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SuicidePsychiatric Nursing: Contemporary Practice

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What behaviors are clues someone may be contemplating suicide?
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Giving possessions away, getting legal affairs in order, and/or any apparently normal act that says good-bye to family and friends.
How can a nurse determine how serious a patient is about committing suicide?
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Ask what thought they have put into the decision and why they view suicide as a solution.
What interventions for the biologic domain should be included in the plan of care for a suicidal individual?
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Focus on safety, alleviation of the immediate crisis, and referral to the appropriate clinician.
How long should each suicide-contract last for?
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No longer than one week.
Who is not considered competent enough to enter into a suicide contract?
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People under the influence of drugs or alcohol, experiencing psychosis, who are extremely isolated, or have attempted suicide in the past
What is the first step in making a no-suicide contract?
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Helping the patient to dismantle their current suicide plan, uncooperativeness may indicate that the patient cannot be safely cared for at home.
What is a critical component of a no-suicide contract?
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Patients have to identify someone who can stay with them or be nearby during a suicidal crisis.
A __________ is an agreement between the patient and clinician in which the patient agrees to make a commitment to treatment.
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Commitment to Treat Statement (CTS) or advanced directive
How is a CTS different from a no-suicide contract?
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A CTS doesn't restrict the patient's right regarding the option of suicide, but the patient make a commitment to live by engaging in the treatment and accessing emergency treatment if needed.
What is a priority commitment of the CTS?
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Removal of any firearm or permit to purchase a firearm.
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What should a patient be able to do prior to discharge from treatment r/t a suicide attempt?
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They should be able to name people who can act as support and have a plan to contact another person when they have distressing thoughts or feel unable to control their behavior.
What are the signs and symptoms that a nurse is developing PTSD from the secondary trauma of caring for suicidal patients?
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Fatigue, dysphoria, tearfulness without provocation, sleep disturbances or nightmares, preoccupation with a stressful situation or morbid thoughts, inability to be distracted from the stressor, anxiety and cynicism, absenteesim.
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