A google search for “nurse suicide” results in a list of headlines of heartbreaking stories… a 28-year-old who had written a letter five months prior to her death “comparing the healthcare industry to an abusive partner” (Becker’s Hospital Review, 2023); two nurse deaths by suicide “rocked the Bay Area nursing community in early 2022” (Wells, 2023); a critical care travel nurse who left during a shift to get something from his car and never returned (evidence points to suicide) (NPR, 2022); and the list goes on.

The research on suicide among nurses

The research is clear that nurses are at risk:  

• Between 2007 and 2018, nurses were 18% more likely to die from suicide than the general population; among female nurses, this risk was almost twice the risk of the general population, and 70% more likely than female physicians (Davis et al., 2021).
• From 2017 to 2018, an estimated 729 American nurses committed suicide, the highest reported number on record (Davis et al., 2021).

We can’t ignore this data and we must pay attention to the fact that these findings were reported before the COVID-19 pandemic. And even in 2017, survey results published in the American Journal of Nursing, found burnout was strongly associated with suicidal ideation among U.S. nurses. In addition, nurses were more likely than other U.S. workers to contemplate suicide and less likely to seek help from a professional (Kelsey et al., 2021).

Protecting the well-being of clinicians

Dzau et al. (2020) identified five high-priority actions during and after the COVID-19 pandemic at organizational and national levels: integrating chief wellness officers or clinician well-being programs during the crisis, ensuring psychological safety of clinicians through anonymous reporting mechanisms, sustaining and supplementing existing well-being programs, allocating federal funding to care for clinicians who experience physical and mental health effects, and allocating federal funding to set up a national epidemiologic tracking program to measure clinician well-being and report on the outcomes of interventions.

How can nurses improve the well-being of fellow nurses?

As nurses are the largest group in the health care workforce, we must improve our own well-being and that of our colleagues to ensure the overall health of the population. What can we do?

1. Recognize risk factors, such as relationship stress, difficulty on the job, burnout, feelings of inadequacy, bullying, medical errors or adverse events, lawsuits, or depression (Lange, 2023).
2. Be alert for warning signs of suicide, such as talking about wanting to die, guilt or shame, or being a burden; or feeling empty, hopeless, sad, anxious, full of rage, or unbearable emotional or physical pain (NIMH, n.d.).
3. Access and/or share available resources and programs, such as 988 Suicide & Crisis Lifeline, NAMI Frontline Wellness, Therapy Aid Coalition, and ANA’s Well-Being Initiative.

As individuals, let’s work toward normalizing conversations about mental health and wellness. We often tell patients, “It’s ok to not be ok” and ask, “Are you feeling like ending your life?” We should be having these conversations with one another as well. By showing the same compassion we show patients to each other, we can help overcome the stigma associated with mental health treatment.
 

References:
Chatterjee, R. (2022, March 31). A nurse's death raises the alarm about the profession's mental health crisis. NPR. https://www.npr.org/sections/health-shots/2022/03/31/1088672446/a-nurses-death-raises-the-alarm-about-the-professions-mental-health-crisis

Davis, M. A., Cher, B. A. Y., Friese, C. R., & Bynum, J. P. W. (2021). Association of US Nurse and Physician Occupation With Risk of Suicide. JAMA psychiatry, 78(6), 1–8. https://doi.org/10.1001/jamapsychiatry.2021.0154

Dzau, V. J., Kirch, D., & Nasca, T. (2020). Preventing a Parallel Pandemic - A National Strategy to Protect Clinicians' Well-Being. The New England journal of medicine, 383(6), 513–515. https://doi.org/10.1056/NEJMp2011027

Kayser, A. (2023, November 14). ER nurse who died by suicide addressed letter to healthcare system. Becker’s Hospital Review. https://www.beckershospitalreview.com/workforce/er-nurse-who-died-by-suicide-addressed-letter-to-healthcare-system.html

Kelsey, E. A., West, C. P., Cipriano, P. F., Peterson, C., Satele, D., Shanafelt, T., & Dyrbye, L. N. (2021). Original Research: Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working Population. The American journal of nursing, 121(11), 24–36. https://doi.org/10.1097/01.NAJ.0000798056.73563.fa

Lee, K. A., & Friese, C. R. (2021). Deaths by Suicide Among Nurses: A Rapid Response Call. Journal of psychosocial nursing and mental health services, 59(8), 3–4. https://doi.org/10.3928/02793695-20210625-01

National Institute of Mental Health (n.d.). Warning Signs of Suicide. Accessed February 7, 2024: https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide

Olfson, M., Cosgrove, C. M., Wall, M. M., & Blanco, C. (2023). Suicide Risks of Health Care Workers in the US. JAMA, 330(12), 1161–1166. https://doi.org/10.1001/jama.2023.15787

Shah, M., Roggenkamp, M., Ferrer, L., Burger, V., & Brassil, K. J. (2021). Mental Health and COVID-19: The Psychological Implications of a Pandemic for Nurses. Clinical journal of oncology nursing, 25(1), 69–75. https://doi.org/10.1188/21.CJON.69-75

Wells, S. (2023, August 25). Suicide Among Nurses: We have to talk about it. American Association of Critical Care Nurses. https://www.aacn.org/blog/suicide-among-nurses-we-have-to-talk-about-it

 

More Resources
CE	CE	POCKET CARD
Suicide Prevention: Protecting the Future of Nurses	The hidden crisis of nurse suicide	Mental Health Assessment