Suicide is one of the most troubling and challenging subjects in modern-day Canada. It begets more questions than answers, brings forth social challenges beyond a society’s ability. Suicide leaves misery, perplexity, pain within the community, and especially the friends and family to the one who commits suicide (Public Health Agency of Canada, 2020). What makes life have significant meaning in the face of adversity and hardship? What makes an individual face the courage of taking their life? Although it is an indicator of collective and personal suffering, suicide demands exceptional attention due to its finality and severity. According to the health department, suicide is the leading cause of death among adolescents, with males leading at 75 percent ( Lewis, 2017) . Pediatric nurses are faced with these rising numbers and are at the forefront of helping grieving families and attempted suicide cases. The paper will integrate and review study literature to come to terms and understand the primary causes and origin of suicide and also identify real interventions. Pediatric nurses face mounting challenges in coming up with evidence-based healthcare solutions to helping suicidal patients and their close family members.
Challenges Pediatric Families and Nurses Face
Accepting the reality of suicide is challenging, especially to family members and nurses. The truth of a departed one often leaves many unresolved health and social issues. Family members are faced with the reality of accepting a loss. They are also faced with the fact that maybe they could have helped but failed. Pediatric nurses often face the difficulty of handling attempted suicide and helping families faced with a suicidal case. Suicide raises the fundamental question about the value of life and living to family members. According to Lewis (2017) pediatric nurses have to contend with the reality of finding a way of helping distressed families and patients who, at one time, attempted suicide. There is no medicinal solution to attempted suicide, and nurses have to weigh complicated options of helping patients and the family faced with a suicide case. With the high rate of suicide among the youth, nurses have to find ways of handling suicidal attempts in addition to helping families faced with a suicidal case.
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In the recent past and with arising complex life challenges, adolescents suffer significantly from the rapid increase in suicide rates in Canada. Bounds, Edinburgh, Fogg & Saeywc (2019) argued that although the rate among other populations is steady or dropping, the suicide rate among adolescents has continued to rise. From ages ten to nineteen, an adolescent is twice as likely to commit suicide as compared to adults. Boys are the most affected. Girls record a high rate of self-harm. More than a third of all death cases among adolescents are attributed to self-inflicted death ( Lewis, 2017) . Despite attempts by both the government and social grouping, there is still no formidable solution to the high rate of suicide among the youth. According to the Canadian Vital Statistics Death Database, the rate of boys committing suicide is high as compared to females. The agency recounts that there are approximately 11.5 deaths per one thousand people. The pattern is high in the country and is mainly attributed to high-stress levels.
Suicide is a self-inflicted death. It results from a direct or indirect action that produces death to the victim. Although the definition of suicide is pretty clear, the assumption is that people understand their efforts at the point of inflicting an action that will result in death. In many cases, there is never a way of reconstructing the certainty of an adolescent intending or thinking about death ( Bounds et al., 2019) . Even to the people around the person, it is never satisfied to pick out definite actions that point to death. Clinically, an adolescent pin-point multiple conflicting or complicated intentions that are modified in the course of their recovery, which in most cases, is often aimed at distancing themselves from the act.
Some suicides are linked to intentional accidents that point to death due to life’s miseries and pain. However, some of these accidents intended by a young person may give forth not an avenue to other primary causes (Public Health Agency of Canada, 2019). In some cases, that result from self-harm such as poisoning or hanging, researchers attempt to conjure the conduct of the type of suicide the victim intended. In many cases, it often points to a self-destructive intent that cannot be affirmed. An adolescent may be caught in various types of self-destructive acts that may not point to their intention to commit suicide ( Lewis, 2017) . However, the majority of suicidal attempts and conducts entail varying levels of incongruity whereby the adolescent in question may either want to die or look forward to relief or rescue.
Nursing Interventions
Pediatric nurses have specific roles in preventing and providing patient-level intervention and systems to reduce suicide cases among adolescents. The nurse will give a close assessment at the systems level and uphold a safe environment practice zero suicide practices such as training other staff and coming up with relevant policies and protocols. The nurse will also assess a patient’s risk level and develop psychotherapeutic intermediations. A close observation of the intervention outcomes will be critical ( Bounds et al., 2019) . The nurse will also closely supervise systems put in place to counter any suicidal attempt. These critical competencies offer a strong foundation of keeping the nurse aware of a suicidal attempt at the healthcare facility, deploying the appropriate attitude, skills, and knowledge.
A risk assessment is also a critical tool for judging a patient with a high risk of committing suicide. The nurse will play a crucial role in formulating the best policy of assessing patients most at risk (Public Health Agency of Canada, 2019). The nurse will also develop a gender, cultural, and developmental strategy to counter suicide issues. It is also essential for the nurse to thoroughly and accurately document all suicide based risks and understand the ethical and legal matters related to suicide. The nurse needs to undertake an on-going evaluation of the environment to determine safety levels and make changes appropriately. At the same time, Lewis (2017) argued that the nurse must establish an on-going plan of continuous assessment that involves maintenance, management, and evaluation of patient safety (Health at a Glance, 2017). The nurse should also develop a comprehensive individualized plan that puts into consideration the family members, family, patient, and all the relevant persons. The nurse should support and motivate all patients while engaging in all facets of healthcare services.
The pediatric nurse should also enhance the collection of precise evaluation details and communicate all the threat factors to the appropriate persons and treatment team, such as duty M.D. and nursing supervisor. A risk assessment will contain information that includes full suicidal inquiries, protective factors, risk factors, current triggers, history of self-inflicted harms, and injuries. Through this, the nurse will formulate a clear evaluation program that will determine the degree of risk. A long and short term program will help prioritize and integrate plans for the intervention measure. According to Lewis (2017) through the long/short term evaluation, the nurse will manage individual beliefs, attitudes, and reactions. The management will involve demonstration of self-awareness towards the suicidal situation, accepting and regulating one’s emotive responses, and participating in the effect analysis or RCA (root cause analysis) in the case of suicide attempt or death. In the management of one’s beliefs and reactions, the nurse will examine the overall effect on the patient’s understanding and emotional response (Public Health Agency of Canada, 2019). It is critical to participate in all briefings that involve the patient’s situation while at the same time maintaining professional supervision and assistance towards the case.
The nurse should also try to focus on the patient’s mental well-being and ways of preventing psychological complications. A nurse needs to respond to face the many situations that involve health needs, mainly with a focus on improving care needs such as effective therapeutic interventions that include close attention and the application of a psychosocial model of engagement. A step by step intervention program will entail;
Neurological Assessment
Initiation of a one on one monitoring program- Patient should never be left alone
Creation of a safe environment devoid of harmful objects, electrical cables, and sharp objects ( Bounds et al., 2019)
The patient should be encouraged to discuss anxieties, emotions, and feelings- this is to help in determining the patient’s mental processes and thoughts
The nurse should emphasize resiliency by assisting the client in dealing with the situation
Assess any attempts of the patient planning to commit suicide
Assist the client in signing a “no-suicide” attempt
Administer effective medications with care ( Lewis, 2017)
Through these, the nurse will help a patient handle the suicidal attempts, and with collaborative efforts from a professional team, the nurse should work with the patient’s family members jointly.
Conclusion
Pediatric nurses have a delicate task in dealing with suicidal cases. Due to the many challenges linked to suicidal cases involving adolescents who have the highest rate of suicide in Canada, nurses have to face the challenge of coming up with realistic intervention strategies to help both the suicidal adolescents and their immediate family members. These involve incorporating practical and evidence-based assessment policies that help in monitoring the patient and helping them overcome their negative mindset. Working together with other professionals and the immediate family members helps the nurse establish strategic management and intervention practices that put the interest of the suicidal adolescents at heart. Despite the challenges of poor mental well-being, the nurse has to provide the best intervention measures and practices to help the adolescents and immediate family members.
References
Lewis, A. (2017). Suicide Prevention and Mental Health Initiatives for Inuit Youth in Canada. https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1013&context=undergradawards_2017
Bounds, D. T., Edinburgh, L. D., Fogg, L. F., & Saeywc, E. M. (2019). A nurse practitioner-led intervention for runaway adolescents who have been sexually assaulted or sexually exploited: Effects on trauma symptoms, suicidality, and self-injury. Child abuse & neglect , 90 , 99-107.a
Public Health Agency of Canada. (2019, July 22). Government of Canada. Retrieved February 19, 2020, from https://www.canada.ca/en/public-health/services/suicide-prevention/suicide-canada.html
Public Health Agency of Canada. (2020, February 10). Government of Canada. Retrieved February 19, 2020, from https://www.canada.ca/en/public-health/services/publications/healthy-living/suicide-canada-key-statistics-infographic.html
Health at a Glance. (2017, June 16). Retrieved February 19, 2020, from https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article/11696-eng.htm
