A deductive thematic analysis of nurses with job-related problems who completed suicide during the early COVID-19 pandemic: A preliminary report.

BACKGROUND: Prior to the novel coronavirus (COVID-19) pandemic, nurses died by suicide more frequently than the general population. Antecedents prior to death include known job problems, such as disciplinary action; diversion of medications; inability to work due to chronic pain; and physical and mental illness. AIM: The aim of this study was to explore the suicide experience of nurses who died with known job-related problems during the early phase of the COVID-19 pandemic compared to what has been previously described. METHOD: Deductive reflexive thematic analysis was used to analyze narratives of nurses with known job problems who died by suicide from the Centers for Disease Control and Prevention's National Violent Death Reporting System. RESULTS: Forty-three nurses with known job-related problems completed suicide between March and December 2020. Factors associated with death were similar to previous findings with notable exceptions, increased prevalence of suicidal ideation and post-traumatic stress prior to the event. Pandemic-specific issues were noted including reduction in hours, fear of disease transmission, civil unrest, and grief-related trauma. LINKING EVIDENCE TO ACTION: Suicide prevention programs need to address both institutional and individual factors associated with nurse suicide. As previously recommended, transitions into retirement and job loss are vulnerable times warranting psychological support. Further, strategies to reduce the impact of stressors and increase support for nurses are needed at the organizational level. A systems level approach to hardwire coping strategies is indicated pre-licensure and throughout nurses' careers. A new focus on how to process personal and professional grief is warranted. Resources are needed for nurses traumatized by life (rape, childhood trauma) or work-related experiences.

The Nurse Leader's Role in Nurse Substance Use, Mental Health, and Suicide in a Peripandemic World.

Nurses are known to be at an increased risk of death by suicide, and recent studies have found links between nurse suicide, substance use, mental health issues, and job problems. Because of stigma, inaccessibility of resources, and regulatory and legal issues, nurses are unlikely to seek help unless a crisis forces them into treatment. The purpose of this article is to review the current understanding of nurse suicide, the psychological impact of the novel coronavirus (COVID-19) pandemic, the strategic planning approach to identify the needs of nurses, and promising interventions and practices. Evidence-based strategies to intervene at the personal, institutional, and regulatory levels should be employed to reduce nurse suicide by focusing not only on suicide but also on treatment of substance and mental health issues, as well as a renewed focus on disciplinary procedures that may place nurses in immediate danger of death by suicide. Nurse leaders have a moral obligation to provide proactive, meaningful interventions to reduce the risk of death by suicide among nurses.