Dealing with suicidal patients – a challenging task: a qualitative study of young physicians' experiences

Høifødt, Tordis Sørensen; Talseth, Anne‐Grethe

doi:10.1186/1472-6920-6-44

Cited by 21 publications

(15 citation statements)

References 20 publications

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“…The interviews lasted 90 to 120 minutes and were audio-taped and transcribed verbatim by the first author. The informants were asked to narrate a story from treating suicidal patients in their own practice [6]. Then they were asked to reflect on what had been the important contributors to their learning related to this clinical situation.…”

Section: Methodsmentioning

confidence: 99%

“…In an already published qualitative study, thirteen newly educated physicians narrated their experiences with suicidal patients. They clearly described their challenges relating to patients, intervening competently, but also the variety of emotional and ethical dilemmas that arose in treating such patients [6]. The same informants were also asked about their learning experiences related to treating suicidal patients and the results from this part constitute the present study.…”

Section: Introductionmentioning

confidence: 99%

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A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence

2007

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BackgroundLittle empirical work has been done in studying learning processes among newly educated physicians in the mental health field.The aim of the study was to shed light on the meaning of newly educated physicians' lived experiences of learning processes related to treating suicidal patients.MethodsThirteen newly educated physicians narrated their learning experiences while treating suicidal patients in their own practice. The interview texts were transcribed and interpreted using a phenomenological-hermeneutical method inspired by Ricoeur's philosophy.ResultsThere was one main theme, four themes and eleven sub themes. The main theme was: Being in a transitional learning process. The themes and sub themes were: Preparing for practice (Getting tools and training skills, Becoming aware of one's own attitudes); Gaining experience from treating patients (Treating and following up patients over time, Storing memories and recognizing similarities and differences in patients); Participating in the professional community (Being an apprentice, Relating clinical stories and receiving feedback, Sharing emotions from clinical experiences, Receiving support from peers); and Developing personal competence (Having unarticulated awareness, Having emotional knowledge, Achieving self-confidence). The informants gave a detailed account of the learning process; from recognising similarities and differences in patients they have treated, to accumulating pattern knowledge, which then contributed to their personal feelings of competence and confidence. They described their personal competence with cognitive and emotional elements consisting of both articulated and less articulated knowledge. The findings are interpreted in relation to different learning theories that focus on both individual factors and the interaction with the learning environment.ConclusionThis study provides additional information about learning experiences of young physicians during the critical transition phase from medical school to early professional life. Peers are used for both learning and support and might represent a more powerful resource in the learning process than previously recognized. Emotional experiences do not seem to be adequately focused upon in supervision, which obviously has relevance both for learning and for the well-being of young professionals. The study indicates some areas of the educational system that could profitably be expanded including stimulating more systematically to critical reflection on and in practice, attention to feelings in the reflective process and provision of more performance feedback to young physicians.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence

2007

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“…Preventing suicides in wards is undoubtedly a complex and challenging task. It is well documented that health care professionals (HCPs) who care for suicidal patients carry an emotional burden and experience fear of blame (7)(8)(9)(10). The instruments used to categorise patients into high-risk groups do not enable HCPs to predict which patients will commit suicide, and clinical decision-making in hospital wards often involves a high degree of uncertainty (11).…”

Section: Introductionmentioning

confidence: 99%

Adaptive capacities for safe clinical practice for patients hospitalised during a suicidal crisis: A qualitative study

Berg

Rørtveit

Walby³

et al. 2019

Preprint

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Background. Safe clinical practice for patients during a suicidal crisis is situated within a complex, non-linear and uncertain context. It involves a complex set of practices in which adaptation is perceived as a source of safety. This study aims to develop a deeper understanding of safe clinical practice and the capacity to adapt to challenges and changes in clinical care for patients hospitalised in mental health wards during a suicidal crisis. Methods. This study applied a qualitative design based on focus group and individual interviews. Twenty-five health care professionals (HCPs) participated in the focus groups, and 18 HCPs were individually interviewed. The study was conducted at open and locked wards in a university hospital in Norway that provides specialised mental health services for adults.Findings. Adaptive capacities for clinical practice were described in relation to three themes. 1) HCPs described using expertise to make sense of suicidal behaviour to support complex decision-making. Their strategies relied on setting the checklist aside to prioritise trust and making judgements beyond spoken words. They improved their understanding by seeking others’ perspectives through a collaborative sense-making process involving the health care team and the patient. 2) HCPs reported individualising the therapeutic milieu to address the diversity of patients with suicidal behaviour. Safe clinical practice was provided by creating individual clinical pathways, making trade-offs between under- and over-protection and adjusting observations 3) It was necessary for HCPs manage uncertainty to provide safe clinical practice. They did so as a team by developing mutual collegial trust, support and shared understanding. Conclusion. HCPs’ adaptive capacities are vital to the complex set of practices involved in safe clinical practice for patients hospitalised during a suicidal crisis. By using expertise, individualising the therapeutic milieu, and managing uncertainty, HCPs individually and collectively develop their capacity to adapt to challenges and changes in clinical care. Safe clinical practice cannot easily be ensured by following standards; it depends on HCP adaptations. Ward systems ensuring collegial trust and support are needed, as are arenas supporting shared understanding and collaborative sense-making. Keywords: Adaptation, sense-making, situational awareness, shared understanding, trade-offs, mental health, suicide, uncertainty

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“…; Samuelsson & Åsberg ), and the professional training and individual perspectives of nursing professionals as it has the potential to influence decisions pertaining to the delivery of care, as well as the qualitative nature of interactions with patients (Conlon & O'Tuathail ). However, studies show that professionals often feel unprepared to manage suicidal behaviour (Høifødt & Talseth ; Vedana et al . ), expressing a desire for additional training in order to work more effectively with patients exhibiting such behaviour (Chan et al .…”

Section: Introductionmentioning

confidence: 99%

The meaning of suicidal behaviour from the perspective of senior nursing undergraduate students

Vedana

Pereira

Santos

et al. 2017

Int J Mental Health Nurs

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The meaning ascribed to suicidal behaviours may influence the quality of the care provided to people at risk of suicide. Such a phenomenon has yet to be properly investigated amongst nursing undergraduate students, the aim of this study being to gain an understanding of the meanings of suicidal behaviour for a particular group of nurses. The study, which utilized grounded theory, was conducted in Brazil in 2016-2017 with 30 undergraduate students. The findings indicated that suicidal behaviour, classified according to the individual beliefs and judgements of the participants, presented a significant barrier to the delivery of care and was complex and multifaceted care phenomenon. Participants were often reluctant to discuss the topic, seemingly wanting to distance themselves from the care of persons exhibiting suicidal behaviour, and to avoid professional engagements relating to suicide prevention. Significant work is required in raising both an awareness and knowledge of suicidal behaviour befitting the promotion of tolerance, emotional competency, resilience, and empathy amongst nursing students.

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Dealing with suicidal patients – a challenging task: a qualitative study of young physicians' experiences

Cited by 21 publications

References 20 publications

A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence

A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence

Adaptive capacities for safe clinical practice for patients hospitalised during a suicidal crisis: A qualitative study

The meaning of suicidal behaviour from the perspective of senior nursing undergraduate students

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