What do you do when a long-term patient says they want to die?

[jess124]

Hi all, this is my first time posting. I'm going to try to keep it short. I just started my first clinical last week and was put in the long term care side of the health facility. I have no previous medical experience. So my question is about a patient I encountered. The patient was paralyzed and unable to speak so they used a letter chart to communicate. They had told me they wanted to die and more things. I was shocked and wasn't sure what to do. I informed my instructor but she just shrugged it off. My question I have is how would you react in that situation and if you have experienced any situations like that and if so what did you do? I don't feel okay with leaving the patient like that and also feel a bit stressed because I'm new to patient care and isn't sure how I should handle the situation. Thank you, I'd greatly appreciate responses and any advice.

[Ruby Vee, BSN]

Think about how you would feel if your mobility was taken away, you were unable to care for yourself and you were stuck in a LTC facility with strangers taking care of you instead of being home with your family and friends. Would you want to die? Can you understand how someone would feel that way? You were right to talk to your instructor about it, but I wonder if you had also talked to that patient's nurse. It could very well be that this isn't new and that the staff is already following up on it. Perhaps the patient wants to die because of some aspect of his situation that could easily be fixed and the LTC is already working on fixing it. Most anti-depressants, for example, take a couple of weeks to build up to a proper blood level to start working, and perhaps the patient hasn't been taking them for long enough for them to start to work. Talking to the nurse may have reassured you that the staff was aware of the situation and was doing their best to help the patient.

[TheCommuter, BSN, RN]

The patient was paralyzed and unable to speak so they used a letter chart to communicate.

This may sound controversial to some. I personally would want to die if I was paralyzed from the neck down, staring at a hospital room wall all day, dependent on staff to feed me and change my diapers, and unable to walk, talk and propel myself in a wheelchair.

Without a half-ass decent quality of life, what is the point of continuing to exist? The patient in the original post seems to be merely existing rather than living a full life.

After a couple of years of working as a nurse you will come to the realization that death is not the worst outcome by a long shot. However, we live in a death-defying, death-denying society that values the quantity of years a person lives over the quality of life (or lack thereof).

Anyhow, suicidal ideations are supposed to be reported to the attending nurse and/or facility social worker for appropriate follow-up.

[Purple_roses]

I'm not good when it comes to these things. One of my patients said this during my critical care rotation. I didn't know what to say because I would have wanted to die in her situation too, but of course I wouldn't say that. I asked her if she wanted me to call a religious person within the hospital or if there was anyone from outside the hospital she wanted to talk to. Aside from that, I honestly didn't know what to say. When I left the room, I told my instructor about it, and in a nut-shell she said sometimes there's not much to say in those situations. The best thing you can do is listen to them and ask them how you can help them or who you can call for them.

That's a rough situation to be in as a first semester student.