so much for the kind words of encouragement. I know I'm not completely clear of this trauma, but it truly helps to have this board with other nurses, not to mention a very patient hubby who waits until I'm ready to talk and a cute little girl to give me hugs.

SlightlyMental RN:

Often times, we allow our emotions to drive our behavior. When emotions are involved, logic usually goes out the window.

Your ability to see and own the logic in your approach to dealing with this emotionally traumatic event is an indication of your abilities as a nurse.

In your reply, you systematically responded in a succinct way. To be able to see past your pain and logically approach a response speaks volumes.

My hat is off to you, SlightlyMental RN.

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Protecting people from themselves is nearly impossible.

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