Helping front-line nurses help suicidal patients

Assessing an individual's risk of suicide is a challenging task for nurses. Three Ryerson researchers, though, are looking for ways to support nurses as they complete the risk-assessment process.

Elaine Santa Mina is a professor in the Daphne Cockwell School of Nursing (DCSN) and principal investigator of a study that aims to enhance nurses' proficiency and confidence when evaluating individuals' suicidal thoughts and behaviour. The first-of-its-kind project also involves DCSN professors Elizabeth McCay and Donald Rose; all the researchers are members of the Centre for Health in at Risk Populations, a research centre in the Faculty of Community Services (FCS), and core members of the Mental Health Research Cluster in the DCSN.

Due to their front-line role in the health-care system, nurses are usually the first health professionals to assess if an individual is at risk of suicide.

"Risk assessments are complex and require sophisticated nursing skills," says Santa Mina. "Generally, suicide is a taboo topic to discuss and suicide risk is often fluid. Although there are rating scales that attempt to quantify risk level, their numeric, linear approach provides limited understanding of an individual's context that identifies one who is at risk of taking his or her life."

In addition to being highly observant and a good listener, a nurse must know the resources that are available to assist individuals at risk of suicide. Critically, nurses must also assess and respond to personal factors that may prevent patients from ending their lives.

To help nurses manage their responsibilities, the Registered Nurses' Association of Ontario (RNAO) created a best practice guideline for assessing suicide ideation and behaviour. In fact, Santa Mina led the team of experts that developed the comprehensive guideline.

But Santa Mina, McCay and Rose wondered, how are nurses implementing the RNAO's many recommendations? And what can be done to help nurses assess the complexity of suicide risk for individuals whose needs fluctuate?

With funding from a FCS seed grant, Santa Mina, McCay and Rose launched a study late last year at a large mental-health hospital in Ontario. Before the project began, all the nurses received education from the hospital on best practices for suicide risk assessment.

During the study, the researchers analyzed the nurses' documentation of individuals' and actions. Additionally, the nurses participated in focus groups and the individuals receiving care participated in interviews.

According to the preliminary findings, the nurses' documentation was consistent with the RNAO's guideline. When it came to how nurses and individuals felt about risk assessments, however, both groups wanted to see changes.

"Nurses recommended improved communication and more time to build relationships," says Santa Mina. "Nurses, in particular, wanted to ask more questions and understand an individual's context in greater depth so resources could be tailored for the individual."

The results of the study will inform educators, both at the hospital and in undergraduate nursing programs, about the effectiveness of assessment training. The findings will also guide future education interventions to help learn how to conduct thorough .

Going forward, the researchers plan to expand their study to include other areas of nursing.

"Suicide and depression are pervasive. They not only affect living with mental health challenges, but also, for example, older adults, women and vulnerable youth," says Santa Mina.

Provided by Ryerson University
Citation: Helping front-line nurses help suicidal patients (2015, May 15) retrieved 29 March 2024 from https://medicalxpress.com/news/2015-05-front-line-nurses-suicidal-patients.html
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