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Nursing care for suicidal patients

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Title: Nursing care for suicidal patients


1
Nursing care for suicidal patients
  • Rebecca Sposato MS, RN

2
  • What does a drowning person look like?

3
(No Transcript)
4
(No Transcript)
5
  • Terminology
  • Completed suicide self administered action
    resulting in death
  • Suicide attempt self administered act with
    intent of death, but did not result in death
  • Parasuicide/Suicide Gesture - act of self harm,
    but lacked the lethality to cause death
  • Unintentional Suicide self-administered action
    without the intent of death, but results in death
  • Suicide Ideation- thoughts of ending own life

6
  • Signs of impending suicide
  • Increase use of alcohol and drugs
  • Increase in risky and reckless behaviors
  • Confrontational, moody, irritable, sad, angry,
    uninterested, hopeless, helpless, withdrawn
  • poor work/school performance, eating and sleeping
  • Seriously or sarcastically talking about killing
    self
  • Giving possessions away or finalizing a will
  • Access to a weapon
  • (http//www.nimh.nih.gov/health/publications/suici
    de-in-the-us-statistics-and-prevention/index.shtml
    )

7
  • Other signs of impending suicide
  • Visiting friends and family
  • Apologizing for past wrongs
  • Improved mood
  • (http//www.nimh.nih.gov/health/publications/suici
    de-in-the-us-statistics-and-prevention/index.shtml
    , 2011)

8

Prevalence
(http//www.nimh.nih.gov/health/publications/su
icide-in-the-us-statistics-and-prevention/index.sh
tml, 2011 and Pikris et al, 2010)
9
Statistics
  • Men account for 75 of completed suicides and
    women account for 75 of attempts
  • Men 56 firearms, 24 suffocation, 13 poison
  • Women 30 firearms, 21 suffocation, 40 poison
  • 10th leading cause of death in the United States
  • 7th for males, and 15th for females
  • 3rd among 15-24 year olds
  • 15 leave behind a suicide note or recorded
    message
  • (http//www.nimh.nih.gov/health/publications/suici
    de-in-the-us-statistics-and-prevention/index.shtml
    factors, 2011)

10
Risk Factors
  • 90 history of depression, bipolar, substance
    abuse, PTSD, schizophrenia
  • Previous attempts
  • Victim of physical and sexual abuse
  • Incarceration
  • Suicidal family member or friend
  • Weapon in the home
  • Recent bad news
  • http//www.nimh.nih.gov/health/publications/suicid
    e-in-the-us-statistics-and-prevention/index.shtml
    factors, 2011)

11
Other Facts
  • Males gt75 is the highest demographic for
    completed suicide. Females 40-55 have highest
    rate of suicide
  • Teenagers have gt100 attempts per completed
    suicide
  • At time of suicide 1/3 test positive for alcohol,
    and 1/5 test positive for opiates
  • (www.cdc.org, 2009)

12
  • Nursing Assessment
  • Follow-up and act upon every reference to
    self-harm or ending life
  • Have you thought about hurting yourself?
  • Do you have a plan? Taken steps?
  • Do you have access to a weapon?
  • Assess comorbid mental illness, stressors,
    support resources

13
Nursing Interventions
  • Assess and treat physiological injury
  • BLS/ACLS
  • Wound care
  • Administer antidote for drug overdose
  • Inventory Belongings
  • No weapons, blades, cords, strings, plastic bags,
    pills, liquids

14
Nursing Interventions
  • Refer to therapist, psychiatrist
  • 72hr Mental Health Hold
  • No Harm/Suicide Contract Informs pt to take
    alternative actions when ideation is present
  • Safety net
  • Suicide Precautions
  • Level 1 seclusion room or close proximity to
    staff member
  • Level 2 within view of staff at all times
  • Level 3 safety checks every 15min

15
References
  • Centers for Disease Control (2009) Suicide facts
    At a glance. Retrieved online www.cdc.gov/violence
    prevention/pdf/Suicide-DataSheet-a.pdf
  • National Institute of Mental Health (2011)
    retrieved from http//www.nimh.nih.gov/health/publ
    ications/suicide-in-the-us-statistics-and-preventi
    on/index.shtmlfactors, 2011)
  • Pirkis, J., Burgess, P., Dunt, D. (2000).
    Suicidal ideation and suicide attempts among
    Australian adults. Crisis The Journal of Crisis
    Intervention and Suicide Prevention, 21(1),
    16-25. doi10.1027//0227-5910.21.1.16
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