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Patient suicide: why nurses need colleagues’ support to grieve

The suicide of a patient can have a devastating effect and provoke feelings of failure

The suicide of a patient can have a devastating effect and provoke feelings of failure

The day I learned of the death by suicide of a child in my care, my world stopped.

I experienced intense feelings: sorrow, shock, anxiety and an overwhelming heavy feeling in my heart, as well as a deep sense of sadness for the family.

Nurses may ask themselves could I have done more?

My thoughts began to race and questions filled my mind. What did I miss? Could I have done more? Will I be blamed?

Sadly, many nurses find themselves in a similar position.

The UKs suicide rate has dramatically increased over recent years

...

The suicide of a patient can have a devastating effect and provoke feelings of failure

Picture: Annette Taylor-Anderson

The day I learned of the death by suicide of a child in my care, my world stopped.

I experienced intense feelings: sorrow, shock, anxiety and an overwhelming heavy feeling in my heart, as well as a deep sense of sadness for the family.

Nurses may ask themselves ‘could I have done more?’

My thoughts began to race and questions filled my mind. What did I miss? Could I have done more? Will I be blamed?

Sadly, many nurses find themselves in a similar position.

The UK’s suicide rate has dramatically increased over recent years and suicide is one of the leading causes of deaths globally.

Research shows the initial phase of the COVID-19 pandemic led to increased rates of suicidal thoughts among young adults.

Given that we often internalise the death of a patient as stemming from a failure in our care, I wanted to share my experience. I hope this will help alleviate the stigma and discomfort often felt when discussing the death of a patient and the impact it may have on our mental health.

I blamed myself for my patient’s death

Despite knowing I had completed all professional duties, my concerns about being somehow responsible for the patient’s death were never far away.

Nursing, rightly, is strictly regulated but healthcare is increasingly litigious.

‘My own emotional well-being quickly deteriorated after the child in my care died… There are barriers to nurses’ grief – including stigma from the nursing culture’

I’m certain that an underlying fear of disciplinary procedures, legal action and possible dismissal has caused nurses to remain silent about their grief in such situations.

I experienced strong feelings of self-blame and failure.

The launch of the zero inpatient suicide ambition contains the notion that all suicides are avoidable and preventable. However, this can reinforce nurses’ feelings of failure or responsibility when such deaths occur.

Nursing culture leaves no room for nurses’ grief

The immense pressure of internalised responsibility is likely to have a catastrophic effect on a nurse’s well-being and mental state.

Certainly, my own emotional well-being deteriorated quickly after the child in my care died.

I was able to access counselling to address my distress and anxiety, but there are barriers to nurses’ grief – including stigma from the nursing culture.

Accessing support can be seen as shameful, a weakness or a professional and personal failure. Despite all efforts to remove such stigma for our patients, I believe it remains ever-present for nurses.

If we are expected to care for others, is it not important that we care for ourselves?

Dealing with grief after a patient dies by suicide

  • Take time to process the death of a patient
  • Seek validation by talking and connecting with trusted colleagues who have personal or professional experience of a patient suicide
  • Write – be open and honest about the way you feel and transfer unclear thoughts or questions onto paper to establish a more accurate vision
  • Consider future practice in meaningful and proactive ways
  • Reconnect with the reason you became a nurse
  • Know that these experiences are individual and not everyone grieves in the same way
  • Be mindful of your own mental health

Conversations with colleagues can promote healing

The recognised stages of grief include shock, anger, debate, depression and, finally, acceptance.

Grieving nurses need their colleagues to recognise this unique, multifaceted and often fragile process.

After a suicide, all healthcare professionals should be encouraged to connect with their peers and have conversations which may be uncomfortable or sensitive.

Conversations with colleagues who have experienced similar grief can be helpful and these interactions can promote healing, acceptance and validation.

Keeping the patient who has passed away at the centre of discussions about practice improvements can be extremely emotive and overwhelming, but it is an important way to enable change.

Through my own grief journey, I learned that it was important to allow thoughts to come and go without reacting to them. These thoughts often generated questions based on personal anxiety or emotions, such as guilt or responsibility.

I found it helpful to write thoughts or questions down and return to them when my emotions were less intense or in the presence of a supportive colleague or supervisor.

We need a culture of support rather than stigma

The loss of an individual changes us and how we think, feel and practise as nurses. Grieving helps us process feelings of pain and loss and allows healing and acceptance to begin.

Acceptance did not mean I felt okay about what had happened, but it helped me reaffirm the reasons I became a nurse.

After experiencing the loss of a patient by suicide, many nurses will never be the same. A career in nursing comes with the rewards and privileges of being part of an individual’s life and journey.

Our profession needs to eradicate the stigma associated with nurses grieving or needing support for their own mental health.

Only through these difficult conversations and reflections can we create a culture of support, validation and acceptance for nurses experiencing the most devastating time of their careers.


Further sources of advice and information


Amie Whitter, senior mental health nurse in an NHS child and adolescent emergency response team

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