Judy Davidson, DNP, RN, FCCM, FAAN, EBP, is the lead author of a recent research paper titled “Nurse Suicide: Breaking the Silence” published in the National Academy of Medicine’s Perspectives: Expert Voices in Health & Health Care.
We interviewed Davidson at length about this incredibly important topic to help raise awareness during National Suicide Prevention Month. What follows is Part 2 of our interview. (Check out Part 1 here.)
It seems like nurses—when it comes to suicide—don’t matter as much in the eyes of the health care system as other health care workers do. Why?
I don’t agree with this statement. It is our own problem that we don’t track these issues or actively address them. Believe me, when the Chief Medical Officer and CEO read the results of our pilot extending the Healer Education Assessment and Referral Program (HEAR) to nurses and hospital staff, they were right on top of it, working out a strategy for how to fund the program moving forward. We, as a profession, have to frame it as a problem with data to back up our emotional plea to move this into the public light.
I am very grateful for nurses who are now coming forward to share their stories, putting a “face” to the problem and helping to destigmatize mental health issues. When our initial data was published in the Journal of Nursing Administration on the same day “Breaking the Silence” came out, the American Foundation for Suicide Prevention changed their website from “Physician” Suicide Prevention to “Healthcare Clinicians.” The content is heavily geared towards physicians, but that is only because we haven’t studied or tested enough strategies with nurses to have more prominence on the page. As soon as we do, they will gladly market best practices for others to learn from.
Since they take the most prominent role of caregiver, do you think this is why they are being ignored? Why hasn’t more research been done? Why haven’t more programs been developed to help nurses prevent suicide and deal with its aftermath?
We are not being ignored, we have ignored ourselves. No one is to blame. We didn’t know what we didn’t know. No one thought to ask. Now that the questions are being asked, we will find the answers. We learn a great deal at an organization level by participating in the HEAR program and offering our nurses the interactive encrypted anonymous risk screening. They tell us about actionable risks that can be reduced in the workplace. Top on the list is bullying and lateral violence. Every leader has an obligation to actively reduce bullying in the workplace. It’s not just an issue of employee satisfaction and retention, workplace wellness—when you come down to it—is about saving lives.
How can nurses recognize signs in coworkers that they may be severely depressed and possibly contemplating suicide?
Burnout and compassion fatigue can lead to or coexist with depression. Recognizing those issues when they occur, and preventing them with caregiver support strategies, can go a long way. We tested a strategy for caregiver support that was originally published by Susan Scott at the University of Missouri. Peers elect peers that are naturally good at helping colleagues through rough days. These peers receive special training to become emotional first aides. They keep on the watch for people who might need help and provide comfort as the need arises. When they sense that this collegial help is not enough, they go up an emotional aide type of chain of command to get their colleague the help they need. It is a wonderful program. We are now expanding the HEAR program to include this level of caregiver support.
In addition, our HEAR counselors who become experts at workplace crisis management also provide emotional debriefings for groups and individuals after a significant clinical event. We don’t wait for them to ask for help. Risk management informs the counselors that there has been a significant event and the counselors proactively offer their services.
If they do become aware of these indicators, what’s the best way for nurses to intervene to help other nurses?
Once the HEAR program is in place, after getting into the habit of recognizing each other when there is stress or crisis, the counselors that run the screening help to triage and find people the professional help they might need.
Is there anything else that you think is important for people to know?
If you or someone you know is suffering from depression or suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255.
For more information about starting a suicide prevention program in your own organization, contact mmortali@AFSP.org.
Do not try to create a screening program on your own. The program at AFSP has been tested and works.