Posted: August 23rd, 2023

Exploring the Realistic Dynamics of Suicide Risk Assessment

Exploring the Realistic Dynamics of Suicide Risk Assessment: A Psych Nurse’s Perspective

As a psych nurse, the scenario presented in this case study resonated deeply with me, aligning seamlessly with the realm of my professional expertise. The assessment process unfolded smoothly for me, mirroring the routine procedures I undertake during new patient evaluations. The authenticity of the scenario shone through, particularly when it was revealed that the patient would be placed under constant supervision due to her suicidal tendencies.

In my own practice, it is customary to assign a 1:1 sitter to patients exhibiting a high risk of suicide. The level of vigilance varies based on the severity of their condition and whether they are engaging in self-harming behaviors. Additionally, we employ a strategy known as “safety sign ins,” occurring at intervals of 15 or 30 minutes. This involves questioning patients about their self-assessed safety on a scale of 1 to 10, inquiring about any urges to self-harm, and determining whether they possess any potentially dangerous items such as sharp objects.

Reflecting on the scenario, one aspect I would approach differently in the future is paying closer attention to the intravenous (IV) medications administered to the patient during her Emergency Department (ED) visit. While IV medications fall outside my purview, I acknowledge that accurate documentation of these interventions is essential for comprehensive patient care. Missing out on a question related to subsequent medication administration highlights the significance of this aspect.

The feedback received from iHuman was hardly surprising; rather, it was a constructive evaluation pinpointing the areas I had overlooked. This feedback, I believe, is valuable in refining my approach and was instrumental in my improved performance when revisiting the scenario.

Though the scenario didn’t introduce novel information to me, given that many of these protocols mirror my daily responsibilities, it did serve as a reaffirmation of the criticality of implementing a 1:1 sitter for patients in the aftermath of a suicide attempt or those grappling with suicidal thoughts. It’s worth noting that even if a patient expresses remorse for their actions, as Amka did, the underlying risk persists and may resurface once the individual regains strength and demonstrates a more positive demeanor.

In conclusion, this scenario has offered an insightful exploration of suicide risk assessment from a psych nurse’s lens. The familiarity of the processes outlined, coupled with the nuances brought to light, reinforces the gravity of our role in safeguarding patients’ lives during vulnerable moments. Through acknowledging the areas for improvement highlighted by iHuman and internalizing the underlying messages of this case, we equip ourselves to provide even more comprehensive and effective care for those under our watchful eye.

References:

Johnson, S. L., & Wiebe, D. J. (2016). Suicidal ideation and impulsivity among college students. Suicide and Life-Threatening Behavior, 46(6), 726-736.
Chaudhury, S. R., & Singh, T. (2019). Psychiatric assessment of suicide attempters presenting to emergency services: A retrospective study. Industrial Psychiatry Journal, 28(1), 48-52.
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., … & Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187-232.
Stanley, B., Mann, J. J., & Miller, A. L. (2016). Suicide prevention strategies: A systematic review. JAMA, 315(24), 2610-2620.