Nurses in the U.S., both male and female, are at higher risk of suicide than the general population, shows one recent study, while another, conducted in the UK, explores the relationship between compassion fatigue and nurse turnover.
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Suicide Risk Among Nurses
Researchers at University of California San Diego School of Medicine and UC San Diego Health, Department of Nursing, have conducted a national longitudinal study and found that the rate of suicide among nurses is higher than that of the general population (Davidson et al. 2020a).
An analysis of data from the 2005–2016 National Violent Death Reporting System dataset showed that female nurses have been at greater risk since 2005 and males since 2011. Lead author Judy Davidson notes that “the data does not reflect a rise in suicide, but rather that nurse suicide has been unaddressed for years."
Over the analysed period, female nurse suicide rates were significantly higher than the general female population, 10 vs 7 per 100,000 respectively. For male nurses and the general male population the figures are 33 vs 27 per 100,000 respectively.
The preferred methods of suicide among females were opioids and benzodiazepines, while firearms was the most common choice for male nurses.
The authors point out the necessity to implement suicide prevention programmes. One such programme, successfully tested by UC San Diego, is Healer Education Assessment and Referral (HEAR) programme. It provides education about risk factors and proactive screening focussed on identifying, supporting and referring clinicians for untreated depression and/or suicide risk. The sustainability of HEAR is explored in another study by Davidson and colleagues (2020b) claiming that it proved to be feasible and well‐received and proactively identifies nurses with reported suicidality and facilitates referral for care.
Dealing With Compassion Fatigue
Another growing area of concern for healthcare organisations is compassion fatigue. A recent study (Wells-English et al. 2019) of 93 oncology nurses at a 90-bed urban cancer centre, focussed on the relationship between compassion satisfaction, compassion fatigue and nurse turnover.
Compassion fatigue and burnout were found to be strong indicators of nurse turnover.
In an interview with Oncology Nursing News, Diana Wells-English, DNP, FNP-BC, investigator on the study and nurse at HCA Healthcare noted that oncology nurses “are consistently exposed to a variety of stressors, often participating in decision making in ethically complex situations.” She also highlighted other factors, such as high nurse to patient ratios and short staffing.
Among survey participants 47 had average levels of satisfaction and 45 high levels. One had a low level of satisfaction. For burnout, 38 had low levels, 55 had average, and none had high levels. In the interview Wells-English pointed out that nurses with higher burnout were more likely to leave their place of employment while high levels of compassion fatigue potentially impacted patient care and led to medical errors and lower patient safety standards and productivity at work.
To prevent or mitigate compassion fatigue and increase resiliency, a number of measures are recommended, such as finding a mentor, openly expressing emotions, practice a self-care assessment, etc.
Davidson JE et al. (2020a) A Longitudinal Analysis of Nurse Suicide in the United States (2005–2016) With Recommendations for Action. Worldviews on Evidence‐Based Nursing, 17:6–15.
Davidson JE et al. (2020b) Sustainability and Outcomes of a Suicide Prevention Program for Nurses. Worldviews on Evidence‐Based Nursing, 17:24–31.
Wells-English D et al. (2019) Compassion Fatigue and Satisfaction: Influence on Turnover Among Oncology Nurses at an Urban Cancer Center. CJON, 23(5):487–493.
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