“Is there anything else we need to address, as nursing leaders, in this upcoming year”, says the Director of Nursing Development. She is speaking to our hospital-wide shared governance group following a discussion on several new initiatives already in the pipeline. The group is made up of front line nurses who serve on unit-based and hospital core councils. The group is coming away from another successful year and is waiting to celebrate Magnet re-designation following a site survey several weeks ago. Normally this is a talkative group but today everybody’s silent. I think everyone just wants to get out early. Something gnaws at me though. There’s something I’ve got to say but I’m afraid:
Afraid that no else sees the problem
Afraid I’m blowing things out of proportion
Afraid I’m opening Pandora’s box…
…but I can’t stay silent.
So I say, “There’s something that’s been bothering me for a long time — five nurses I know have died by their own hand in the past five years.” I go on and speak of death either by suicide or risky (deadly) behavior. These deaths are taking a piece of me each time it happens and this is why I can’t be quiet.
I’m emboldened to speak because the colleague sitting next to me just lost her best friend — a nurse — to suicide. I once was a nurse on the unit where this young woman worked and I already knew of her death. A seasoned nurse from that unit posted a beautiful soliloquy about her on Facebook. Within it, Momma G laced a message for nurses; a message begging, pleading, imploring nurses not to make this unchangeable decision.
Like me, she just can’t face the AGAIN.
Again, someone we never get to laugh with until we’re crying over something you’ve got to be a nurse to understand.
Again, someone we never get to go to for expert advice on how to do this or that.
Again, someone who will never comfort us when our patients turn the wrong corner.
But back to my meeting and now I’m all choked up. I get out, “I’ve got to be part of the solution but I have no idea where to start”. I talk about how searching the literature is a black hole for information. There’s plenty about suicide screens, prevention and intervention but it’s all related to how nurses need to do a better job of screening, preventing and intervening for their suicidal patients. There’s almost nothing about nurses killing themselves!
That’s when I realize something is stirring. The once silent meeting is no longer quiet — a buzz leads to a crescendo of voices. Most of my colleauges know a nurse that ended his or her life. Stories are shared from nurse to nurse. One knows of five nurses that committed suicide. He speaks of a prevention organization founded as a result of this tragedy. Another knows of a nurse that attempted suicide but failed. Other nurses express their worry that there’s someone on their unit susceptible to suicide. As I look around, I wonder if there’s a nurse in this meeting that’s considering it.
Why? Because all the stories include top-tier nurses, award winners, nurses you want caring for your family members, dedicated nurses. Nurses who give it their all without ever letting anyone know of their hopelessness.
How could they do this? Is it they are busy dealing with issues of death and dying or worrying about patient care outcomes or is it continually facing people in desperate need for them? I’ve experienced perfect storms of moral distress and know, given the right circumstances, suicide may look like the only escape for a nurse. It Is Not! Still, I don’t know what to do.
Then I remember something — I AM A NURSE(!), confronting a disease and I own a framework to solve the problem — The Nursing Process!
Assess the problem.
Develop a plan.
Implement the plan
Evaluate what I learn
Something else — I am not alone! The help is coming at me like a deluge. My colleagues want in on this mission. I’m struck that I almost missed the opportunity to ask for help but now it is time to get to work!
Do you share my burden? Do you never want to face AGAIN again? Then raise this issue in your unit, hospital and health system.
Be a Voice!
Are you a nurse backed into a corner, feeling hopeless, facing no way out?
Don’t Give Up!
Is there at least one person you can go to for help? If, when you just read that sentence, did a person pop into your mind? Go to them! Be with them! If not, please consider calling the National Suicide Prevention Lifeline @ 1-800-273-8255. Additionally, come see me or my collegues in your closest Emergency Department. Tell us you need help!
Allow us to keep you and keep each other from AGAIN.