Suicide. One nurses story. 

This is the story of Nurse X. It is a true story. It is a brave story. 

I’m a registered nurse who has worked for five years in a busy, metropolitan trauma centre.

I’m an ED nurse, and have been since new grads. Being an ED nurse is a huge part of my identity, I love it so much and it’s everything I ever wanted to be.

I moved very far from home, from my family to work in this specific emergency department because I heard it was the best of the best. And in so many ways it was.

One of my colleagues took his own life in January. A medical officer. Registrar. To all accounts and everyone I spoke to, this was completely unexpected.

I have worked with many doctors in my five years, and I can honestly say that watching their experiences, I would never want to do medicine. Especially for the first few years.

Junior doctors in our system get the shortest end of the stick. They do all the grunt work, put in all the hours and get pressured from every side. I’ve seen them being yelled at, berated and bullied by patients, nursing staff and senior medical staff. I’ll admit that even I have lost my patience with a junior doctor or two.

The doctors I work with don’t have breaks in their 10 hour shifts. And their 10 hour shifts always go into unpaid overtime. I’ve never seen a medical officer get out on time, and the worst I’ve seen is 5 hours overtime. Unpaid.

Nursing wouldn’t stand for that. We’d kick up a stink, call the union, insist on being paid for our hard work. And we have the support to do that. But junior doctors, they don’t. All of this is an expectation for them.

The culture says they cannot complain, because that makes them weak. And it results in senior medical staff telling the juniors how bad they had it in their residencies. As if that makes it ok. Junior doctors get paid less than an RN.

Many of my intern/resident friends were living with their parents because they couldn’t afford not to. They put their lives on hold, they didn’t have friends outside of medicine, or start families. That’s the sacrifice they make. And they willingly do this. Because they want to help people.

While they’re working these long hours, sometimes up to seven days in a row, they’re also studying. Full time work and full time study, for years. I’ve seen doctors fail exams. I’ve seen them depressed, devastated.

Because of the nature of the job, they put their whole lives into this and when they fail it’s huge. Because many of them, like me, put so much of their self and identity into the job. If they fail, they feel like failures.

That’s the culture.

Add to all of this, that they are young people with impossible responsibilities and in charge of life-altering decisions. If they make a mistake, if they don’t escalate in time, if nobody hears them, someone could die.

And sometimes despite their best efforts, their patients will die anyway. What training do they get to prepare them for the emotional toll that will take on them? Like everything else, it’s just part of the job that they’ve taken on and they have to manage it on their own.

These are the reasons I’d never want to be a doctor. I don’t believe I’d survive the first few years. And here’s why;

I barely survived my first years nursing in ED. Like a significant number the population, I have a history of anxiety and depression. I don’t believe that that should stop me from working as an RN, or in ED.

I’m capable, insightful and good at managing my illness. However, I did feel the pressure. I was so young and in charge of so many people’s lives.

As I said above; if I made a mistake, if I didn’t escalate on time, if nobody heard me, someone could die. And sometimes, people died anyway. The pace was difficult to adjust to, and I didn’t always get a break when I needed it. Sometimes the staffing ratios and skill mix were dangerous.

Sometimes I’d feel so unsafe, documenting everything ‘just in case’ as I was told to.

Sometimes when I’d escalate this, I’d be told I just needed to manage my time better. That I just needed to prioritise.

Sometimes when I’d escalate a patient, I would be asked, “What do you want me to do about it?”. I heard that statement more often than I’d like. I heard staff referring to each other as ‘acopic’. I heard management referring to staff the same way.

A word in this context meaning, ‘unable to cope with the workload’, or as I understood it, ‘unable to cope without asking for help’.

At the same time we were constantly told to escalate issues and concerns by senior management. But it started seeming like a futile exercise.

I was told, ‘this is what working in ED is like’. When a new nurse would start, it was a rite of passage for them to have their first cry and rush off the floor. That was expected. It was heavily implied that if I couldn’t hack it, ED wasn’t for me. Because the problem wasn’t staffing, it wasn’t resources, it wasn’t the number of presentations. It was me.

I started having trouble. I had my medications increased. I kept working, kept accepting the overtime my managers begged me to do. I wouldn’t want to ‘let the whole department down’.

A statement which is a lot to place on the head of a junior nurse who didn’t know any better.

This spiralled for me. I worked myself into the ground. I didn’t understand the importance of self-care. I engaged in joking night shift conversations about the suicidal patients who made feeble attempts on their own lives, trying to overdose on antidepressants. I heard staff joke about how they ‘would do it’, and make it stick.

It goes without saying that by the time I was so down I wanted to end my own life, my medical knowledge had given me a few very effective plans. And I had access to everything I would need.

One day on a normal, run-of-the-mill shift (not especially busy or tense), I broke. I was afraid of what my thoughts were doing. I was afraid that these thoughts, these plans were becoming reality. I was fortunate in that I still had feelings of self-preservation.

I went outside and broke down.

My favourite nursing manager came out, and I told her everything. She saved my life. I was seen in my own ED. I was admitted to mental health. I was so fortunate to have supportive management on that day, who cared about me. To this day, I am so happy I said something. I got the help that I needed.

My return to work was hard. I was recovering well, healthier than I had been in a long time. But I was pulled into many meetings by senior hospital staff, checking in to ‘ensure I was ok to be at work’. I was treated like I was made of glass.

I believe that they were absolutely trying to support me, but some conversations didn’t go as easily as others. I remember being in a meeting with my department manager and the director of nursing; being asked if I ‘thought emergency nursing was really for me’, because ‘as we all know, it’s very stressful’. I was heavily encouraged by senior staff to work elsewhere, even though I was on the floor every day managing to do my job perfectly fine. I asked if there were any complaints about my practice or any issues, and they couldn’t provide anything.

At one point the statement was said to me, “what if you’re in a resuscitation and you suddenly have a panic attack and have to leave?”. Maybe I could understand that, if I had a history of panic attacks and suddenly became incapable. But I didn’t. And I wondered how it was any different from any physical illness.

How it would be if my type 1 diabetic colleague had a hypo during a resus and had to leave. But he was never asked if he was capable. I started to wonder how much it was about supporting me, and how much it was about liability.

It took me two years to shake the stigma from that event. Two years of proving every day that I was the same person I was before I became unwell, but stronger and with more coping strategies.

In that time, I understood why people don’t come out and say that they’re suffering. I can understand why people don’t ask for help. Although I’m glad I did and I’m glad I’m still here, my problems didn’t end when I got well. The stigma of mental health is alive and well in the nursing profession.

I still flinch when I hear someone describe a nurse or doctor as ‘acopic’.

Medicine and nursing require such a high level of resilience. Self-care, support and coping strategies are needed for everyone -not just those with existing mental illness.

This needs to be taught. Shared. Encouraged.
And the stigma needs to stop.

 

 

 

13 thoughts on “Suicide. One nurses story. 

  1. Thank you for sharing your story. I, too, was an RN for 19 years.

    Having fibromyalgia, undiagnosed (at the time) Bipolar Disorder, Adult ADD as well as unrealistic expectations of myself (perfectionism) took its toll. I also was raising two teenagers by myself.
    However, all appeared to be well on the outside and i regularly received promotions.

    I found myself struggling to give my patients the TLC they needed in addition to excellence in practical nursing practice. It became harder for me to focus as I administered medications and found myself stopping what i was concentrationg on to answer calls for help to get to the toilet, etc., when the overworked nursing assistants were not able to answer because they were occupied elsewhere.

    Finally, I did seriously try to end my life but was unsuccessful and instead came out of a 23- hour coma. One of my physicians said it was a wonder that I escaped without major organ failure. For the next week, I had vivid images of warring angels whenever i closed my eyes. This crisis brought me closer to God and I was filled with aawe at His amazing grace.

    My boss referred me to IPN (my hubby referred to them as the “Nurse Nazis”) and I managed to comply with their many stringent restrictions for more than three of the required five years of my contract.

    Struggling to work full time in multiple roles as an ADON, Risk Manager, Staff Educator, an Infection Control Nurse of a 144 bed health and rehab center, I also had to fulfill the stipulations of my IPN contract.

    One mandate was a weekly mental health group meeting which took place in another County. I found the grueling 1&1/2 hr. one-way rush hour commute to be unsafe for me to drive because of an exacerbation of my chronic fatigue syndrome. I decided to write to my IPN case manager explaining the situation and telling her i couldn’t safely drive to this far-away meeting.

    Instead of helping me try to figure out a solution for my dilemma, she reported my “noncompliance” to the Board of Nursing. I was given the “choice” of voluntarily relinguishing my RN license or it would be revoked by them. In retrospect, i should have appealed my case, but i was so exhausted i had neither the resources nor energy to find an attorney to fight for me.

    I “chose” to voluntarily relinguish my license and found myself in a string of low-paying jobs, unable to hold onto any of them for more than three months at a time. I finally sought help from Voc Rehab, and they ordered and paid for neuropsychiatric testing. That’s when I was diagnosed with BP Disorder, Type II and Adult ADD. I was prescribed much needed medication which helped alleviate the drastic mental and emotional rollercoaster i had been riding.They assisted me to locate a job as a home health aide for a woman with Alzheimer’s. After she passed on, I was hired as a cashier at a Publix grocery store but only told them at the beginning about my fibromyalgia. I’ve been there over nine years, but it was several years before I shared that I also have Bipolar. They have been incredibly supportive.

    Sorry to have rambled on, but writing all of this has freed me in some way. I am no longer ashamed of my mental illness. Thank you for reading.

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  2. I am a nurse who had depression and anxiety. I have been very lucky in that I have been supported by my co workers and occupational health. I used to stress out so much about my job but now I realise sometimes you have to be your own nurse and say no. Also I spoke to a top occupational therapist doctor who said that it is very common for people with mental health problems including bipolar and depression to work in the nursing profession. Is this because we are seeking for that unconditional love we didn’t get in our personal lives? Nursing is my life and to be honest with you that un judgemental love you get from your patients is one of the things that attracted me to the job. Also remember that nurses are people too- we aren’t super heroes.

    Liked by 1 person

  3. WOW We all relate but do nothing . My experience is over 30 years that the person who ask for help as such above are crucified . 2years of stigma to prove herself . Shameful. What a blessing we have courageous young nurses who are speaking out . Gen Y are learning that’s it not normal to be treated poorly that we who have been nursing for so long have survived and just pushed on . I have to many stories from colleauges who have been in the same position . Too many !! Management should be mortified. Self care is not taught . Rosters are ridiculous . Workload is dangerous. Demands from the public too high . Clinical Governace not adhered too . It is brace to tell ones story . But what are we going to do about it as a nursing profession ? Leave !!

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    1. My nursing experience meshes with yours. Ask for help or say you’re having issues and it’s blame game. Blame whomever speaks up.
      Management needs radical change!!
      Abuse is not ok.
      I made first ever complaint to management in 25 yrs nursing….Union: “You’re lucky not to have been bullied eariler”. HR: We can move you to another ward. GP: Bullying is so common+ do you work in ED?
      Turned out bully had long history of complaints vs my clean record, yet I was pressured to minimise the complaint. Pt care was being affected and it was making me ill.
      C’mon. We can do better.
      Thank you for speaking up!

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  4. Thank you for sharing your personal experience I to am a nurse , a Nurse Unit manager of a high demand service of Community Nursing in a very aged and frail demographic, thank you reminding me of the value of being a supportive NUM and also being sensitive enough to the needs of my staff , who may have mental health issues that I don’t know about.

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  5. You are very strong. I believe that your willingness to share such intimate events in your life is very brave. I am sure many nurses have felt the way you did. Unfortunately management seems to have no compassion or empathy for their staff. Hopefully things will change some day. Healthcare professionals need to learn to care for themselves so they may care for everyone else. Thank you for your story

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  6. Thank you for sharing your story. Having worked in a hospital (non-clinical but working with clinical staff), with many wonderful nurses amongst my friends, with a daughter and son-in-law who are junior doctors, and having experienced several episodes of depression during my adult life, your story hit home on so many levels. You are the people we rely on to help us when we are vulnerable, we must let you know it is ok to be vulnerable and need help too. Seeking help must not be seen as weakness. Far from being acopic, it is often the “copers” who hit that wall and need to reach out. I am so glad you did, and so glad your nurse manager was there for you. I wish you good health and a long career doing what you love. And always take care of you xx

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  7. Not sure what dream-health setting this author works in, but unpaid overtime and no breaks are a regular feature wherever I have worked in my 25 year nursing career!

    I’ve never known a nurse to kick or scream or run to a union..

    Perhaps the next generation of nurses knows something I don’t!

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  8. Thank you so much for sharing your story. It is powerfully insightful, and I will share it with my friends. You are so wonderful for making your story available to those who need it most.
    With great appreciation,
    Heather

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  9. Very powerful and excellent article!!! You are SO right! The mental Health stigma HAS TO STOP! I like the comparison to the Diabetic Nurse. Depression and anxiety ARE physical illnesses-only that it effects the brain, instead of some ‘other’ body part! They should require a course about this and “self-care” in every Nursing program! You should submit this article to some of the Professional Nursing journals!!! After beinng an RN for over 30 yrs, I could definitely relate to ALL that you have experienced. Great job!

    Liked by 2 people

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