When Suicide Occurs on the Unit

[indigo girl]

It has been a difficult week on my unit. I am trying to be mindful of

privacy concerns and legal issues as I type this. I have removed

my state of residence from my profile.

Though this forum seems to be about the mental and emotional issues

of our patients, a suicide, and in this case more than one just a few days

apart, impacts not only the patients and their families but caregivers as

well. Flashbacks of the death I witnessed, and crying over the loss of the

second patient, someone who had been with us for several weeks, I am

most definitely struggling to deal with my own feelings.

I know that I could not have prevented either death, and was not present

for the second one. What I feel is anger, and frustration, and sadness.

I dread hearing more bad news. As the hospital tries to keep costs

down, I know that all of the additional staffing that is being provided for

additional surveillance as a result of these deaths will eventually be

withdrawn, but there will soon be cameras in patient rooms and common

areas.

I am wishing that I could explain more fully everything that happened

in the milieu the night prior to the first death, because I believe all of

those additional stressors and events made everything so much worse.

We were fully staffed the night of the first death though staffing is not

always about the census. It can look good on paper, but the type of

patients, the occurrence of other medical emergencies, as well as a

significant environmental disruption can negatively impact everything.

One of our staff having worked both nights of these events is on

emergency leave for PTSS with remedial therapy provided by the hospital.

We are all in shock but functioning with the additional staffing, though the

stress level is very high.

[inthesky]

*huge hugs*

My preceptor/mentor (nurse of 25 years) can recount decades ago incidents of patient suicides/deaths like they happened yesterday. He told me that he cried. He questioned his nursing career. He gave himself time to move past it.

:icon_hug:

[medsurgrnco, BSN, RN]

I wanted to express my sympathy for your having to deal with 2 suicides in a week - and in a new specialty area for you. People can have many different ways of reacting to such events and also have different ways of dealing with it. Some workplaces aren't very good at helping workers deal with their resultant feelings/thoughts. A mental health therapist would likely be more helpful than a chaplain.

[indigo girl]

Maybe some of what they have done in response to these deaths

is a knee jerk reaction. These sentinel events will trigger a close

look by Joint Commission, the Feds, and the State very soon. We no

longer have any closet doors in rooms. All plumbing will be enclosed.

No long necked faucets, etc. All patients locked out of their rooms most

of the day to facilitate observation. It goes on and on...

Many patients now on close visual observation, increased techs

charting safety checks.

Today, you could have knocked me over. They have taped into

Integrative Medicine for ideas of how to make the place more peaceful.

Murals, and painting soothing colors, changing the lighting to softer

light. Already rock and roll has been replaced by pan pipes, and New

Age music. The room where both deaths occurred has been blocked

since the second death. Integrative Medicine says the room must

be cleared energetically, and Management agrees!

Don't get me wrong. I agree, it does need clearing. It's just that in this

so very clinical environment, I never expected them to agree with this.

They are playing New Age in that room 24/7, and it remains blocked.

I met with Integrative Medicine today, and spent a blissful hour getting

some healing time. They recommended that all of our staff get this work

done monthly. Most won't but, it would not hurt. All of us are so stressed.

The blocked room will be cleared. The staff will be supported. One of the

ICU's sent us a card and some food to tell us that they cared.

All of us on the evening shift had opted to go to double shifts so as not

to be there 5 days. So, we all do 2 doubles and one single shift. It seems

to help with the stress to only work 3 days instead of 5 on the most difficult

shift. We started this just before the deaths occurred. And, it does help.

We are a Crisis Stabilization Unit. This is where people get sent that need

intervention. I never thought of psych as being particularly an area where

tragedy occurs, but it is one of the very saddest places that I have ever

been in, and is really more heart breaking than Hospice. Our patients are

frequently homeless, hopeless, and abused. Their families suffer because

they can not help their mentally ill loved ones, and they have to deal

with this forever because most are not curable though some can get better.

What these families have had to endure is unbelievable

This is where we are right now, trying to deal and move beyond all of this

into healing space for all of us.