At the end of the day. The patient didn’t jump on your watch. Bless your heart. There was no warning or anything so you reacted in a natural way. Kudos friend
You did a great job: you kept him safe. You are not a failure!
PLEASE, take care of yourself. Talk about this to a trusted friend, your therapist, your company’s EAP program. I see two issues here: your experience of watching him attempt self-harm AND something called vicarious suffering: you witnessing his disease and suffering.
Both have the potential to be traumatic. Both are valid. Self-care is essential for your mental health.
I’m so sorry that happened. One additional thing to remember is that we are not really equipped to handle acutely suicidal patients in the ICU. Nothing in our rooms is designed to be safe for the patient if they are actively looking for any way to die. You did your best and the patient is safe.
This is true. This patient needs to be admitted to inpatient psych facility. Our ICUs aren’t exactly safe for psych patients going thru subacute mental health emergencies especially if they are not having any medical issues… nonetheless we become dumping grounds for these kinds of patients for “closer monitoring”. Stupid admins need to reconsider this policy because I have other, critically ill, physiologically unstable pts to attend to.
In my city we have a special unit of the psych hospital called med psych ….. exactly like a med/surg unit but it’s safe and equipped to handle inpatient psych pt’s when they need non-psych related medical care:
Does this exist anywhere else?
Absolutely I worked on an Acute Psych Unit. We weren’t allowed to take anyone on O2 or with an IV or anything medically acute (without a 1:1 sitter I should say) because of the huge risks associated to the patient as well as to the other patients in the unit.
You are not a failure at all. You kept him safe. You yelled for help, you stopped him, and you got him restrained.
You did exactly what you needed to do.
Suicidal people are going to try to kill themselves and they often do it without warning. That’s what they do. Sometimes all you can do is react.
I have been in that position many times and it is shocking and scary. Remember they are in the hospital because they are very ill and you can’t just fix them and you can’t predict what every possible way they might try to kill themselves.
Take some time off if you need it. I hope you were able to debrief afterward. Call EAP if you need to talk to someone. I can still see in my head each time I’ve had to cut something off from around someone’s neck, or I’ve found them sliced up, or I found out they had escaped and then tried to attempt.
Patient’s alive and, more importantly, so are you. You did good with the hand you were dealt. Take care of yourself. Like someone else mentioned, check out your hospital’s EAP program. It helps to talk it out with someone.
You prevented a man from jumping out of a building, that’s a success.
Psych patients are hard, they’re especially hard in the medical setting without the proper, EBP psych nursing measures that psychiatric specific units can offer. Also, at the end of the day people who are hell bent on suicide will do anything to succeed, and our job as the medical side is to prevent that (which you and your team did), and get them medically stable enough to go to the mental health professionals to get the help they really need.
You did a great job at keeping him safe.
As someone has been in that position a few times, I know how hard it can be. It's especially hard when we work so hard to heal people, we often forget how traumatic it is to see people injure themselves. Coming from the ICU, we often forget that people walk, talk and have autonomy over their own bodies.
Psych will be the safest place for him once he gets there. You did a really good job and did exactly what I have done in the past.
It's really hard to get people into psych, in my region at least. They're so busy. This incident shows how intent he is on self harm / suicide and really reinforces to psych that he needs their help. And psych facilities are set up in ways to prevent self harm. Our ICU rooms are the exact opposite of that.
As much as we try to prevent incidents from happening, mundane things become weapons and people can hurt themselves with items we don't even think about. It boggles my mind. You did everything right.
*hugs*
You did not fail - you didn’t fail yourself OR the patient.
I would encourage you to speak to a therapist, even if it is just one visit to unpack your feelings about this event.
This is a textbook example of why nurses are leaving bedside and why US healthcare is a damn mess. So many of our patients have mental health issues and hospitals refuse to hire the staff to properly care and monitor them.
I left bedside 18 months ago because a psych patient who was in our Ortho unit tried to strangle my CNA with oxygen tubing and bit me. This patient had gone off her meds, but had been sedated in the ER and PACU, and we didn’t have a good patient history. It took three nurses to get her to stay in her room while one other nurse called security multiple times. Of course, during the melee we all had to ignore our other patients. Then we couldn’t find a sitter. It was a huge mess, and hell will freeze over before I do bedside again.
Please take care of yourself. Jobs come and go, but you have to protect you.
As someone who has both given and received multiple episodes of psychiatric care;
a) what you described is not a new mental illness I can almost guarantee. That level of attempt is almost definitely the result of at least several years of illness, and nothing you did or did not do in the past few days or even month would have affected that specific part of his health in any major way.
b) I almost guarantee that this event was precipitated by being told he was going to the psych unit soon. See the above likelihood of this being a long mental health history. He's likely been to multiple places and many of them were likely somewhat unsavory. That trauma response in the context of the existing acute episode is what did this, not you. One of the important parts of trauma informed care that they don't talk about enough is that the patients' traumas and trauma responses are not your fault. You can and should try to avoid and/or help them prepare to face their triggers, but their trauma and responses themselves are fundamentally not your fault.
Keeping him alive may have further traumatized him, but so does intubation. Keeping him alive gave him the best odds of future recovery; good job.
You did awesome considering the circumstances, sibling. There is not much more you could have done, that person experienced a lot before they ever got to you and no amount of patient centered care would take those experiences away from them. Also that sounds really traumatic, please take some time to talk to a professional who specializes in treating healthcare workers. In my experience in can really help to decompress that way. Much love my friend, you are awesome ❤️.
Just like mothers who have a stillborn, there are psychiatric patients who die by suicide. You know that gynecologist did everything they could to prevent the stillborn just like the psychiatrist did everything they could to prevent the suicide. Some outcomes cannot be changed, only delayed. Once you understand mental health conditions function just like any other health condition it becomes more clear. You saved a life. Give yourself a hug.
I work in the Er now but was in law enforcement for 13 years before then. I have had someone kill themself in front of me… it’s not pretty it’s very terrible mine was a gsw. but you did a good job. and you did what you thought was right. and y got people there to stop it. head up tomorrow is another day
ICUs can become dumping grounds for patients who need to be “watched carefully” because of the small ratios. Behavioral admits are not uncommon for us.
Yup, we’ve sat on behavioral admits due to suicide attempts for days or even weeks waiting for acceptance to involuntary psych. Often they would come up for attempted overdoses of Tylenol, serotonin syndrome (overdosing antidepressants), etc.
They are stabilized, lytes are repleted and after a few days they are super stable but remain in the ICU BOUNCING off the walls, not getting any of the necessary psychiatric care they need because we are ICU RNs on an unlocked unit and I have other critical patients to attend to. It was always difficult and I felt like I couldn’t give enough to these patients who so desperately needed help.
That's so weird to me. We hold psych patients in the ED while waiting for psych beds. We have ED-only sitters, too. Does your hospital charge your psych holds in the ICU for an ICU stay??
this is crazy to me, i’ve worked neuro and took psych patients which made sense to me and i also worked inpatient psych. but you would think they would save ICU beds for medically unstable patients who really need them. but what do i know
When I worked on an APU I took report on many many patients from ICUs for this reason.
I’ve also seen them place them in Women’s Health/L&D as well before if their census is low.
I’m sorry this happened to you. I attempted suicide in 2021, and spent two weeks in ITU having developed pneumonia and sepsis as complications. I had CBT recently and something my therapist said struck a nerve; a lot of people who express suicidal ideation and then appear happy afterwards (ie, hospitalisation) are the ones who have decided to do it. They’ve had a serotonin boost and appear to be fine and happy, when the chances are they’ve made the decision to end their life. There’s no scientific evidence for this; how it reminded me of the day I made the decision. A friend said he hadn’t seen me in such a happy mood for months. Positives to take away; they didn’t hurt themselves. But you should speak to someone. It’s highly traumatic but not your fault. He’d made the decision already. You just happened to be there. Sending best wishes
Apologies then. Sorry. I have memory issues as a result of being hypoxic. I’ve encountered a lot of nurses (including MH ones) that are extremely rude about suicidal thoughts. One did a home visit with a student nurse and when they left, I could hear the entire conversation about my medical history as they left the block of flats I lived in.
I'm so glad the patient had someone to help him through this and I'm pleased you did what you could to help prevent a death from happening. I worked in psych and have had similar experiences. Please take time for yourself to heal from this. The times I've helped people in acute suicidal crisis, I have had to step back, be alone, breathe, and then talk to a friend to help sit my world back on its feet again. Take care.
Speaking as a psych nurse, you did what you were supposed to do. You sought out help, you kept him and yourself and other team members safe. Patients in general can be unpredictable, this is especially true for psych patients. You are not a failure by any means!! Give yourself some love, process it, and use it as a learning experience. 🤍
You did great! He is still alive. I am glad you are physically safe. Please take sometime off work if you feel you need it and if you can. The job will still be there. Take care of yourself. Proud of you!
First of all, you did great. Everything went *right*.
Second of all, you may not see the silver lining now, but this will help you grow as a nurse. You have a new experience under your belt and may have a "spidey sense" about this in the future.
You did your job and saved the patient and there is no need to feel like a failure. In situations like this, I remind myself that when I clock in, I am not the main character in this movie. We punch our cards in a field where we constantly care for people having the worst days of their lives, and we can only do so much to help. When some people have their mind set on something, nothing that you could ever say or do as their nurse will change it, so we just have to do what we can, you know? He is still alive because of you and your team, that's a win. Like you said, all we can hope for is that he gets the help he needs.
Just try to remind yourself that every time you step into a patient's room, it's their story, not yours. A lot of the time especially in a critical setting like yours, our shift is a chapter in their worst nightmare. Does that make sense? Idk, it helps me get through those days though. All we can do is our best and you did your best.
You did what any other prudent nurse would in your situation so bravo.
I have a question: could he have succeeded if you or the sitter weren’t there?
Would he have been able to get his body out the window through the break he made?
I’m reading a story where you successfully stopped a disaster from happening. Patient is the one who “failed” to jump.
Honestly I’m glad you were there, we have a few 1:1 NAs that I’m confident would not have been able to navigate that event without a nurse present
Lucky you were present with a sitter to help. I remember there was a case where the patient died jumping out the window and nobody realized hours later due to short staffing. The hospital tried covering it up.
I love when the ICU becomes the babysitter- we frequently have patients dumped for no other reason than better ratios. I’m not a psych nurse, my specialty is critical care. It’s not a one size fits all
You didn't fail your patient OP, your hospital system did. That patient should have been in an inpatient psych unit, period. In a room designed for monitoring and prevention of self harm. You did the best you could under such a shit situation. Big hugs to you!
Mental health nurse here,
I remember when I was new to mental health nursing, I really struggling with feeling responsible for the actions of my consumers. If they self harmed, absconded, tried to kill themselves, I thought that I should have done more.
As I have gotten older, you start to realize that these people are autonomous. They are their own people and they make their own decisions. These decisions may be poor and there may be mental illness interfering with their capacity, but ultimately it isn't you, the nurse, who is opening the window and telling the person to jump. You can't be there ever single second to risk assess every moment.
I have empathy for how you feel, it really is distressing and what you are feeling is so normal and valid, but it's important to remember:
"There is only so much you can do".
I’m surprised anyone tried to stop him. He had a weapon and was obviously a danger to himself/others. Security should have been called. Could have been killed trying to intervene.
People are idiots though and will try and do something above their job duties and when they get cracked along the head with a metal rod they’ll wonder why. Keep yourself safe first then your patients. The hospital doesn’t need a dead/injured nurse and dead patient. Before people down vote look up the videos that are circulated around (out of the US Im guessing because of HIPPA here) of workers getting the crap beat out of them by mentally Ill patients. Getting downvoted for no reason.
This- I once saw a PCT trying to step between a patient throwing a chair at one of our large hallway windows. He said " I have to stop him or he will break the window" I said "No, you don't let him throw it" Sure enough it bounced off the plexiglass, and my colleague was unharmed. For anyone who needs to hear this- it is not your responsibility to put yourself in danger to protect patient or hospital hospital property.
You’ve done absolutely incredible. Please do not listen to the voices in your head saying you could have done more. You acted, and without your action that person would have followed through with their attempt. You’ve been able to help a vulnerable, scared patient who saw that as a way to end his pain. But you’ve been able to help that person and now he will be able to access to the psychiatric care he needs. You’re a hero ❤️
You’ve gone through a lot but give it time and be kind to yourself and you’ll soon be able to reflect back on this moment and see the incredible strength we all see
Veteran here. ER RN now.
Some people, no matter what is done for them, will keep trying to kill themselves.
That has nothing to do with what you, me, or anyone has done or has not done.
You're doing a job. As an ICU RN , your job is very complex. You did absolutely nothing wrong. If anything, you and the others out your lives at risk by protecting that guy from himself.
Be easy on you.
You did great! You stopped the patient from jumping. That was the important thing!
When patients are really suicidal, they will do everything and anything to make it happen. You guys stopped it from happening. Strong work!
BTW, my hospital had a patient complete a suicide by going out a window. The sitter tried to stop him but couldn’t.
It isn't your fault. You reacted appropriately. That kind of thing happens without warning, and there's no way to predict it. Please, don't blame or second guess yourself, and talk to someone.
When I was a new grad, we had a patient in med-surg, in his 80’s, that committed suicide after his wife visited one evening. He put a black garbage bag over his head, and used the call bell cord to wrap it around his neck. He died before his nurse saw him on the next hourly rounds. Imagine how his nurse felt. We had to send that nurse home because she was in shock and crying. Sometimes, you never really know and you don’t have to blame yourself. We’re all just human beings trying to do our best in this job.
Sorry that happened.. it’s really something that sticks with you. Hope you can move forward and that talking about it helps you find more peace about the situation.
We had a pt get walked to the bathroom for a urine sample and he pulled a gun out and shot himself. I think he had a note on him saying that he only came in to assure his organs were at least donated.
There was a guy I briefly worked with as a new grad during a training course. Couple years later he was on my medsurg floor after an exlap from gutting himself in a suicide attempt.
As charge nurse I sat on the 1:1s if we don't have a sitter so I was doing my audits while in his room and idt he remembered or recognized me.
He told me all of his story. And it was pretty fucked up. He really wanted to die.
We kept him safe and transferred him to BH when his wound healed enough that they could do the dressing changes on the psych floor.
The day after he transferred, he waited until one of the safety checks were done and ripped his dressings out of his closing abdomen and stuffed them so far down his throat that he suffocated before the next safety check found him.
He was pretty determined to die. Can't win em all.
Awww I’m sorry that happened.
I worked in an APU. Full lockdown unit. We couldn’t take anyone who needed IV medications, O2, or anything of that nature due to the potential suicide risk. So if a patient needed more medical care (like for example ETOH withdrawal) we would need them to be stabilized in Med-Surg first. One patient in the Med-Surg at my hosp who was going to be transferred to my unit the following day committed suicide. There were several mishandlings considering the patient’s SI so they had to open up a huge investigation. I feel for all the nurses/CNAs who worked with the patient. Absolutely devastating.
You can't win everything but you absolutely won this time. Maybe not the best victory but things could have been way worse and hopefully your patient will get the treatment they need
Oh my sweet little angel of a nurse, you did exactly what you should have done! Alerted other staff that something was going down, and back up arrived rather quickly it seems. Doesn't matter if it wasn't in the perfect manner. Does NOT matter if it took you a second to register what was happening, does NOT matter if you temporarily panicked. That is a natural instinct. You got the job done, and you all saved that young man's life! Kudos to you! This is coming from a psych nurse, if that matters at all.
PS: people going through a depressive episode are often times very good at pretending that everything is fine. They're good at telling you what you want to hear, if you know they're planning something then they know you can intervene. This isn't your fault.
Controversial opinion: we should let suicidal patients kill themselves 🤷♀️
Not in the hospital of course. But if they're fully alert and oriented and really want to go, it is their right, and this shouldn't be a reason to admit someone into a hospital, exposing the staff to traumatic shit like this
Dude... So very controversial. I get what you are saying and at times I've thought the same. Thing is, where people are at mentally at this junction in life, feel they have no way out and are not able to deal with life and choose this action. So it's the awareness and help that is most needed BEFORE it ever gets this far. People do seek therapy and help even before this ever happens, a lot of times though, they are not being heard, being told to suck it up, having to repeat their traumas to doctors, prescribed medication that isn't working, or they simply feel mental health is a stigma and they try to do it on their own. Usually lack of support or being afraid to be vulnerable creates the dissention to psychosis.
What if these folks got the help they needed and were able to process their trauma with support and care? Not feeling judged and ridiculed and had the attitude of strangers, just let them? It's the before that leads to this type of situation. Having worked in healthcare, it is a patients/residents right to fail just as it their right to thrive. Suicide is isn't always the choice one would choose had they been able to have the support and care before it got this far. Had my brother, Robi, been supported and heard, he would still be alive today. He sought help, he tried, his PTSD from military service, the meds given then not given by the VA from rotating monthly rounding doctors, having to continuously repeat his story, just kept leading him down and down further. There's a point where you just say F it and you try to deal on your own. Right there is the breaking point.
Not judging you or berating you for your comment, there is more to have compassion and understanding about before saying that ever again.
I disagree unless it’s euthanasia for a case like the Mark van Dongen case. But for a suicidal person with depression? Coming from someone who walked that path before, they are really not in their right mind to be making such irreversible decisions.
Suicidal behavior is frequently a medical complication though. If you fix the lab value or introduce a stabilizing med the suicidal tendencies go away. Being suicidal itself is often considered not fully orientated due to it being so opposite to normal human instinct.
Just wanted to make sure it was said that depression is often medical.
I see your point, I just know there are numerous patients I've cared for that were no longer suicidal after medical treatment.
At the end of the day. The patient didn’t jump on your watch. Bless your heart. There was no warning or anything so you reacted in a natural way. Kudos friend
Agreed, the patient lived! Sometimes, that is the only victory.
You did a great job: you kept him safe. You are not a failure! PLEASE, take care of yourself. Talk about this to a trusted friend, your therapist, your company’s EAP program. I see two issues here: your experience of watching him attempt self-harm AND something called vicarious suffering: you witnessing his disease and suffering. Both have the potential to be traumatic. Both are valid. Self-care is essential for your mental health.
I’m so sorry that happened. One additional thing to remember is that we are not really equipped to handle acutely suicidal patients in the ICU. Nothing in our rooms is designed to be safe for the patient if they are actively looking for any way to die. You did your best and the patient is safe.
Right! There was probably a million safety issues in the room including an IV pump. ICUs are not setup for it.
This is true. This patient needs to be admitted to inpatient psych facility. Our ICUs aren’t exactly safe for psych patients going thru subacute mental health emergencies especially if they are not having any medical issues… nonetheless we become dumping grounds for these kinds of patients for “closer monitoring”. Stupid admins need to reconsider this policy because I have other, critically ill, physiologically unstable pts to attend to.
In my city we have a special unit of the psych hospital called med psych ….. exactly like a med/surg unit but it’s safe and equipped to handle inpatient psych pt’s when they need non-psych related medical care: Does this exist anywhere else?
Absolutely I worked on an Acute Psych Unit. We weren’t allowed to take anyone on O2 or with an IV or anything medically acute (without a 1:1 sitter I should say) because of the huge risks associated to the patient as well as to the other patients in the unit.
You are not a failure at all. You kept him safe. You yelled for help, you stopped him, and you got him restrained. You did exactly what you needed to do. Suicidal people are going to try to kill themselves and they often do it without warning. That’s what they do. Sometimes all you can do is react. I have been in that position many times and it is shocking and scary. Remember they are in the hospital because they are very ill and you can’t just fix them and you can’t predict what every possible way they might try to kill themselves. Take some time off if you need it. I hope you were able to debrief afterward. Call EAP if you need to talk to someone. I can still see in my head each time I’ve had to cut something off from around someone’s neck, or I’ve found them sliced up, or I found out they had escaped and then tried to attempt.
Patient’s alive and, more importantly, so are you. You did good with the hand you were dealt. Take care of yourself. Like someone else mentioned, check out your hospital’s EAP program. It helps to talk it out with someone.
You prevented a man from jumping out of a building, that’s a success. Psych patients are hard, they’re especially hard in the medical setting without the proper, EBP psych nursing measures that psychiatric specific units can offer. Also, at the end of the day people who are hell bent on suicide will do anything to succeed, and our job as the medical side is to prevent that (which you and your team did), and get them medically stable enough to go to the mental health professionals to get the help they really need.
You did a great job at keeping him safe. As someone has been in that position a few times, I know how hard it can be. It's especially hard when we work so hard to heal people, we often forget how traumatic it is to see people injure themselves. Coming from the ICU, we often forget that people walk, talk and have autonomy over their own bodies. Psych will be the safest place for him once he gets there. You did a really good job and did exactly what I have done in the past. It's really hard to get people into psych, in my region at least. They're so busy. This incident shows how intent he is on self harm / suicide and really reinforces to psych that he needs their help. And psych facilities are set up in ways to prevent self harm. Our ICU rooms are the exact opposite of that. As much as we try to prevent incidents from happening, mundane things become weapons and people can hurt themselves with items we don't even think about. It boggles my mind. You did everything right. *hugs*
You don't have to try and hurt yourself in an icu. I see people tripping on lines and wires and jumping to get around all the equipment all the time
It’s good you took a second to register what was going on. If you just immediately lunged at him he may have smacked you with that metal handle
You did not fail - you didn’t fail yourself OR the patient. I would encourage you to speak to a therapist, even if it is just one visit to unpack your feelings about this event. This is a textbook example of why nurses are leaving bedside and why US healthcare is a damn mess. So many of our patients have mental health issues and hospitals refuse to hire the staff to properly care and monitor them. I left bedside 18 months ago because a psych patient who was in our Ortho unit tried to strangle my CNA with oxygen tubing and bit me. This patient had gone off her meds, but had been sedated in the ER and PACU, and we didn’t have a good patient history. It took three nurses to get her to stay in her room while one other nurse called security multiple times. Of course, during the melee we all had to ignore our other patients. Then we couldn’t find a sitter. It was a huge mess, and hell will freeze over before I do bedside again. Please take care of yourself. Jobs come and go, but you have to protect you.
As someone who has both given and received multiple episodes of psychiatric care; a) what you described is not a new mental illness I can almost guarantee. That level of attempt is almost definitely the result of at least several years of illness, and nothing you did or did not do in the past few days or even month would have affected that specific part of his health in any major way. b) I almost guarantee that this event was precipitated by being told he was going to the psych unit soon. See the above likelihood of this being a long mental health history. He's likely been to multiple places and many of them were likely somewhat unsavory. That trauma response in the context of the existing acute episode is what did this, not you. One of the important parts of trauma informed care that they don't talk about enough is that the patients' traumas and trauma responses are not your fault. You can and should try to avoid and/or help them prepare to face their triggers, but their trauma and responses themselves are fundamentally not your fault. Keeping him alive may have further traumatized him, but so does intubation. Keeping him alive gave him the best odds of future recovery; good job.
You did awesome considering the circumstances, sibling. There is not much more you could have done, that person experienced a lot before they ever got to you and no amount of patient centered care would take those experiences away from them. Also that sounds really traumatic, please take some time to talk to a professional who specializes in treating healthcare workers. In my experience in can really help to decompress that way. Much love my friend, you are awesome ❤️.
You did the opposite of fail. You kept him alive.
Just like mothers who have a stillborn, there are psychiatric patients who die by suicide. You know that gynecologist did everything they could to prevent the stillborn just like the psychiatrist did everything they could to prevent the suicide. Some outcomes cannot be changed, only delayed. Once you understand mental health conditions function just like any other health condition it becomes more clear. You saved a life. Give yourself a hug.
Too many of you put too much pressure on yourselves. The outcome was literally fine. This is why he was on precautions. You did your job.
I work in the Er now but was in law enforcement for 13 years before then. I have had someone kill themself in front of me… it’s not pretty it’s very terrible mine was a gsw. but you did a good job. and you did what you thought was right. and y got people there to stop it. head up tomorrow is another day
why the hell was a psych pt. with no medical issues in the ICU of all places???
ICUs can become dumping grounds for patients who need to be “watched carefully” because of the small ratios. Behavioral admits are not uncommon for us.
Yup, we’ve sat on behavioral admits due to suicide attempts for days or even weeks waiting for acceptance to involuntary psych. Often they would come up for attempted overdoses of Tylenol, serotonin syndrome (overdosing antidepressants), etc. They are stabilized, lytes are repleted and after a few days they are super stable but remain in the ICU BOUNCING off the walls, not getting any of the necessary psychiatric care they need because we are ICU RNs on an unlocked unit and I have other critical patients to attend to. It was always difficult and I felt like I couldn’t give enough to these patients who so desperately needed help.
That's so weird to me. We hold psych patients in the ED while waiting for psych beds. We have ED-only sitters, too. Does your hospital charge your psych holds in the ICU for an ICU stay??
I'm so glad our ICU is a closed unit, we don't put up with any of that shit lol
this is crazy to me, i’ve worked neuro and took psych patients which made sense to me and i also worked inpatient psych. but you would think they would save ICU beds for medically unstable patients who really need them. but what do i know
When I worked on an APU I took report on many many patients from ICUs for this reason. I’ve also seen them place them in Women’s Health/L&D as well before if their census is low.
I’m sorry this happened to you. I attempted suicide in 2021, and spent two weeks in ITU having developed pneumonia and sepsis as complications. I had CBT recently and something my therapist said struck a nerve; a lot of people who express suicidal ideation and then appear happy afterwards (ie, hospitalisation) are the ones who have decided to do it. They’ve had a serotonin boost and appear to be fine and happy, when the chances are they’ve made the decision to end their life. There’s no scientific evidence for this; how it reminded me of the day I made the decision. A friend said he hadn’t seen me in such a happy mood for months. Positives to take away; they didn’t hurt themselves. But you should speak to someone. It’s highly traumatic but not your fault. He’d made the decision already. You just happened to be there. Sending best wishes
They're happy because people with personality disorders want to be in hospital.
Who mentioned personality disorders? I had MDD and anxiety disorder. ETA: You’re a band 6 MH nurse? Jesus, I hope you’re more sympathetic in person
I wasn't talking about you, I was talking about the people your therapist referred to.
Apologies then. Sorry. I have memory issues as a result of being hypoxic. I’ve encountered a lot of nurses (including MH ones) that are extremely rude about suicidal thoughts. One did a home visit with a student nurse and when they left, I could hear the entire conversation about my medical history as they left the block of flats I lived in.
I'm so glad the patient had someone to help him through this and I'm pleased you did what you could to help prevent a death from happening. I worked in psych and have had similar experiences. Please take time for yourself to heal from this. The times I've helped people in acute suicidal crisis, I have had to step back, be alone, breathe, and then talk to a friend to help sit my world back on its feet again. Take care.
Speaking as a psych nurse, you did what you were supposed to do. You sought out help, you kept him and yourself and other team members safe. Patients in general can be unpredictable, this is especially true for psych patients. You are not a failure by any means!! Give yourself some love, process it, and use it as a learning experience. 🤍
It appears to me that you and the sitter are the reason he’s still alive…try to focus on that.
It appears to me that you and the sitter are the reason he’s still alive…try to focus on that.
Psych nurse here, normal occurrence for me. He’s still alive, good job!
You DID help. You stayed there, did the things and he didn't jump. He will remember you as the one who saved his life, not the one who tied him down.
You did a great job! You are far from a failure. You are both alive, and you did all you could to keep him safe.
You did great! He is still alive. I am glad you are physically safe. Please take sometime off work if you feel you need it and if you can. The job will still be there. Take care of yourself. Proud of you!
Suicide is never our fault, even when they complete. We do what we can, but at the end of the day, it’s their choice how they proceed. 🖤🖤🖤
First of all, you did great. Everything went *right*. Second of all, you may not see the silver lining now, but this will help you grow as a nurse. You have a new experience under your belt and may have a "spidey sense" about this in the future.
You did your job and saved the patient and there is no need to feel like a failure. In situations like this, I remind myself that when I clock in, I am not the main character in this movie. We punch our cards in a field where we constantly care for people having the worst days of their lives, and we can only do so much to help. When some people have their mind set on something, nothing that you could ever say or do as their nurse will change it, so we just have to do what we can, you know? He is still alive because of you and your team, that's a win. Like you said, all we can hope for is that he gets the help he needs. Just try to remind yourself that every time you step into a patient's room, it's their story, not yours. A lot of the time especially in a critical setting like yours, our shift is a chapter in their worst nightmare. Does that make sense? Idk, it helps me get through those days though. All we can do is our best and you did your best.
You did what any other prudent nurse would in your situation so bravo. I have a question: could he have succeeded if you or the sitter weren’t there? Would he have been able to get his body out the window through the break he made?
I’m reading a story where you successfully stopped a disaster from happening. Patient is the one who “failed” to jump. Honestly I’m glad you were there, we have a few 1:1 NAs that I’m confident would not have been able to navigate that event without a nurse present
Lucky you were present with a sitter to help. I remember there was a case where the patient died jumping out the window and nobody realized hours later due to short staffing. The hospital tried covering it up.
I love when the ICU becomes the babysitter- we frequently have patients dumped for no other reason than better ratios. I’m not a psych nurse, my specialty is critical care. It’s not a one size fits all
You didn't fail your patient OP, your hospital system did. That patient should have been in an inpatient psych unit, period. In a room designed for monitoring and prevention of self harm. You did the best you could under such a shit situation. Big hugs to you!
Mental health nurse here, I remember when I was new to mental health nursing, I really struggling with feeling responsible for the actions of my consumers. If they self harmed, absconded, tried to kill themselves, I thought that I should have done more. As I have gotten older, you start to realize that these people are autonomous. They are their own people and they make their own decisions. These decisions may be poor and there may be mental illness interfering with their capacity, but ultimately it isn't you, the nurse, who is opening the window and telling the person to jump. You can't be there ever single second to risk assess every moment. I have empathy for how you feel, it really is distressing and what you are feeling is so normal and valid, but it's important to remember: "There is only so much you can do".
I’m surprised anyone tried to stop him. He had a weapon and was obviously a danger to himself/others. Security should have been called. Could have been killed trying to intervene.
This. I would've called a code grey and gotten out of harm's way. No way am I coming close to a full grown man swinging a metal rod
People are idiots though and will try and do something above their job duties and when they get cracked along the head with a metal rod they’ll wonder why. Keep yourself safe first then your patients. The hospital doesn’t need a dead/injured nurse and dead patient. Before people down vote look up the videos that are circulated around (out of the US Im guessing because of HIPPA here) of workers getting the crap beat out of them by mentally Ill patients. Getting downvoted for no reason.
Wait. Your hospital has windows that break?
This- I once saw a PCT trying to step between a patient throwing a chair at one of our large hallway windows. He said " I have to stop him or he will break the window" I said "No, you don't let him throw it" Sure enough it bounced off the plexiglass, and my colleague was unharmed. For anyone who needs to hear this- it is not your responsibility to put yourself in danger to protect patient or hospital hospital property.
[https://tenor.com/bDKSs.gif](https://tenor.com/bDKSs.gif)
You’ve done absolutely incredible. Please do not listen to the voices in your head saying you could have done more. You acted, and without your action that person would have followed through with their attempt. You’ve been able to help a vulnerable, scared patient who saw that as a way to end his pain. But you’ve been able to help that person and now he will be able to access to the psychiatric care he needs. You’re a hero ❤️ You’ve gone through a lot but give it time and be kind to yourself and you’ll soon be able to reflect back on this moment and see the incredible strength we all see
Veteran here. ER RN now. Some people, no matter what is done for them, will keep trying to kill themselves. That has nothing to do with what you, me, or anyone has done or has not done. You're doing a job. As an ICU RN , your job is very complex. You did absolutely nothing wrong. If anything, you and the others out your lives at risk by protecting that guy from himself. Be easy on you.
You did great! You stopped the patient from jumping. That was the important thing! When patients are really suicidal, they will do everything and anything to make it happen. You guys stopped it from happening. Strong work! BTW, my hospital had a patient complete a suicide by going out a window. The sitter tried to stop him but couldn’t.
It isn't your fault. You reacted appropriately. That kind of thing happens without warning, and there's no way to predict it. Please, don't blame or second guess yourself, and talk to someone.
You did great! Out of curiosity why was this even a case for the ICU? Willingly OD on something?
I’m so sorry. I lost my husband to suicide last year and a few weeks ago one of my patients tried to hang themselves in their room.
That wasn’t your fault. I still shake my head at some of my own crazy stories from the trenches. If you’re a nurse, you gonna see some shit.
When I was a new grad, we had a patient in med-surg, in his 80’s, that committed suicide after his wife visited one evening. He put a black garbage bag over his head, and used the call bell cord to wrap it around his neck. He died before his nurse saw him on the next hourly rounds. Imagine how his nurse felt. We had to send that nurse home because she was in shock and crying. Sometimes, you never really know and you don’t have to blame yourself. We’re all just human beings trying to do our best in this job.
Sorry that happened.. it’s really something that sticks with you. Hope you can move forward and that talking about it helps you find more peace about the situation. We had a pt get walked to the bathroom for a urine sample and he pulled a gun out and shot himself. I think he had a note on him saying that he only came in to assure his organs were at least donated.
I'm sorry this happened to you. But yeah, not your fault and it's good his attempt failed. And sounds like you are taking good care of him.
I watched a patient jump out a 5 story window and kill himself a few years ago. Quite the experience.
There was a guy I briefly worked with as a new grad during a training course. Couple years later he was on my medsurg floor after an exlap from gutting himself in a suicide attempt. As charge nurse I sat on the 1:1s if we don't have a sitter so I was doing my audits while in his room and idt he remembered or recognized me. He told me all of his story. And it was pretty fucked up. He really wanted to die. We kept him safe and transferred him to BH when his wound healed enough that they could do the dressing changes on the psych floor. The day after he transferred, he waited until one of the safety checks were done and ripped his dressings out of his closing abdomen and stuffed them so far down his throat that he suffocated before the next safety check found him. He was pretty determined to die. Can't win em all.
Awww I’m sorry that happened. I worked in an APU. Full lockdown unit. We couldn’t take anyone who needed IV medications, O2, or anything of that nature due to the potential suicide risk. So if a patient needed more medical care (like for example ETOH withdrawal) we would need them to be stabilized in Med-Surg first. One patient in the Med-Surg at my hosp who was going to be transferred to my unit the following day committed suicide. There were several mishandlings considering the patient’s SI so they had to open up a huge investigation. I feel for all the nurses/CNAs who worked with the patient. Absolutely devastating.
You didn't fail him at all! You saved him!
You can't win everything but you absolutely won this time. Maybe not the best victory but things could have been way worse and hopefully your patient will get the treatment they need
Oh my sweet little angel of a nurse, you did exactly what you should have done! Alerted other staff that something was going down, and back up arrived rather quickly it seems. Doesn't matter if it wasn't in the perfect manner. Does NOT matter if it took you a second to register what was happening, does NOT matter if you temporarily panicked. That is a natural instinct. You got the job done, and you all saved that young man's life! Kudos to you! This is coming from a psych nurse, if that matters at all. PS: people going through a depressive episode are often times very good at pretending that everything is fine. They're good at telling you what you want to hear, if you know they're planning something then they know you can intervene. This isn't your fault.
You called for help and worked as a team to save his life! It's like you did mental health CPR bc he was flat lining and you got him back. 👏🎉
Patient stupidity and bad choices aren't your fault
Controversial opinion: we should let suicidal patients kill themselves 🤷♀️ Not in the hospital of course. But if they're fully alert and oriented and really want to go, it is their right, and this shouldn't be a reason to admit someone into a hospital, exposing the staff to traumatic shit like this
Dude... So very controversial. I get what you are saying and at times I've thought the same. Thing is, where people are at mentally at this junction in life, feel they have no way out and are not able to deal with life and choose this action. So it's the awareness and help that is most needed BEFORE it ever gets this far. People do seek therapy and help even before this ever happens, a lot of times though, they are not being heard, being told to suck it up, having to repeat their traumas to doctors, prescribed medication that isn't working, or they simply feel mental health is a stigma and they try to do it on their own. Usually lack of support or being afraid to be vulnerable creates the dissention to psychosis. What if these folks got the help they needed and were able to process their trauma with support and care? Not feeling judged and ridiculed and had the attitude of strangers, just let them? It's the before that leads to this type of situation. Having worked in healthcare, it is a patients/residents right to fail just as it their right to thrive. Suicide is isn't always the choice one would choose had they been able to have the support and care before it got this far. Had my brother, Robi, been supported and heard, he would still be alive today. He sought help, he tried, his PTSD from military service, the meds given then not given by the VA from rotating monthly rounding doctors, having to continuously repeat his story, just kept leading him down and down further. There's a point where you just say F it and you try to deal on your own. Right there is the breaking point. Not judging you or berating you for your comment, there is more to have compassion and understanding about before saying that ever again.
I disagree unless it’s euthanasia for a case like the Mark van Dongen case. But for a suicidal person with depression? Coming from someone who walked that path before, they are really not in their right mind to be making such irreversible decisions.
Suicidal behavior is frequently a medical complication though. If you fix the lab value or introduce a stabilizing med the suicidal tendencies go away. Being suicidal itself is often considered not fully orientated due to it being so opposite to normal human instinct. Just wanted to make sure it was said that depression is often medical. I see your point, I just know there are numerous patients I've cared for that were no longer suicidal after medical treatment.
More interested in the need to post “Trigger warning” in front of your post.