Nurses face a higher risk of suicide than other profession in the U.S. Healthcare providers across all positions are four times more likely to commit suicide than those working outside of medicine. Repeated exposure to trauma, moral injuries, burnout, and unsafe working conditions can leave nurses feeling hopeless and alone. When a nurse takes their own life, it makes it harder for their colleagues to do their jobs. The people they leave behind continue working, afraid it may happen again.
Celia Nieto, an ICU nurse, struggled with depression and anxiety during the pandemic while juggling work and her responsibilities at home as her kids were forced to stay home for school. She remembers losing the will to go on last October.
“It’s not that I wanted to die per se. I just wanted all of it to stop: the crying, the racing thoughts. That’s when I knew something was wrong,” said Nieto. She soon started therapy, but the threat of suicide is all too real for nurses like her.
She has since lost a colleague to suicide and another to COVID-19.
Around 85% of nurses are women and female nurses have double the risk of suicide compared to women in the general population, according to a study published in JAMA Psychiatry that relied on pre-pandemic data. But the last two years have only made the issue worse.
The suicide rate is “much higher than I expected,” said Matthew Davis, the lead author of the study. “We’ve focused so much on physician welfare that, historically, we haven’t paid enough attention to this huge workforce that, based on our data, is at much higher risk.”
Even though we are in a much position now compared to the early days of the pandemic, the threat of suicide remains. Jennifer Feist, an advocate for suicide prevention for healthcare professionals, says that the brunt of COVID-19 trauma may hit healthcare workers after the pandemic.
“It’s when things calm down, it’s when you relax, it’s when you can take a breath, that’s when the real problems start,” she said.
Many nurses have shared their stories of losing colleagues to suicide online.
“A nurse jumped from the parking garage on site at the hospital the night I was working. It was covered up media-wise of course. It was hard to think about anything else the rest of the night,” wrote a nurse named Kristin.
Another nurse, Annette, wrote about losing a colleague back in 1995. “I would never have known he had any signs of depression. He checked into a hotel in Portsmouth, knowing he wouldn’t be found until the morning when it was too late – very very sad 💔,” she wrote.
“We had a skill fair at work Saturday morning. The Educator hung himself on Monday at home. He was always friendly, smiling and a good teacher. His wife is an ICU nurse. Anytime we have a skill fair I think about him. 🙏🙏🙏,” wrote Bozena.
Others discussed their own struggles with suicide.
“I lose myself in thoughts…but I just keep going. Keep looking to the remaining lights in my life,” wrote Trisha.
Several nurses mentioned they had just lost a colleague the week before or were about to attend the funeral of someone that had died.
According to a study published in The American Journal of Nursing, burnout is the leading cause of suicide ideation among nurses. And having a robust support system in place is often key to preventing these kinds of tragedies.
“Burnout contributes to the risk of suicidal ideation. These issues warrant greater attention,” said Elizabeth A. Kelsey, DNP, APRN, CNP, of Mayo Clinic Minnesota, and colleagues, in the study. “Systems- and practice-level interventions must be identified and implemented, both to address the higher prevalence of burnout and suicidal ideation in nurses and to mitigate the stigma about mental health problems and other barriers to seeking help.”
The findings suggest that around one in 18 nurses experience ideation at least once a year, and these providers are less likely to reach out for help compared to their colleagues.
According to the authors, many nurses decline to seek out assistance due to fears of impacting their careers, doubts about confidentiality, difficulties in obtaining time off work for treatment, and difficulties scheduling appointments. They also pointed to the fact that some states inquire about mental health history on nursing licensure applications, increasing the concern that their mental health concerns will be stigmatized.
“Collectively, this evidence convincingly builds the case that health care organizations must address systems-level causes of burnout, for the good of both patients and health care workers… to be effective, systems-level interventions must take into account the differences in various health care roles. Such actions should concentrate on balancing job demands with job resources and on creating a constructive work culture,” said study authors.
“To these ends, strategies that focus on managing team conflict, ensuring appropriate staffing levels, creating fair work schedules, optimizing benefits, developing leaders, and facilitating professional growth and career advancement are useful. The implications for nursing practice, education, and policy should include steps to build psychological safety in the workplace and reduce stigma. Given the increased stress nurses are experiencing during the COVID-19 pandemic, the need to act has never been more acute.”
