“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 ribbon-3-lgearly. 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.



5 thoughts on “Again

  1. Adam, I too am someone that knows of someone who was a nurse and committed suicide. She was one of my closest, best, most awesome friends. I loved her tons. I never knew the pain at she was carrying with her like an anchor around her neck. I never knew that she needed help. Now, looking back, it is all too obvious. We are helpers. We are problem solvers. We are the ones that God gave a true gift for healing others. I ask myself all too often, ” How the hell did I miss that in her???”. I carry that guilt with me all the time now. I miss my friend. Now, I am ever vigilant in checking, double-checking, and hell triple-checking with people to make sure they are ok. We are in a profession where we see tragedy at its best. It smacks us like a 2×4 right between the eyes and burns itself right into our collective brains….but we deal with it. At the end of the day, at the end of the call/code/whatever just hits us the wrong way, all we truly have is each other to see our way through. I lean on you and you lean on me.
    I love this article. Please reach out to me if ever you need help and I will promise to do the same to you. (That goes for anybody reading this) Although it has been half a lifetime since we last saw or spoke to each other, (seems like yesterday….lol) we are all in this together. We have “been there, done that, and got the T-shirt” together through our chosen mission in life. Miss ya buddy, Kev


  2. Adam I lost my cousin, who was a nurse 3 years ago this October. She was in her early 60’s. In her early career she was a Shock Trama surgical nurse. She helped develope the new Breast Cancer Center at Franklin Square Hospital. Breast Cancer was her passion. She was all the things you described in your post ……giving, caring, went the extra mile for anyone……and she was also my closest friend. Did I see it coming, yes. She had tried 2 times before she got it ‘right’. Her husband, her children and myself did all the things we could to help her. We stayed in contact. Made her feel loved. She saw a psychiatrist once a week. She knew she could call any one for us at any time. I loved her very much. She was so good to me. I accepted her with all her flaws and she accepted me with mine. She was doing so much better. She had gotten her Masters and was teaching nursing at Towson State. We were all so proud of her. ( at her fureral one of her colleagues came (( fureral was rear D.C. )) and told us wonderful stories about her. Things none of knew that she had done or been involved in. She was so loved and respected in her profession )
    But none of that was enough. She couldn’t find peace within herself. She was brilliant. She had some physical pain from a back surgery she’d had years before. She stock piled her med’s and one afternoon she took them all. It just happened to be my 5th wedding anniversary. She always said we should never forget her…….it’s one of the saddest experiences of my life, second only to the death of my son. Some days I take it personally and am angry we her because she knew what losing Richie did to me, she was right there with me holding my hand. Other days I know she was so lost she felt suicide was her only answer. All I know for sure is I miss her like crazy. Her name was Jan. She signed all her correspondence…..J.A.N……..Just a nurse.
    Thanks for writing this article. Suicide should be out of the closet and brought into the light! You’re doing that. Very proud of you nephew.
    Much Love,
    Aunt Emelie

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