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A call for action has been issued nationwide to prevent suicide among nurses. An increased understanding of contributing and protective factors associated with suicidal ideation in nurses is needed to implement preventive measures. Factors needing exploration include nurses' burnout, mental well-being, physical health, and workplace characteristics.
This study aimed to determine factors associated with suicidal ideation in 501 moderate-to-high-risk nurses, including their mental health, level of burnout, health-related personal beliefs, healthy lifestyle behaviors, and workplace characteristics.
A descriptive, cross-sectional correlational study was conducted on baseline survey data that was completed before the nurses were randomized to one of two interventions as part of their participation in a randomized controlled trial investigating the efficacy of a combined mental health screening program and cognitive-behavioral skills building intervention versus a screening program alone. Nurses were recruited from across the United States via email. Only nurses identified with moderate-to-high-risk adverse mental health outcomes, including suicidal ideation, were included. The survey used valid and reliable measures to assess burnout, anxiety, depression, suicidal ideation, post-traumatic stress, healthy lifestyle behaviors, health-related personal beliefs, resilience, job satisfaction, self-perceived mattering to the workplace, and intent to leave. Bivariate tests were performed.
Burnout, anxiety, depression, and post-traumatic stress were individually correlated with increased odds of suicidal ideation, as were nurses working 12-h shifts and those who reported an intent to leave their jobs. Protective factors against suicidal ideation included resilience, positive health-related personal beliefs, healthy lifestyle behaviors, job satisfaction, and workplace mattering.
There is an urgent need for policies and implementation of evidence-based interventions to address mental health issues in nurses to ultimately prevent suicide. Burnout should be considered as a possible precursor to serious adverse mental health problems and not just an operational retention issue. Leaders need to invest in resources to enhance nurses' mental health, fix system problems that are at the root cause of burnout, routinely recognize employees for their excellent work, and communicate that they matter. Leaders should listen carefully to their nurses, prioritize their ideas for impactful change, and appreciate those who contribute to improving culture and caring practices.
Work-related stressors have been associated with physician suicide. Physician burnout and depression were exacerbated by the COVID-19 pandemic, remain unresolved and of national concern. Future pandemics are predicted. This study is the first to characterize professional and pandemic-related stressors in physician suicides during the COVID-19 pandemic.
This study aimed to evaluate whether there was a change in reported job-related stressors after the beginning of the COVID-19 pandemic.
Physician suicides were identified within the National Violent Death Reporting System dataset (March 1, 2020 to December 31, 2021). Free-text law enforcement and medical examiner notes for physician suicides were analyzed using reflexive thematic analysis.
Of 307 physician suicides, 70 included professional or pandemic-related stressors associated with death. Themes included pandemic-related dysregulation, financial distress, relationship issues, mental/physical/substance use problems, grief, and discipline.
While loss of employment, physical, mental health, legal, and substance use issues continue to be associated with suicide, grief and pandemic-specific stress were novel findings. Fear of disease, quarantine, and prolonged illness due to contracting COVID warrant psychological support. Psychological support is also indicated for recent discharge, grief management, transition into retirement, and during disciplinary processes. The stress of a pandemic may exacerbate previous risks. Proactive physician suicide prevention measures remain indicated.
Burnout and mental health concerns are prevalent among healthcare workers. Female physicians, nurses, and healthcare staff are at a higher risk of suicide than the general population. Burnout and depression have been known to coexist with suicidal ideation and behaviors.
To identify what is known about the relationship between burnout and depression in the context of suicide among healthcare workers.
Registered scoping review of English language articles indexed to CINAHL, PubMed, and PsychInfo databases with date of publication prior to March 5, 2024.
The review yielded nine eligible studies, all employing observational or descriptive methodologies. Depression was found to be a predictor of suicidal ideation. While burnout was associated with depressive symptoms and found to coexist with suicidal ideation, it was not predictive of ideation. Emotional exhaustion and depersonalization were key components of burnout linked to depression. No studies were found exploring survivorship factors in healthcare professionals. Suggested prevention strategies that need to be tested include mindfulness and cognitive-behavioral skills training, improved workplace conditions, addressing loneliness, and fostering resilience.
Interventional studies are needed to test strategies addressing burnout, depression, suicidal behaviors, and survivorship of suicide attempts. Depression should be considered and evaluated when healthcare workers exhibit symptoms of burnout. Moreover, the Socio-economic Model of Suicide Prevention (i.e., SESM) can be used to categorize suicide prevention measures in healthcare. Burnout and depression interact to influence mental health outcomes among healthcare professionals, with depression playing a more significant role in predicting suicidal ideation. Despite the demonstrated relationships, critical gaps in knowledge exist in understanding survivorship and in the development and testing of effective interventions. Future interventional multisite research is needed using validated tools to identify best practices in suicide prevention for healthcare professionals.
Nurses and healthcare support staff have a higher suicide risk than the public. This elevated risk calls for increased efforts to support mental health. Additionally, nursing leaders' education on employee-specific suicide prevention is lacking.
An evidence-based project was implemented using the PICO question: Among nurse leaders at an academic healthcare system in California, does the provision of an educational program using role-playing practice and the creation of a suicide prevention toolkit versus no standard education or training improve self-efficacy and knowledge on how to take action with a team member who is suspected of being suicidal or voicing suicidal ideation?
Education sessions were planned based on the literature, with surveys collected preintervention, immediately posteducation, and 1-month postintervention to assess suicide prevention self-efficacy and knowledge. Knowledge was measured using a researcher-constructed questionnaire validated by six suicide prevention experts. The General Self-Efficacy Scale (range: 10–40) was used.
Sixty participants attended one of 11 scheduled remote-learning sessions. Mean self-efficacy significantly improved (pre: 31.3 [n = 46, min: 18, max: 40]; immediate post: 33.49 [n = 37, min: 24, max: 40]; 1-month post: 33.77 [n = 31, min: 28, max: 40]) (X 2 = 8.0184, df = 2, p = 0.01815). The proportion of incorrect knowledge questions was significantly lower postintervention (mean pre: 24.5%, immediate post: 11.5%, 1-month post: 10.7%, X 2 = 23.195, df = 2, p = 0.000001). All participants (100%, n = 55) recommended the program. Leaders reported feeling better prepared to support suicidal employees.
Project results demonstrate the need to provide suicide prevention training for leaders. The authors recommend requiring training/return demonstration competency as a component of new leaders' onboarding. This program can easily be modified for nurses from prelicensure through senior leadership.
Suicide rates in healthcare members are higher than those of the general population. Suicide prevention programs can help nursing leaders feel better prepared to support and connect at-risk healthcare workers with resources.
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