A Review of Nurse Suicide in the United States

This week we will be discussing an article published in the Journal of Worldviews on Evidence-Based Nursing. The article is titled A Longitudinal Analysis of Nurse Suicide in the United States (2005-2016) With Recommendations for Action. In this article, authors Davidson, Proudfoot, Lee, Terterian, and Zisook use a longitudinal study design to retrospectively analyze nurse suicide in the United States. 

What did they do?

Using data collected between 2005 and 2016 from the Centers for Disease Control and Prevention (CDC) National Violent Death Reporting System (NVDRS), the authors conducted a retrospective analysis of suicide incident rate ratios (IRR) to identify the longitudinal incidence, method, and risks of nurse suicide in the United States. 

Why did they do it?

According to the World Health Organization and the American Foundation for Suicide Prevention, the rate of deaths by suicide are increasing in the United States. While there is a large body of literature examining suicide in the general population, there is an apparent gap in the literature with regard to evaluating suicide risk in a population of nurses. Accordingly, the authors of this study aimed to investigate the incidence and risk of nurse suicidality using national data, and to explore social and mental health risks of nurses who died by suicide compared the broader population.

How did they do it?

As explained by the authors, this study was conducted as an exploratory, descriptive, retrospective, longitudinal analysis of the CDC NVDRS dataset between 2005 and 2016. In total, data from 1,824 nurses and 152,495 non-nurses who died by suicide were included in analyses. The authors analyzed 34 dichotomous categorical variables related to the social and mental health characteristics of the included sample, and calculated odds ratios and 95% confident intervals for each determinant of suicide. 

What did they find?

General demographic results indicated that nurses who died by suicide were similar to the general population with the exception of age and racial profile. Specifically, nurses who died by suicide were slightly older on average, and relative to general population, fewer non-White nurse died by suicide. Additionally, a greater proportion of female nurses died by suicide than females in the general population. Both female and male nurses were also at greater risk of suicide than the general female and male population. 

Relative to social and mental health risk, both female and male nurses were more likely to experience job problems compared to the general population. Nurses who died by suicide were also more likely to have a history of mental health difficulties and were more likely to have left a suicide note. We encourage you to read this study to see all of the potentially meaningful variables the authors examined.

In their analysis, the authors also included data on methods of suicide. Overall, they found that female nurses completed suicide using different methods than male nurses. Females nurses most commonly utilized pharmacological poisoning), whereas male nurses typically utilized firearms. The authors note that while male nurses were significantly more likely to use firearms, the incidence of female nurses using firearms as a method of suicide may be rising. 

What does it all mean (our take)?

We thank the authors for this important review. Suicide continues to be an important topic for the general public, and is clearly critically important among subfields of our population. Here, nurses are identified as being a high risk group of individuals. A group that has devoted their careers to the helping of others...we must continue developing approaches to provide them with assistance.

This is not to say that great developments are not being made - as our knowledge about suicide risks and potential intervention seems to be improving on a daily basis. We just need to continue pushing forward and working together...which we will undoubtedly do!

As a sign off - thank you to these authors and all of the researchers and clinicians working tirelessly to combat suicidality in our country and around the world. Your hard work will change the world and we are thankful for all of your efforts!