Nurse Mental Health and Suicide

Written by: Sarah Wells, MSN, RN, CEN, CNL


Struggling

For eleven years, I worked as a nurse in the emergency department (ED). I struggled with depression, anxiety, and suicidal ideation. There was a love and hate relationship I had with my job. (I hated its negative impacts on my mood and feelings of self-worth). I cried a lot, sometimes drank too much, and felt really uncomfortable in social situations with non-healthcare people. When I couldn’t sleep for days at a time, I assumed it was a “just me” problem. I felt isolated in my dark thoughts. It took a car wreck to get me on the path to healing.

Trauma Nurse to Trauma Patient

One night, I clocked out of work at 0323 and hopped in my car to head home. While on the highway between the hospital and my apartment, I was in a single-vehicle accident that resulted in me making a quick return to work in an ambulance with a dislocated shoulder and sizable concussion. My team took incredible care of me and discharged me home for follow-up and rehabilitation.

While my physical healing got started promptly, my mental health started to tank. I was profoundly depressed, post-concussive, and struggling to figure out my identity as a non-working nurse. For years, I had thrown myself into work, picking up OT, and mostly hanging out with my co-workers. The majority of whom were nurses, because they were the only people who “got me.” At home for over two months rehabbing my shoulder and brain made me consider – who am I when I’m not at work? And why do I feel so shitty about it all?

Talking About My Mental Health

It was during this time that I started seeing a therapist who I think really saved my life. My therapist was a former nurse who helped me start to unpack my trauma(tizing) career and beyond. My therapist got me to the point where I could start another life-saving treatment, a daily antidepressant and a PRN anxiety medication. I started to heal my mind and slowly, share my mental health journey with other nurses that I knew. I was shocked to find that so many nurses and other healthcare workers had similar experiences with feelings spanning the spectrum of stress, anxiety, sadness, and anger. Some had official diagnoses and years of treatment to discuss while others were barely comfortable acknowledging their distress. I was overwhelmed with a new sense of community after years of struggling alone.

This got me thinking – how many other nurses are out there experiencing poor mental health or suicidal ideation? It turns out… a lot.

Overall Nurse Mental health is Not Good

Healthcare is not the healthiest or safest space to work in. The Centers for Disease Control and Prevention found that healthcare staff experience high levels of stress due to working long hours, frequently experiencing difficult interactions with colleagues and patients, and risking regular exposure to infectious diseases. In a 2022 survey by the American Nurses Foundation, only 42% of nurses reported considering their work-environment healthy. Respondents to the “National Nurse Work Environments – October 2021: A Status Report” reported frequently experiencing verbal abuse, physical abuse, sexual harassment, and discrimination while at work. Possibly the most distressing, healthcare environments are at significant risk for workplace violence. In recent years, nurses, nurse practitioners, and other healthcare workers have died while working to care for others.

Nursing specifically can have a negative impact on our mental health. The American Nurses Association (ANA) shares that nursing staff in specialty areas caring for traumatized patients, terminal, or seriously ill patients often report increased stress, anxiety, and depression. Working in these areas also often require nurses to support patients’ loved ones who are also suffering, emotional work that can lead to compassion fatigue and burnout. The work of nursing has been ever more challenged by a historic staffing crisis compounded by a large number of nurses leaving or intending to leave the profession. I would be remiss if I did not acknowledge the negative effects of the COVID-19 pandemic on nurse mental health, an era that further traumatized an already strained workforce.

Suicide Among Nurses

Judy E. Davidson, DNP, RN, MCCM, FAAN and their research team at the University of California San Diego have raised the alarm about suicide among nurses. Their work has established that nurses are at higher risk for suicide than the general population and are urging the healthcare community to take action. The American Academy of Nursing (AAN) released the “AAN Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide” which shared that rates of suicide, substance use disorder, and mental health issues have risen among nurses and issued recommendations to address risks to mental health and the factors contributing to nurse suicide through informed policy, education, research, and clinical practice.

Where do we go from here?

Nurses have to make it better for ourselves and each other. Luckily, we can make improvements in many ways. Here are just a few:

Talk about it – Break the silence around mental health by fostering open conversations with each other. This can look like simple check-ins with your colleagues or sharing space with your nurse friends. Do what feels comfortable for you and others.

 

Seek mental health support – The most important thing you can do is take care of yourself. Whether that is through self-care, peer support, talk therapy, medications, or other support strategies, you can start the process of healing yourself at any time.
Share suicide prevention resources – The 988 Lifeline offers 24/7, free and confidential support for anyone at any time. The National Alliance on Mental Illness (NAMI) has a wonderful curated web page with suicide prevention resources specifically for healthcare professionals.
Support healthy work environments – The National Academy of Medicine’s “National Plan for Health Workforce Well-being” calls for creating and sustaining positive work and learning environments and culture. For our nurse mental health to improve, we must advocate for healthy spaces to work in. Use your voice to help systems change and progress to support professional well-being.

 

Advocate for workplace safety – Engage in efforts to promote workplace safety in healthcare environments.Learn about healthcare workplace violence. Discuss workplace violence prevention and mitigation programming with your employer. Educate community members. Contact elected leaders. Your nurse voice is so influential. Use it.

 

Why I am hopeful…

My mental health journey is never ending. I have to continuously check-in with myself and see how I am feeling. My depression and anxiety are generally well controlled as long as I regularly go to therapy, take my daily medicine, and engage in the support strategies that work for me. When I neglect those things, my mental health suffers. It is a constant effort to care for myself.

I am hopeful for the future of nursing and healthcare, because I see opportunity everywhere. Nurses are realizing their power. We are organizing and advocating. Nurses are at the bedside and the boardroom. We are part of the decision making groups, creating spaces where we are healing, and collaborating with other industries to make healthcare better for patients and clinicians.

Most importantly, we are talking about our mental health, and not a single one of us has to suffer alone.

 

Bio:

Sarah is a former emergency nurse who is committed to making healthcare better for patients and clinicians. Sarah is the founder of New Thing Nurse and WellGan Consulting, which are organizations that support the nursing community.

 

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3 thoughts on “Nurse Mental Health and Suicide”

  1. Thank you !!! I experienced the same thing. 27 years in the OR & burnout out over 3 years ago. Anxiety, depression & PTSD. I am still in recovery. Weekly therapy, medications & my support people keep me in check. Unfortunately, I am still in the same work environment, trying to get out.

  2. Sarah, thank you for sharing your journey. Many of us are afraid to talk about our experiences, however, I believe we all have to speak out! By bringing the topic to the table, we create a safe environment for nurses and other healthcare providers to seek help, find resources, peer support and help prevent suicide amongst health care providers. Thank you again!!! This is a powerful piece!

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