SI in Healthcare, Prevention Resources

Ironically, in the health profession, mental illness and suicide remain some of our strongest taboos. Emotions are not isolated from your career, but it’s considered un“professional” to take them to work. However, mental health affects everything we do; resources, hotlines, and people on standby prove that point, and yet there’s still a stigma in health care and something must change.

Take Breaks or Risk Being Broken

Nurse.org found about 20% of nurses suffer from depressive symptoms and nurses are 4x more likely to commit suicide compared to other careers. They suggested four great reasons to take a mental health day, here’s a summary:

  1. Distractions: life/work can be so busy that sometimes you need a mental break to process and cope with the changes and taking a break will help tackle your biggest concerns before the stress becomes more serious.
  2. Neglect: breaks are important to give our bodies some TLC (tender, loving, care), which we sometimes forget to do because we are so focused and busy with everything else.
  3. Appointments: just like we tell patients, keep your health a priority and attend appointments. Speak with a counselor or a professional to make sure you are doing okay or simply need some guidance.
  4. Physical health: having an active lifestyle can ward off additional health problems and breaks are the perfect time to take a walk, fast, meditate, or do other activities that can promote your well-being.

–Nurse.org

healthcare

Nurse Commits SI Because of Bullying

Bullying cannot ever be tolerated, it’s never the solution and it usually reflects a personal problem, not what you did wrong and it’s not limited to nursing. Here are some helpful tips if you’re dealing with any type of intimidating behavior or ways to not let it get out of control:

  • Know that you are not alone. Many victims of bullying tend to internalize their feelings or convince themselves that they are to blame when in reality, bullying is very common. For instance, reading a comprehensive 2012 study detailing the experience of 99 nurses who were bullied can help you recognize that you are not alone.
  • Seek out resources. Check if your state is one that has laws on reporting or offers violence in the workplace programs
  • Speak to your nurse manager or supervisor. If you can, arrange for a closed and confidential meeting with your nurse manager to talk over the situation. There may be workplace solutions that could help, such as re-arranging your schedule or ensuring that there are other coworkers working alongside you to be more supportive.
  • Talk to your coworkers. There may be other nurses who are feeling the same way that you are.
  • Arrange a meeting with HR. Going to a higher-up on the list to discuss workplace bullying may be necessary, especially if your bully is a nurse manager or other supervisor. In some situations, it may be helpful to arrange a sit-down to discuss any issues that exist.
  • Talk to your union rep. Your union rep may have suggestions or other resources in your area to help you, or lending your voice to speak out against bullying in the workplace may start a push against it happening to others.
  • Text 741741 to have a conversation with a trained crisis counselor or call 911 immediately if you are having thoughts of hurting yourself or others.

–Nurse.org

Paramedics are at risk

Every four days a firefighter, EMT, or paramedic in the U.S. dies of suicide. The rate of post-traumatic stress is estimated to be on par with that of the U.S. military, which is about 15 to 20 percent of EMS providers.

Conversations about PTSD and suicide awareness are largely avoided in public safety professions. EMS1 is helping break the silence. They suggest the following warning signs:

  • Being late, sloppy appearance, not taking care of their ambulance or equipment
  • Anger or a bad attitude towards colleagues, patients, and facility staff
  • A change in behavior such as refusing to work overtime, or not attending agency events
  • Getting upset or angry when reminded of a certain call
  • Admitting to increased stress outside of work
  • Increased alcohol use, or substance abuse

(If you think a co-worker is under the influence on the job, report it immediately. No friendship or partnership is worth the risk of having someone under the influence of drugs or alcohol operating emergency vehicles or treating patients.)

How to Speak up if You’re Worried about a Co-worker’s Mental Health

Option 1: Talk to the person about what you see

Many times, people who are having mental health problems want to talk about how they are feeling, but they don’t know how to start the conversation. They may fear being stigmatized. Approaching someone and letting them know you are there to listen and not judge may be enough for them to feel comfortable opening up and talking about what is going on.

Consider saying things like “I’ve noticed [describe a specific behavior], how are you feeling?” or “I’m concerned because of [describe a specific behavior or conversation], is there anything you want to talk about?” This allows you to give a specific example of why you are concerned and also ask an open-ended question. Additional advice for a conversation:

  • Plan ahead; think about what you want to say and how you’re going to say it
  • Talk to the person in private, during a time where you won’t be interrupted
  • Make sure you’re sober and have a clear head
  • Ask open-ended questions and be prepared to listen
  • Don’t be afraid to ask “are you thinking about suicide?” It won’t put the idea in their head.
  • Don’t be judgmental, accusatory, or dismissive
  • Avoid platitudes like God has a plan. Everything will work out on its own
  • Have resources available, such as helpline numbers or the information for your agency’s employee assistance program (EAP)
  • Talk one-on-one. An “intervention” style talk involving a group of people can feel like a group attack and cause a defensive response

Option 2: Talk to a trusted intermediary

It can be difficult to approach someone you think is having a mental health problem. You may not want to overstep your bounds or worry you don’t feel like you know the person well enough to say anything. Another option for broaching the subject is through a trusted third party; a co-worker, friend, family member, or significant other.

I’ve used this approach with a co-worker whom I didn’t know well. Our mutual friend was appreciative that someone was looking out for my co-worker, and she was able to make sure everything was OK.

When talking to a third party, have a plan, be specific about why you are concerned, and let them know why you are talking to them instead of the person you’re worried about.

Option 3: Talk to a supervisor/superior officer

Going a step up in the chain of command can be as difficult as talking to the person yourself. It can be hard to get rid of the feeling that you are ‘ratting’ them out. Remember, you are going up the chain of command because someone needs help, not because you want them to be punished.

It also has the advantage of talking to someone who has a bigger perspective than you do. You might not be the only person to approach a supervisor with concerns.

Having more than one person say “Hey, I’m worried about Bob” can make it easier for someone in a management position to approach a subordinate about any problems they might be having. Talking to a supervisor/superior officer may also be an option if you’ve already talked to the person but still have concerns about their mental health.

Option 4: Call the authorities

If you feel that someone is at immediate risk of self-harm or harm to others, call the police. Hopefully, you will never be in this situation, but if you are nothing is more important than life safety.

If you see something, say something

There are multiple ways to approach and assist a co-worker in getting the help that they need. Know your options and plan ahead to increase the likelihood that your intervention will result in the improved mental health of your co-worker. Don’t be afraid to speak up.

–EMS1

Doctors Need Support

suicide in healthcare

Dr. Wible is doing an amazing job of reaching out to physicians and residents who are suffering and here are a few notes:

  • Male anesthesiologists are at the highest risk. Most die by overdose. Many are found dead in hospital call rooms.
  • Lots of doctors die in hospitals. Doctors jump from hospital windows or rooftops. They shoot or stab themselves in hospital parking lots. They’re found hanging in hospital chapels. Physicians often choose to die where they’ve been wounded.
  • “Happy” doctors die by suicide. Many doctors who die by suicide are the happiest most well-adjusted people on the outside. Just back from Disneyland, just bought tickets for a family cruise, just gave a thumbs up to the team after a successful surgery—and hours later they shoot themselves in the head. Doctors are masters of disguise. Even fun-loving happy docs who crack jokes and make patients smile all day may be suffering in silence. We are all at risk.

Indeed, no one is exempt but my God, WE NEED OUR DOCTORS.  If they’re fragile and hurting, imagine the implications for everyone else who does not have the same educational background or lifestyle. It’s too unfortunate to ignore and she inspired me to write this post in addition to shedding some tears. She’s doing an awesome job to raise awareness:

  • Dr. Wible also has retreats (beahappydoctor) that are geared towards physicians, but anyone can attend
  • As of 8-18-18, Dr. Wible has 1,013 doctor suicides on the registry. If you’ve lost a doctor or medical student to suicide, please (confidentially) submit names here.

–Ideal Medical Care

In Conclusion

I hope that some of the information was helpful about the risks of mental illness and working in healthcare. Additional SI prevention help and resources:

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