Suicide

Who is most likely to die from suicide

-men

-white

-40-65 middle aged

-rual

What are the risk factors for suicide?

-previous attempt

-SI

-Hopelessness or helplessness

-severe depression

-auditory hallucination

-recent loss

-substance use

-social isolation

-family stress

-poverty

-knowing someone who dies by suicide

Protective factors

-strong family and social support

-religious or spiritual beleifs

-sense of purpose or responsibility (children/pets)

-Coping skills and problem solving abilities

-access to mentala health care

Suicidality

Overall term

SI Suicidal ideation

Thinking/Planning ones own death

Suicide attempt

An action, not fatal, intent to die

Parasuicide

any potentially lethal action against the self that does not result in death

Immenent warning signs of suicide

-giving away possetions

-sudden calmness after severe depression

-writing goodbye notes

-withdrawing from others

-increase un substance use

-talking about being a burden

Suicide risk assessment questions

-intent to die

-severity of ideation

-degree of planning

Low suicide risk

thoughts w/o plan or intent, strong support

Medium suicide risk

ideation with some planning, limited support

High suicide risk

specific plan, intent, means available

Imminent suicide risk

active intent, inability to maintain safety

Nursing interventions

-suicide precautions (per policy)

-remove harmful objects

-provide close observation (if high risk than 1:1)

-do not leave high risk pt alone

-place pt close to nurses station

-monitor bathroom use

-"tell me whats making life feel unbearible"

-"Im glad you told me you are not alone"

Biologic theories R/T suicidal behavior

-depression

-sever childhood trauma

-genetic factors

Cognitive triad

feelings of hopelessness, helplessness, and worthlessness

Suicide contagion

exposure to suicide or suicidal behaviors within one's family, one's peer group, or media reports of suicide

Family response to suicide

-devastating

-1 suicide is estimated to leave at least 6 survivors who are significantly impacted

-grief, guild, shame, self blame, dysfunction

What is priority in SI

-safety

-suicide risk assessment is ongoing not one time

-nurses responsibility to ensure safety

-always take suicidal statements seriously even if they seem like they are joking

What is suicide precautions

-remove harmful objects, cords, sharps

-provide close observation if high risk 1:1

Nursing interventions Immediate goals

-reconnecting the pt to the other people abd instilling hope

-restoring emotional stability and reducing suicidal behavior

-ensuring safety

:Long term nursing interventions

-ongoing preventative interventions

-teach to expect setbacks

-encourage hopefulness

-review goals that have already been achieve