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nurse suicide breaking silence

Nurse suicide: Breaking the silence

By: Lillee Gelinas, MSN, RN, CPPS, FAAN

More research and awareness are needed.

The recent sudden deaths of fashion designer Kate Spade and TV host Anthony Bourdain have propelled the topic of suicide into the headlines. These two celebrities were well-known, seemingly happy people with wealth, popularity, and social status who often were seen in public with smiles on their faces. We now know that concealed behind those smiles were uncontrolled depression and suicidal ideations, which in the end, claimed their lives. Knowing that their families and the public could be so fooled by their successful behavioral “cover-up” begs the question: What’s being hidden in plain view by our nursing colleagues?

Worldwide, one death by suicide occurs every 40 seconds, which means that more than 1,000,000 people die by suicide each year. In the United States, we know that 45,000 people died by suicide in 2016, up 30% since tracking began in 1999. And we know that suicide occurs across all professions. In June 2018, the Centers for Disease Control and Prevention (CDC) reported that suicide is a leading cause of death for Americans and warned that U.S. suicides are “increasing at an alarming rate.”

Suicide is called an alarming, silent, irreversible, and devastating mental health scourge. So why is a huge, developing health trend not getting a lot of public attention? What data do we have specific to the health professions and especially nursing? The answers lie between the headlines because numeric facts pertaining to nurse suicide in the United States are few.

nurse suicide breaking silence 350Alarming absence of U.S. data on nurse suicide

The United Kingdom, Japan, and Denmark have been tracking nurse suicide rates for over 10 years. In the United States, however, little credible data exist. To learn why, read the National Academies of Medicine 2018 paper “Nurse suicide: Breaking the silence”. I’m appalled at the state of the current science and data specific to nursing.

In today’s complex, chaotic healthcare environment, nurses have more and more responsibility, accountability, and pressure, and they’re expected to get their work done in less and less time. Caring and compassion come at a price. The high-pressure nursing environment, associated demands, and human impact (burnout, cumulative stress, and moral distress) are well-documented in research and literature, so is it any shock to know that despair, depression, and hopelessness can result? The American Association of Critical-Care Nurses, the American Nurses Association, and the American Organization of Nurse Executives have all called for action to optimize a healthy work environment. The urgency for that work couldn’t be greater.

Unfinished business, unfinished lives

Establishing the true incidence of nurse suicide in the United States is unfinished business for nursing. It will take profession-wide attention and action to fix the variation in reporting mechanisms, incomplete availability of nurse gender data, and the organizational silence that prevents acknowledging suicide when it occurs. One bright light is the San Diego County pilot of their Healer Education Assessment and Referral Program, which is being led by the University of California, San Diego. But we need a lot more. What else can we do to stop the scourge? How can we recognize the unfinished lives of the nurses who have died by suicide?

I’ve been touched by the suicide death of someone I never fathomed could have considered such an act. Don’t be fooled like I was. September is Suicide Prevention Awareness Month, but every day of every month is an important time to consider whether your colleagues are at risk. Check out the warning signs and watch for our continuing nursing education article on this topic in the October issue of American Nurse Today.

lillee gelinas msn rn cpps faan editor in chief





Lillee Gelinas, MSN, RN, CPPS, FAAN

Selected references

Bolster C, Holliday C, Oneal G, Shaw M. Suicide assessment and nurses: What does the evidence show? Online J Issues Nurs. 2015;20(1):2. 

Davidson J, Mendis J, Stuck AR, DeMichele G, Zisook, S. Nurse suicide: Breaking the silence. National Academy of Medicine. January 8, 2018.   

Kõlves K, DeLeo D. Suicide in medical doctors and nurses: An analysis of the Queensland Suicide Register. J Nerv Ment Dis. 2013;201(11):987-90.  

Office of National Statistics. Suicide by occupation, England: 2011 to 2015. March 17, 2017.    

Yazdi M. Suicide in nursing: Much more common than you think. Nurse.org. September 28, 2017.




  • Annie Dayton MSN RN
    March 22, 2023 10:46 pm

    My condolences to all of us experiencing the loss of friends and loved ones by suicide. The lack of research in the US speaks to the stigma associated with mental health in healthcare professions and in the US in general. Our ignorance regarding mental health has helped create the current culture of psychological peril. We’re all grieving right now, trying to recover from the pandemic. It seems to me we’re at a crossroads— continue punishing human fallibility , or admit that we’re all human and need to belong no matter what. We need the assurance we belong and are valued, no matter what.
    I think we’ve been focused so long as a profession on proving ourselves , we’ve lost sight of the goal — compassionate care. Easing suffering. Justice.
    We don’t need to prove anything more. Nurses are vital in every way. It’s ok to stop long enough to help a friend, a son/daughter, our partner. It has to be ok for us to be human.
    We’ve got to build this into our professional structure somehow, in order to go forward.
    I’m grateful to have discovered research on suicide by Drs. Halter and Davidson. They’re part of the solution. EVERY suicide is preventable. Suicide prevention is Now, and Here, and in your town too. Please let’s act, now.
    friendsforsurvival.org; compassionate friends.org (for parents who’ve lost a child).
    We can do better.

  • Cynthia Saver
    August 28, 2019 5:12 pm

    Laura, I am so sorry for the loss of your colleague. Unfortunately, it’s not always possible to know that someone needs help, and even when you see that someone is hurting, the person may not agree to get help. One thought for moving forward is to ensure staff know about the American Foundation for Suicide Prevention (https://afsp.org/), which has a lot of resources that might be helpful. I hope you will also reach out to talk to someone about the pain you are feeling. Again, my sincere condolences on the loss of your friend.
    Cynthia Saver, MS, RN, editorial director, American Nurse Today

  • Laura Rita Santoro
    August 28, 2019 4:08 pm

    I thank you for your article, and the insights are very interesting.
    I was just a qualified nurse, I was enrolled in the specialization. I received a shocking call. They had looked for me. A friend and colleague of mine had a problem.
    I didn’t seem to want to understand. A present friend, Laura told me, is serious.
    We were all nurses and unemployed, with few prospects. I had already thought, if my friend is serious, we will organize assistance shifts, which not even the President of the Republic, could not aspire to so much.
    But my friend was already dead. The relatives were looking for me, to know if I had heard it recently? They were looking for me to know if I understood, did they have suicidal intentions?
    We are nurses, we study to help others, but I did not understand that my friend and colleague needed help! During the funeral we cried, and we said, we don’t find work, but we have learned to commit suicide! My colleague had committed suicide with the exhaust pipe of her car with carbon monoxide.

    Could I have done something?

  • Tsitsi Muhoma, RN BSN, DNP student
    October 15, 2018 1:04 pm

    I am writing in response to the September 2018 editorial piece “Nurse suicide: Breaking the silence”. As a practicing nurse, this article echoed my experiences of losing friends and colleagues to suicide. I am appalled at the lack of resources that deal with such tragedies at institutional levels and am concerned that the profession which is front-line in the interaction and identification of individuals at risk for suicide, does not have adequate resources to support their own. The stigma of suicide is perpetuated by a lack of acknowledgement of such losses and paucity of research (Davidson et al,2018; Odom-Forren, 2018). In addition, nurses are not adequately trained to assess, evaluate, treat or refer patients with suicidal tendencies (Odem-Forren, 2018; Bolster et al., 2015), and they may have poor attitudes, decreased knowledge, and indifference to patients, adding to the negative outcomes in health care delivery (Bolster et al., 2015).
    Nursing leaders must play a significant role in decreasing the risk of suicide by nurses by proactively addressing stressors identified in the work environment (Davidson et al., 2018). They must encourage, support, facilitate, fund, and implement programs to support nurses in gaining knowledge in suicide risk assessment and prevention. Educational training regarding risk factor identification, grief counseling after unexpected loss, crisis support, and promotion of well-being programs to assist nurses in reducing burn out are paramount. Suicide training will allow nurses to be confident and knowledgeable in dealing and communicating therapeutically with individuals and colleagues at risk for suicide.

    Bolster, C., Holliday, C., Oneal, G., & Shaw, M. (2015). Suicide Assessment and Nurses: What Does the Evidence Show? Online Journal of Issues in Nursing, 20(1), 1.

    Davidson, J. E., Stuck, A. R., Zisook, S., & Proudfoot, J. (2018). Testing a Strategy to Identify Incidence of Nurse Suicide in the United States. Journal of Nursing Administration, 48(5), 259–265.

    Gellinas, L. (2018) Nurse Suicide: Breaking the silence. American Nurse Today,13(9), 6.

    Odom-Forren, J. (2018). Suicide and Nurses. Journal of PeriAnesthesia Nursing, 33(4), 363–365.

  • Lois Williams MN, RN
    September 18, 2018 5:25 pm

    I have been a nurse manager for 19 years. I have had three nurses commit suicide and the awful feeling that happens when you get that call in the middle of the night that one of your nurses has been brought in with gun shot wound to the head. Then there was the call two days before Christmas that one of your nurses was found dead in her car at a rest stop along the freeway, or the call I had to make to the local police to do a welfare check on a nurse who failed to show up to work, and than find out she had hung herself. These nurses will ever be etched in my mind and thoughts, the grief their families felt, their co-workers and patients who knew them well. We have got to bring nurse suicide to the forefront and perhaps require training to nurses about the warning signs. We need to understand that the pressures of the job are high and we need to proactively encourage our nurses that it is okay to seek help and it’s okay to feel the pressure of their job. We need to help them be okay with reaching out instead of reaching for a gun, pills or ropes. They need our help.

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