Suicidal behavior is the most extreme manifestation of violence, because it is oriented towards the individual himself. It is a human problem that exists from the very origin of man, happens in all periods, affects both sexes and all social classes. Suicide does not occur as an isolated event outside the communities and although it is considered a health problem it goes beyond the limits of public health and medicine.
This poses a challenge on how to care for a suicidal patient. Julia Hagen, Birthe Loa Knizek, and Heidi Hjelmeland conducted a study to determine the perception of mental health care nurses on some of the principles to consider when caring for a suicidal patient. They interviewed eight nurses in charge of mental health. They then analyzed the data qualitatively so as to create themes. Several themes emerged as far as the nurse perception on caring for suicidal patients is concerned.
The first theme is the idea of identifying the suicidal cues. Most of the nurses revealed that when caring for suicidal patients, nurses should be alert in order to detect cues and take appropriate action. The value of cues in caring for suicidal patients is evidenced by one of the statements made by one of the nurse respondents. She asserts, “We have saved many people, we managed to, so in the moment we should be there, we were there. We managed to save them. (…).” (Hagen, Knizel and Hjelmeland 2017 p. 32).
Being close to the patient and knowing the signs is a really important aspect of caring for suicidal patients. You need to be closer to a patient, more observant to notice expressed symptoms and see the observable signs. You also may help the patient get away from the need to inflict self-harm or even the want to end their own life. In doing so, mental health nurses have to be involved with the patients while at the same time not getting too involved. Caring for these patients can drain you mentally. They have to protect themselves from getting too close so if something were to happen it isn’t as hard on them.
While they do use their observations to help, they also use their “gut-feeling”. They sensed their patients mental state and acted when they had a bad feeling. “Several of the participants believe they have saved patients by acting at the right time” (Hagen, Knizel and Hjelmeland 2017). Even when wrong about your feeling, I believe it is always better to be safe than sorry. Evidently, the idea of identifying suicidal cues is effective because the psychological mechanisms that lead to suicidal behavior resemble those usually involved in other forms of self-destructive behavior, such as alcoholism, reckless driving, and violent antisocial acts. Often, suicide is the final act within a behavior of that style.
The second theme that emerged from the responses is that most of the nurses agreed with the fact that when caring for suicidal patients, it is crucial to relieve psychological pain and inspire hope. This can be achieved by broadening the patient’s perspective. The third theme that emerged is the emotions evoked by suicide. Under this theme, the authors revealed that nurses often feel angry after suicide. Not only do these nurses try to help the patient, they can also grow close to them. So, if a patient does go through with it, there are many things the nurses feel.
Sadness for the lost life of this patient they had to get to know to understand, as well as guilt. They wondered if they didn’t do enough, or give the patient enough attention. In fact, they appear helpless and may feel that they failed on their part. This clearly indicates that caring for suicidal patients is not an easy task. The fourth theme is the theme of regulations of emotions and emotional expressions. Under this theme, Hagen, Knizel and Hjelmeland (2017) found out that most nurses feel that calmness is essential when caring for suicidal patient. Calmness enables nurses to be steady without being affected by suicide. This is evidenced by responses given by one of the nurses interviewed that states:
“You must be aware of it so that the patient’s crisis does not color [affect] you so much that you are at a loss, but that you’re able to be there and endure hearing that someone says ‘yes, I want to die. I don’t want to live” (Hagen, Knizel and Hjelmeland 2017 p. 34)
Lastly, it is demonstrated that when caring for suicidal patient, one should balance emotional involvement and professional distance. They proposed self-delineation as a way of balancing emotional involvement and professional distance.
Being a mental health nurse, you’re not only caring for this patient, you could also be preventing suicide. Experienced mental health nurses are trained, and learn from experience, to be there. Not only in a health care capacity, but in an emotionally supportive way as well. No matter the amount of training, there are somethings that can’t be taught.
- Hagen, J., Knizek, B. L., & Hjelmeland, H. (2017). Mental Health Nurses Experiences of Caring for Suicidal Patients in Psychiatric Wards: An Emotional Endeavor. Archives of Psychiatric Nursing,31(1), 31-37. doi:10.1016/j.apnu.2016.07.018