Nurse Suicides: Getting Help Before It’s Too Late

Speaker 1: 00:00 Many people who work in the medical field experienced secondary trauma. There are long hours, there are irregular shifts, and when a patient doesn't survive or suffers a great loss, it can all take a toll. Uc San Diego researchers are discovering now that suicide rates among nurses may be higher than the general population. Shannon firth, a Washington correspondent with medpage today reports the problem has been overlooked with little data about suicide among nurses. Researchers are now working to change that. Here's my interview with Shannon Firth. Well, Shannon, I want to thank you for coming here today. Thank you for having me, ted. So you write about a southern California nurse who died by suicide and the reaction to her death by her emergency room colleagues really gives insight into how that industry deals with this. Can you talk about that for a bit? Speaker 2: 00:52 Sure. So I wrote about a nurse named Dana who is this vibrant, energetic, caring, smart, funny nurse who took her own life last year. And when that happened, a lot of her nurse colleagues and even her family were really shocked by this. Even though they're medical professionals and they're trained to recognize the signs of depression and suicide, they really never saw this coming. Um, and the reaction to, uh, to her death among the leadership at the hospital where she worked was also kind of a second below for some of the nurses at that hospital. They felt like it wasn't, they weren't given the time to grieve that they need it. There was a crisis debriefing, um, for people who had worked directly on Dana because Dana was brought to the same hospital where she worked and there was a sort of memorial for her. Uh, they put up a memorial box in the nurses lounge, but on the whole, the message from leadership was, Shh, don't talk about this. We don't want to hear you talking about this at the hospital. Um, here's a number to call if you need to talk to someone, but we need this. Kept quiet. Speaker 1: 02:08 And you know, the issue of depression has a real stigma in the medical community. How does that impact who gets treatment? Speaker 2: 02:15 Stigma in general, in society around mental health is very strong. Even now, even with the celebrities and the pop stars coming out and talking about their mental health issues within Madison, stigma is extremely strong. Um, even though medical professionals, we'll see a patient and give caring to be caring towards that patient among themselves, it's not uncommon for them to talk about, you know, the crazy in bed three or if there's an overdose, you know, they might joke, well that person didn't do a very good job, did they? And, um, I think that kind of language and that behavior, uh, is observed and absorbed by those people who may be struggling themselves and they do not want to be lumped into that category of patient. Speaker 1: 03:03 [inaudible] you spoke to a researcher at Uc San Diego who is frustrated, really frustrated with the fact that there is no tracking on this. What is she doing to fix that? Speaker 2: 03:14 Sorry. Yes. I spoke with duty Davidson, who is a nurse scientists and she talked to me a little bit about this, this problem, this lack of data. When there were a few suicides at Uc San Diego, she wanted to know how common the problem was and was frustrated by not having any data. So she started looking in San Diego County and then did see that there was a higher suicide rate among nurses than the general female population. And you have to look at females versus males because males are three to four times as likely to complete suicide. Since nursing is a female dominant profession, you want to measure apples to apples. So she looked at the San Diego County data and then from there she said, okay, we see something but it's only a small sample size. So she wanted the national data. So she looked to the CDCs own dataset for violent death and she tried to parse that data. Speaker 2: 04:11 And now the CDC Dataset, the NVD Rs, it's the national violent death reporting system that has data. At the time she was looking at had data for about 18 states. So she got a sense of what was happening there. And she saw again a signal that there is a higher rate of suicide among nurses and she could only get limited data because that gender breakdown pieces and always available. So what we have right now are those studies and then studies outside of the u s so Denmark, Canada, Australia, um, in those countries that have done studies and in all of the published studies that we've seen, the suicide rates among nurses are higher. So that's what's known. Speaker 1: 04:54 And she's now piloting a program at Uc San Diego to identify nurses who are at risk and connect them to the treatment. How does that program work? Speaker 2: 05:03 The program is called the Healer Education Assessment and referral program. The program started at Uc San Diego in 2009 and it was dedicated to doctors and medical students. Now after, um, they started to see this problem was relevant to nurses as well. In 2016 they expanded it. So the way the program works, that sort of technology meets human touch. Um, there's two parts. There's the outreach component and there's the online survey tool. And the survey tool though it is just a simple questionnaire with a blank box where people can convey their thoughts and questions. It's actually at serves as a lot more than that because on the other end of that questionnaire, when you complete it, there was a human, a counselor who's looking at those questions and looking at that person's response. And so after each person completes the survey, it gets routed through a backend algorithm sent to this counselor who reviews the results and looks at the person's questions and comments, and then sends a personalized response to that person that may say, oh, it looks like you're very depressed, or oh, it looks like you may have an addiction. Speaker 2: 06:19 You may have an issue with drugs or alcohol, or it seems as though you may be having suicidal thoughts here, and I'd like to know if you have supports, and also do you have a plan and will you reach out to me? Can we stay connected? And then that counselor will give that person options. One reason why they think it's been so effective is because it's anonymous. So the tool is an encrypted software program that's licensed by the American Foundation for suicide prevention that allows someone to give their thoughts, their feelings, their questions without ever saying their name. So even though they put their email address in there, it's encrypted and then get a response without anyone ever knowing who they are. Right. You know, I'm curious to know what had the early results of this pilot program then over about 10 years with the medical staff in total, there's been about 400 people who've been brought into counseling and treatment and that since 2009 and since 2016 when I was brought on, when nurses were included in the whole hospital, staff was included. Speaker 2: 07:29 Um, they've seen 40 nurses brought into counseling and treatment in two years. And that might sound like a small number, but a lot of the people who respond to the survey, they are highly at risk. A lot of those people are tier one and tier two response rates. So that means that they're either severely depressed or they may even be actively suicidal and a percentage of them have attempted suicide before. So what I'm hearing as that the people who are most in need of help or really being serviced by this tool. So what are some of your biggest takeaways from this reporting? One of my biggest takeaways here has been that the stigma in health care among healthcare providers is incredibly dangerous. Life threatening. If people are afraid to ask for help, if they're afraid to seek care, they may die rather than be hospitalized, rather than seek treatment, rather than have it known among their colleagues that they have an issue, they may take their own life. It's all very eye opening. Shannon firth, a Washington correspondent with Med page today. Thank you so much for joining us. Thank you Jay.