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. 2020 Feb;17(1):6-15.
doi: 10.1111/wvn.12419.

A Longitudinal Analysis of Nurse Suicide in the United States (2005-2016) With Recommendations for Action

Judy E Davidson  1   2 , James Proudfoot  3 , Kelly Lee  4 , Garni Terterian  5 , Sidney Zisook  2
Affiliations

A Longitudinal Analysis of Nurse Suicide in the United States (2005-2016) With Recommendations for Action

Judy E Davidson et al. Worldviews Evid Based Nurs. 2020 Feb.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Worldviews Evid Based Nurs. 2020 Apr;17(2):180. doi: 10.1111/wvn.12427. Epub 2020 Mar 29. Worldviews Evid Based Nurs. 2020. PMID: 32267615 No abstract available.

Abstract

Background: Previous studies have demonstrated nurses are at risk of suicide. This is the first national longitudinal study of U.S. nurse suicide.

Aims: To identify the longitudinal incidence, method, and risks of nurse suicide in the United States.

Methods: 2005 to 2016 Centers for Disease Control and Prevention National Violent Death Reporting System retrospective analysis of suicide incident rate ratios (IRR).

Results: A total of 1,824 nurse and 152,495 non-nurse suicides were evaluated. Nurses were at greater risk of suicide than the general population (female IRR 1.395, 95% confidence intervals [CI] 1.323, 1.470, p < .001; male IRR 1.205, 95% CI 1.083, 1.338, p < .001). Female nurses who completed suicide did so most frequently by pharmacologic poisoning (n = 399, 27.2% vs. n = 8,843, 26.9%), whereby male nurses and the general public used firearms (n = 148, 41.7% vs. n = 57,887, 48.4%). Job problems were more likely in nurses (female odds ratio [OR] 1.989, 95% CI 1.695, 2.325, p < .001; male OR 1.814, 95% CI 1.380, 2.359, p < .001), as well as mental health history (female OR 1.126, 95% CI 1.013, 1.253, p < .027; male OR 1.302, 95% CI 1.048, 1.614, p = .016) and leaving a suicide note (female OR 1.221, 95% CI 1.096, 1.360, p < .001; male OR 1.756 [1.412, 2.181], p < .001).

Linking evidence to action: The increased risk of suicide in nurses is congruent with previous reports. The consistency in results increases confidence that findings are generalizable and warrant action. The use of pharmacologic poisoning as a method of suicide, most often by opioids and benzodiazepines, indicates a need for improved identification and treatment of nurses with substance use. Workplace wellness programs need to focus on reducing workplace stressors. Further research is indicated to determine best prevention methods. Policy indications include the need to accurately track gender in nursing, enhance substance use disorder programs, and mandate suicide prevention activities.

Keywords: burnout; depression; firearms; mental health; poisoning; substance use disorder; suicide; workplace wellness.

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References

    1. Accardi, R., Sanchez, C., Zisook, S., Hoffman, L., & Davidson, J. (2020). Sustainability and outcomes of a suicide prevention program for nurses. Worldviews on Evidence-Based Nursing, 17(1), 24-31.
    1. Alexander, M. J., Kiang, M. V., & Barbieri, M. (2018). Trends in black and white opioid mortality in the United States, 1979-2015. Epidemiology, 29(5), 707-715.
    1. American Foundation for Suicide Prevention (2017). Suicide statistics. Retrieved from https://afsp.org/about-suicide/suicide-statistics/
    1. Anonymous. (2018a). Depression and substance abuse: The danger of being strong for far too long. American Nurse Today.
    1. Anonymous. (2018b). Heart, soul, and redemption: My journey to addiction - and back. American Nurse Today, 13(2). Retrieved from americannursetoday.com/blog/my-journey-to-addiction-and-back

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