Nurse Suicide: Prevention and Grief Management

Judy E. Davidson, DNP, RN, MCCM, FAAN; Rachael Accardi, MA, LMFT; Courtney Sanchez, LCSW; Sidney Zisook, MD


Am Nurs Journal. 2020;15(1) 

In This Article

Suicide Prevention

Our HEAR suicide prevention program, which includes the therapists and psychiatrist who lead our bereavement team, provides comprehensive education designed to address mental health stigma and inform healthcare providers about second victim syndrome, burnout, depression, substance use, and treatment resources.

Reducing Stigma, Assessing Risk

To overcome the stigma associated with suicide and proactively assess risk and provide timely treatment, the HEAR program team deploys an annual anonymous, encrypted electronic stress and depression risk screening to all employees and faculty members. Invitations to take the screening are sent via executive team members in staggered batches of 500 so that counselors can keep up with responses. The screening identifies those at risk for suicide and helps program therapists provide feedback, encourage further assessment and dialogue for those at risk, and facilitate treatment referral as appropriate or desired. The encryption, which is managed by the AFSP, allows nurses to remain anonymous throughout counseling and referral if they wish. HEAR has successfully identified approximately 40 nurses per year with suicide risk who have accepted treatment referrals.

Emotional Debriefings

The HEAR team mobilizes after critical or stressful workplace events to provide emotional debriefings to anyone affected. Emotional debriefings normalize the situation so that everyone knows that feeling pain, frustration, and sorrow in the face of stressful, sometimes overwhelming, situations is acceptable. The goal of this approach is to make it more likely that employees will reach out for help when needed. In addition, risk management now routinely communicates with the HEAR team so that when an event occurs that requires clinical investigation, HEAR therapists are informed and can quickly offer group emotional debriefings to those who need them and reassure employees that they aren't alone in their feelings.

The emotional debriefings are culture-shifting interventions that support the healing process and decrease stigma associated with seeking help for mental health issues. We've found that as more debriefings occur, word spreads about their benefits, and employees begin to request them instead of waiting for them to be offered. (See Debriefing feedback.)