Saturday, July 14, 2007
This presentation is part of : Adult Mental Health Issues
Nurses' concerns in caring for suicidal patients
Sharon M. Valente, RN, PhD, FAAN, Veterans Health Administration, GLA, Los Angeles, CA, USA
Learning Objective #1: 1. Describe the nurses concerns in caring for suicidal patients
Learning Objective #2: 2. Identify the nursing interventions (e.g., teaching, advocacy) that were demonstrated

Contradictory data exist about prevalence of nurses’ patient teaching, emotional support and advocacy for suicidal patients. These areas reflect priorities in the Nursing core curriculum.    Aim: This secondary data analysis examined RNs’ assessments, interventions,  education, emotional support, and advocacy for a suicidal patient. This large exploratory, descriptive study of a random sample of oncology nurses’ knowledge of and attitudes to suicide surveyed clinical oncology RNs (n=1200) from the Oncology Nursing Society and was completed by (n=454; 37%). Aijian and Fishbein's theory of attitudes was used to guide study. Methods: Instruments included  sociodemographic and clinical inventory,  6-itemVignette, and 7-itemSuicide Questionnaire (SOQ) (suicide knowledge, assessment, and skill). Content analysis provided systematic analysis of narratives from the Vignette and SOQ (Downe-Wambolt, 1992; Morse, 1994). Test-retest reliability was above r=.90.   Findings:  Sample: Nurses (n=454; 37%) responded to a vignette and Suicide Opinion Questionnaire; narrative texts were analyzed for content. RNs (>50%) exaggerated the suicide risk and could not differentiate depression, anxiety, and suicide. RNs’ assessments included social and family support (48.3%), suicide risk, intent or plan (27.9%), depression (25.8%), pain (20.4%), feelings (18.3%), spirituality (10.7%).  Some RNs (18.3%) would assess patient’s feelings or distress and over half (10.7%) of those cited a goal related to those feelings. However, only 0.3% of  RNs intervened to provide emotional support, counseling, or education. Interventions included pain management (40.8%) and social support (13.9%). Few assessments, goals or interventions were identified for patient teaching.  Respondents reported low rates of emotional support and advocacy for suicidal patients and had difficulty identifying the goals and delivering the corresponding interventions, particularly in education, emotional support, and advocacy.

Overcoming barriers to patient teaching, emotional support and advocacy is essential.  An ongoing campaign could increase awareness of the importance of the RN’s patient teaching, advocacy and emotional support.