As a primary care nurse, one is more than likely to come across patients who are experiencing suicidal thoughts, and it’s important that nurses are prepared to respond compassionately to patients who are considering suicide. The suicide cases should not be taken lightly because it is an epidemic proportions in the U.S., as well as across the globe. Internationally, around one million people die every year by a suicidal act. In the U.S., over 30,000 people die every year by this. As nurses, we must remember that suicide can be prevented. Also, as nurses are practicing on the front-lines, they have the highest number of chances to recognize suicidal patients and intervene when they can. However, there should be more awareness in the nursing field so these signs could be easily recognized.

Signs that a patient is at risk of suicide:

Whenever a nurse cares for a patient, she should be able to identify that the particular patient is at risk of suicide. Identifying the patient at risk is critical in order to save the patient from killing themselves. Even just a warning sign could indicate that an individual is at risk of suicide. In this line, the following behaviors can be taken into consideration. If the nurse finds one or more of these warning signs, she or he should be alarmed that something is not right with the person. The warning signs are:

• Threatening to kill themselves
• Seeking ways to kill themselves
• Talking about a suicide plan
• Talking/writing about death or dying
• Showing feelings of hopelessness
• Engaging in risky acts
• Showing feelings of being caged
• High use of alcohol or drugs
• Isolating themselves from one’s friends and family
• Abnormal agitation
• Anxiety
• Abnormal sleep patterns
• Dramatic shifts in moods

Things that should be done by a nurse when a person is at risk of suicide:

The first and foremost thing that the nurse should be doing if she is concerned about the risk of any patient is to discuss the situation with her line manager. It can be anyone, from the nurse unit manager to the clinical director, as long as the patient’s intentions are brought up in some way. The nurses should also be aware of their workplace procedures when it comes to evaluating the mental health of  patients. Today, several healthcare centers have access to a mental health clinician or a consultant liaison service. These are the people who can perform a thorough mental health evaluation of the patient at risk.

While caring for suicidal patients, nurses should also remember that it is important to act immediately if they sense something wrong. In this, it’s also important for the nurses to allow the patients to talk freely. This can be achieved only when the nurses can demonstrate their empathy. It’s to be noted here that only if the nurses show the willingness to listen, the patients would open up. While doing so, it’s equally important for the nurses to take care of their own safety, and they must ensure a safe environment for the patient, themselves, and other staff. Also, they should not forget to document their interactions with these patients while following their record, keeping protocols that are followed by their healthcare organizations.

Apart from these things, the nurses should also remember that the patient’s expressions could affect their minds too. So, they must be very mindful of their own feelings, as well as reactions to such things. To prevent any negative impacts on themselves, they can take some supervision or debriefing opportunities with their co-workers. Finally, the nurses have to keep their role in mind, which is to care and support the suicidal patient. They should also remember that to counsel or assess the suicidal patients is not their role. However, the nurses who care for suicidal patients can think about the possible impacts of the cultural background of the patient and can get advice from their loved ones.

Recommended nursing interventions for the suicidal patients:

The nurses can help relieve the suicidal patients from their isolation by arranging to stay with their family or friends. Here, the primary goal of the nurses will be to provide safety, as well as comfort to these patients. Nurses should also understand that the people cannot think clearly during crisis situations and can encourage them to avoid making this decision. In this line, nurses can give patients some other ways to deal with their strong emotions. They can encourage the patients to speak out freely about their feelings. As mentioned earlier, providing a safer environment for the patients is important. Any potential weapons or pills should  also be removed from their surroundings.

In some cases, a relief of anxiety is what the patient needs. As such, the restoration of his or her sleep can help them think clearly and restore the sense of well-being. If the nurses can see the patient’s anxiety is extremely high, a tranquilizer can be prescribed. Finally, the nurses should arrange for counseling by discussing the issue with their senior staff as early as possible.