Suicide Risk, Changing Jobs, or Leaving the Nursing Profession in the Aftermath of a Patient Safety Incident

Abstract

Background: Nursing retention is a concern for healthcare systems, hospital administrators, and nurses who have spent considerable time and money to achieve educational goals. Nearly, 33% of nurses will drop out in the 2 years practice. Those who stay in practice face an increased risk of suicide when compared the general population.Aims: To examine the relationship between nurse sociodemographic data and unique study variables with potential morally injurious outcomes (i.e., dropping out variables: changing jobs, intention to leave the profession, or suicidal thinking).Methods: A descriptive, correlational study design was used to characterize the relationship between the sociodemographic data of 216 registered nurses (RNs) and patient safety and the suicidal behavioral questionnaire.Results: RNs involved in a patient safety incident (PSI) considered changing jobs when the degree of harm was death (p < .001) or was unknown (p < .05) when compared with no harm. RNs were more likely to consider leaving the profession when the degree of harm to the patient was permanent (p < .01) or the patient died (p < .05) when compared with having no harm. RNs future suicidal thinking (i.e., their self-reported likelihood of future suicidal behavior) was statistically significant when degree of harm to the patient was death (p < .05) as a result of a PSI (95% CI [1.11, 8.71]) when compared with no harm. The RNs who had suicidal thoughts over the past year compared with those without and the RNs with future suicidal thinking compared with those without, may respond differently in the aftermath of a PSI.Linking evidence to action: This study served as a pioneering effort to the current understanding between nurse characteristics and patient harm and "dropping out" outcomes in RNs involved in PSIs. RNs involved with PSIs that led to more harm were more likely to change jobs, consider leaving the profession, or contemplate future suicide. These findings have important implications for nurses, administrative managers in healthcare organizations, and researchers.

The hidden crisis of nurse suicide

“…9 A PSI involves at least two victims: one being the patient, the other being the healthcare worker. 9 Healthcare workers may leave a job or change departments to avoid remembering a PSI. Following a PSI, nurses face a 20% increased risk of attempting suicide.…”

“…Following a PSI, nurses face a 20% increased risk of attempting suicide. 9 Other factors that increase the risk of suicide among nurses include inadequate resources such as staff shortages leading to longer shifts, bullying or harassment from peers or supervisors, feelings of isolation due to a lack of social support networks in the workplace, loss of an important personal relationship, financial problems caused by low wages, and difficulty balancing demands between home and work responsibilities. 10 Nurses face numerous mental health challenges, including compassion fatigue, anxiety, depression, ethical dilemmas, and second-victim syndrome.…”

“…Risk factors for nurse suicide include relationship issues, difficulty on the job, professional burnout, working long hours, feelings of inadequacy due to incomplete orientation, bullying, medical errors or adverse events, and lawsuits (see Risk factors). 4,7,9,10,[11][12][13][14] The pressures of being a nurse can often strain relationships between nurses and their significant others. 9 Such relationship strain can arise from varying work schedules, long hours, and their partners' inability to provide empathy for nurses' job stressors due to ethical issues that prevent nurses from sharing details, leading to feelings of loneliness and increasing depressive symptoms.…”

“…4,7,9,10,[11][12][13][14] The pressures of being a nurse can often strain relationships between nurses and their significant others. 9 Such relationship strain can arise from varying work schedules, long hours, and their partners' inability to provide empathy for nurses' job stressors due to ethical issues that prevent nurses from sharing details, leading to feelings of loneliness and increasing depressive symptoms. 10 In turn, depression increases the likelihood of suicidal ideation among those affected by relational distress.…”

Understanding the wider impact of patient safety incidents

“…However, the broader impact of safety incidents on staff and the healthcare system is less well understood 2. This study aimed to understand the effect of patient safety incidents on nurses’ well-being and professional intentions 3…”