Self-Directed Violence and the Nurse

Suicide, a major preventable health risk, reported as the tenth leading cause of death in the US, requires discerning nursing knowledge to provide patient-centered care for individuals-at-risk. The purpose of this chapter is to discuss the nurse’s role in caring for self-injurious individuals. Whether employed in emergency departments, general clinical practice, psychiatric mental health centers, or correctional health-care settings nurses may encounter suicidal and/or self-injurious patients. Being aware of the range of self-injurious behaviors with differentiation from suicide attempts will be critical in the assessment of living or deceased patients for the forensic nurse. Suicide is the ultimate act of self-destruction in which a person ends his or her own life. Self-injurious behaviors (SIB) are self-mutilating behaviors, however, there is a lack of consensus regarding whether SIB exists as a separate diagnostic category or whether SIB is a symptom, transiently evident over many categories of psychopathology, or as a marker of more severe pathology. Even the most experienced forensic nurse may have difficulty assessing the range of self-injurious behaviors or completed suicides in a patient population. It is critical that not only the forensic nurse but nurses in a multitude of clinical settings incorporate techniques to uncover the intention of behaviors and include close interprofessional collaboration with caretakers, family, friends, and the presenting patient. This presentation will provide an overview of self-injurious behavior and suicide, identify the risk and protective factors associated with each, and identify evidence-based nursing interventions for the treatment of the patient with self-injurious behavior and suicide ideation, and/or suicide attempt.