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Definition of Suicide:
- Intentional act of killing oneself
- Permanent solution to a temporary problem.
- Once a suicide risk, always a suicide risk.
- Suicidal people only want to hurt themselves, not others
- People who talk about suicide never commit suicide
- There is no way to help someone who wants to hill himself or herself
- Mentioning suicide will make a person more suicidal
- Genetic and biologic theories
- Sociological theories
- Psychological theories
- Theory of parasuicidal behavior
Incidence and Prevalence:
- 30,000/year are successful
- 8-10 times higher for attempts
- 72% of suicides are men
- women are 4 times more likely to attempt
- Spring on Monday on antidepressants = more energy to accomplish the task
- 1 out of every 10 persons entertains recurrent or persistent thoughts of suicide
The first two years after an attempt represent the highest risk period, especially the first three months.
- Psychiatric disorders
- Chronic medical illnesses
- Environmental factors
- Social factors
- Family hx
- History of previous attempt
- Warnings of suicidal intent
- Risky behaviors
- Lethality assessment
80% of persons attempting suicide give clues (verbal, behavioral or situational)
Required close observation and acute listening.
Questions to ask?
- Have you had thoughts that life is not worth living?
- What worries do you have?
- Do you want to die?
- Do you have a specific plan? If so, what is your plan?
- What keeps you from acting out your plan?
- Have you attempted suicide before? If so, how so.
- Risk for injury r/t a recent suicide attempt
- Risk for suicide r/t state desire to
- Risk for violence: self directed r/t multiple losses
- Impaired social interaction
- Ineffective coping
- Chronic low self esteem
- Using an authoritative role
- Providing a safe environment
- Creating a support system list
The overall goals are first to keep the client safe and later to help him or her to develop new coping skills that do not involve self harm.
The nurse must indicate unconditional positive regard not or the act but for the person and his or her desperation. The nurse must monitor his or her feelings and reactions closely. Unless the client is suicidal or is experiencing a crisis, the nurse does not try ot solve the client's problems.
- Suicide prevention
- Suicide precautions
- No suicide contract
- Seclusion and restraint
Legal ethical Issues:
Physician assisted suicide
What would you like to do?
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