Supporting Nurse Leaders to Recognize and Intervene in Team Members' Suicidality

Abstract

Introduction: Nurses and healthcare support staff have a higher suicide risk than the public. This elevated risk calls for increased efforts to support mental health. Additionally, nursing leaders' education on employee-specific suicide prevention is lacking.

Design: An evidence-based project was implemented using the PICO question: Among nurse leaders at an academic healthcare system in California, does the provision of an educational program using role-playing practice and the creation of a suicide prevention toolkit versus no standard education or training improve self-efficacy and knowledge on how to take action with a team member who is suspected of being suicidal or voicing suicidal ideation?

Methods: Education sessions were planned based on the literature, with surveys collected preintervention, immediately posteducation, and 1-month postintervention to assess suicide prevention self-efficacy and knowledge. Knowledge was measured using a researcher-constructed questionnaire validated by six suicide prevention experts. The General Self-Efficacy Scale (range: 10-40) was used.

Results: Sixty participants attended one of 11 scheduled remote-learning sessions. Mean self-efficacy significantly improved (pre: 31.3 [n = 46, min: 18, max: 40]; immediate post: 33.49 [n = 37, min: 24, max: 40]; 1-month post: 33.77 [n = 31, min: 28, max: 40]) (X ² = 8.0184, df = 2, p = 0.01815). The proportion of incorrect knowledge questions was significantly lower postintervention (mean pre: 24.5%, immediate post: 11.5%, 1-month post: 10.7%, X ² = 23.195, df = 2, p = 0.000001). All participants (100%, n = 55) recommended the program. Leaders reported feeling better prepared to support suicidal employees.

Conclusion: Project results demonstrate the need to provide suicide prevention training for leaders. The authors recommend requiring training/return demonstration competency as a component of new leaders' onboarding. This program can easily be modified for nurses from prelicensure through senior leadership.

Clinical relevance: Suicide rates in healthcare members are higher than those of the general population. Suicide prevention programs can help nursing leaders feel better prepared to support and connect at-risk healthcare workers with resources.

Keywords: mental health; nursing leader; role play; self‐efficacy; suicide; workplace wellness.

FIGURE 1

Nursing leaders' increase in self‐efficacy scores. Average scores: Presurvey: 31.3 (n = 46), Postsurvey #1: 33.49 (n = 36), Postsurvey #2: 33.77; Postsurvey #1 = Immediately following intervention; Postsurvey #2 = 1‐month postintervention; Scale range = 10–40. Range of scores decreases over time, with mean moving in the right direction demonstrating retention of confidence.

FIGURE 2

Proportion of incorrect answers on each survey. Dark Bar = Percent correct answers; Light Bar = Percent incorrect answers; Postsurvey #1 = Immediately following the intervention; Postsurvey #2 = 1‐month postintervention.