The Impact of Losing a Patient to Suicide

“Healer, heal thyself”

When we become nurses, we witness the beginning of life as well as the end. In many specialties, it can be common and we learn to process the loss. I’ve worked in the ER, the rational brain knows some injuries are just not survivable. I spent a year in the NICU and shared in the heartbreak of parents but also understood the odds stacked against the tiniest of patients. In primary care, age and natural disease process could be anticipated and understood.

But no one talks about the loss of a patient in mental health. My first experience was as a green ER nurse. A quiet, reserved young man came in with suicidal ideation. He was polite, wished to remain a silent patient and cooperated with the assessment process. I provided a warm blanket, sandwich and compassionate care. The mental health team deemed he was not in imminent danger and he was discharged. Just a few days later we learned he left the hospital and completed suicide. I will never forget his face 15 years later even though we spent only a few hours together.

This week as a nurse practitioner, I lost a patient that I cared for for over a year. They had a difficult past and had been through every level of care. We worked hard to find the right medication regimen but as we know, they come with unpleasant side effects and feeling disconnected. We met just a few weeks ago and they seemed optimistic. Then I got the call no provider can prepare for, their mother let us know they had died by suicide the night before. I was absolutely gutted. They were my kids’ age. They sat across from me so many times, some days at their lowest and others with a confidence for the future. But as we all strive for, I thought I could make a difference.

I left for the day, unable to process all of the emotions and tried to go back to care for my other patients two days later. Halfway to the office, I had a complete breakdown. I pushed down the emotions and thought I could do it. But you know what, I couldn’t. And that’s ok.

We recite the mantra, it’s ok to not be ok. But then when we as mental health professionals are not ok, we shove it down deep and push on.

This is what burnout does. 17 years as a nurse and I’m tired. A level of fatigue that can’t be put into words. Self-care isn’t bubble baths, girls’ nights out and the other lies we tell ourselves

Self care is knowing when to step back. Take a break. We put years in to our education and feel like a quitter, too weak if we

consider leaving a profession we chose. Caring for patients that are at their lowest, darkest days. Vicarious trauma and real trauma happens every day. And it’s something rarely talked about, whether in nursing school or two decades down the line.

So yes, it’s ok to not be ok

But it’s also ok to say, my wellbeing is more important than the ones I am tasked to care for.

Sincerely,

A Tired Nurse