Nurse Suicide: Breaking the SilencePage 4 of 10

2. Absence of Procedures

The loss of a nurse colleague to suicide is more common than generally acknowledged [9-11] and is often shrouded in silence, at least in part due to stigma related to mental health and its treatment [12,13]. After a suicide, nurses grieve in different ways as they continue to deliver patient care. A standard operating procedure for how to handle the suicide of a nurse colleague does not exist, compared with what is available for physicians [14,15]. Without a predefined process, each unit manager is left to independently develop a grief recovery plan to support the staff in processing resultant emotions. In our collective experience, no one, at any level, was comfortable talking about suicide when it occurred. One nurse leader speaks of her experience following a suicide.

Case: Hearing Whispers

I found out through a whisper in the wind. Not a memo. Not an announcement. Just chatter. Then later, another whisper; another event. Again, there was no formal announcement. I thought more about the memos we received about key events with the physicians and how that seemed to be handled so differently. Each of their losses is sent out as a mass email so that anyone touched by that person could know, reach out to the family or friends, and grieve together. In this situation, each manager prepared their own action plan to process their staff through the grief, fielding the event independently. I was not a member of those departments, yet the news moved me in a profound way. I wanted to process it. I didn’t even know the nurses personally, yet I wanted to know more. I felt unsettled and needed closure. Maybe it was because I am a scientist and saw the pattern emerge. I was fixated on determining one of two things: Was there anything we could do to prevent this in the future, or on the contrary, should I resolve myself to the fact that suicide happens? I knew that everyone was doing the best they could do to deal with the situation, but also questioned whether there were best practices somewhere else to learn from. I wondered about whether or not having more than one event in an organization was unusual. I attempted to seek out best practices, went to the internet and then to the literature. The results were sobering.