Caring for suicidal patients - L'Infirmière Magazine n° 363 du 01/09/2015 | Espace Infirmier
 

L'infirmière Magazine n° 363 du 01/09/2015

 

FORMATION ANGLAIS

ÉMILIEN MOHSEN  

The psychiatric unit has a new trainee nurse. The resident nurse offers to show her around and gives her some advice concerning suicidal patients.

Nurse : It is important to know the risk indicators of suicide, how to interact with a patient who is at risk and who to talk to.

Trainee : Why might a person be suicidal ?

Nurse : This is a complex issue. But to put it simply, suicidal thoughts and behaviors are most likely to occur when someone feels helpless or hopeless, and considers suicide as his only option. Many reasons can explain this suicidal behavior : mental illness, chronic disorder, immobility, low self-esteem, lack of meaning and purpose in life, poor coping skills, feeling of guilt and shame, abuse and violence, separation and loss, peer rejection, social isolation, imprisonment, poverty, crime and violence, economic insecurity or family history of suicide.

Trainee : What are the signs that someone might be at risk of suicide ?

Nurse : There are many warning signs. That person may simply express the feeling that he has no reason for living or purpose in life. But he can also show abnormal anxiety or agitation, an increased use of drug or alcohol, withdrawal from friends and family. He can feel constant sleepiness, and show dramatic changes in mood, aggressivity against himself or others, etc.

Trainee : What should I do then ?

Nurse : You should immediately ask the patient to talk openly while ensuring a safe environment for you, the patient and the staff. You can record your interaction with the patient according to the record keeping protocol. But keep within your role to support and nurse the patient.

Trainee : And what if this impacts on me ?

Nurse : If you think that nursing a suicidal patient will impact on your own reactions and feelings, ask for supervision and time to debrief with colleagues. Working with such patients can be very challenging and stressful. You should confide your anxiety of not doing the right thing to your colleagues. And always hold back your anger if you feel that in spite of the care you give, the patients don’t value the nursing you provide.

Trainee : Are there behaviors to avoid while facing a suicidal patient ?

Nurse : Don’t ignore him or dismiss threats. If a person’s life is at risk, it is your duty to share the information with relevant people. Do not feel pressured to have the right answer. You should remember that there is no one right answer. It is much more important to be there for the patient and let him talk and feel listened to. Morever, you should not judge the patient’s feelings or actions or be afraid to ask why he thinks about suicide or self-harm. This can make him feel understood, and therefore ask for help.

Trainee : Is there a procedure to follow if I feel that a patient might be at risk of suicide ?

Nurse : You should refer immediately to the unit manager and be aware of the procedures in the hospital for accessing specialist mental health assessment for your patient.

VOCABULAIRE

Risk indicators : facteurs de risque

Low self-esteem : sentiment d’infériorité

Poor coping skills : faibles capacités d’adaptation

Guilt and shame : culpabilité et honte

Peer rejection : rejet de ses pairs

Warning signs : signes précurseurs

To nurse : prodiguer des soins

Hold back : retenir

Common phrases

Suicidal thoughts and behaviors are most likely to occur when the person feels helpless or hopeless.

→ Les pensées et comportements suicidaires surviennent lorsque la personne se sent impuissante et désespérée.

Give the opportunity for the patient to talk openly.

→ Donnez la parole au patient et laissez-le s’exprimer librement.

Keep within your role to support and nurse the patient.

→ Ne sortez pas de votre rôle d’aide et de soins vis-à-vis du patient.

Working with someone who is suicidal can be extremely challenging and stressful.

→  S’occuper d’un patient suicidaire peut s’avérer extrêmement compliqué et stressant.

You should contain your anger and distress towards a suicidal patient.

→ Il faut savoir contrôler sa colère et sa détresse face à un patient suicidaire.

Don’t ignore or dismiss threats or suggestions of suicide or self-harm.

→ N’ignorez pas et ne rejetez pas les menaces, ni les allusions au suicide et à l’automutilation.