When Studying Mental Illness in Nurses Means Studying Yourself

Carrying the burden of depression as a nurse.

As I read Anna’s (not her real name) description of how much effort it took to drag herself into work, how much she felt like a burden to her family, and her fear of being “found out,” tears welled up.

“I know,” I said to myself.

I was analyzing an interview transcript for a qualitative study of psychiatric-mental health nurses (PMHNs) who have experienced mental illness. More specifically, my colleagues and I wanted to know how their illnesses impacted their work as nurses.

I have been a PMHN for over 40 years, with an even longer experience of a mental illness. I recognized many of the participants’ stories in my study as my own, but none affected me the way hers did. An alarm bell inside my head went off. If I couldn’t create a clear boundary in my mind between Anna’s experiences and my own, I might be at risk of unduly influencing the study results.

Reflecting on shared experiences of depression.

I was grateful that a colleague was also analyzing these transcripts; to minimize the effects of my own potential bias, I took the opportunity to write down my thoughts and feelings in my reflexivity journal. This is […]

2023-02-02T10:33:57-05:00February 2nd, 2023|mental illness, Nursing, patient experience|1 Comment
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We Haven’t Made You Better: Orthopedic Trauma and Emotional Healing

Learning that healing the body isn’t always enough.

For much of my career as a trauma ICU nurse and orthopedic trauma nurse practitioner, I focused on building my knowledge of pathophysiology and mastering the assessment and procedural skills required to care for trauma survivors. After a decade of practice, I felt like I had entered the “expert” phase of clinical competence described by Dr. Patricia Benner in AJN in 1982.

But I was completely ignorant of a giant hole in my practice. A trauma survivor pointed out this gap during a routine clinic visit. Ms. H was six months removed from an ankle fracture she’d suffered in a motor vehicle collision on her way to work one morning. On exam, she had regained full strength and range of motion, the fracture was healed on radiographs, and her pain was limited to a minor ache after extended activity. She’d healed remarkably.

I told her that she had done an excellent job with her recovery and could resume her life, including going to work. I’ve come to believe that Ms. H’s response to this assertion changed my entire perspective on patient care. “I can’t go back to work,” she said. “Since the accident, I can’t get in a car without having panic attacks.”

I […]

2022-09-16T11:39:37-04:00September 16th, 2022|Nursing, nursing research, Patients|0 Comments
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Children’s Mental Health Crisis Reveals Holes in System

You don’t have to look far for evidence that the mental health of children and adolescents has been entering a crisis in recent years, one exacerbated by the unusual conditions imposed by Covid-19.

The June 18 Morbidity and Mortality Weekly Report (MMWR) from the CDC reported:

During February 21–March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17 years, suspected suicide attempt ED visits increased 3.7%.

Photo by Yasser Chalid/Getty Images

As noted in a recent Washington Post story, “Emergency departments have meanwhile become a tattered safety net for adolescent mental health care.”

In this month’s AJN, Betsy Todd summarizes some of the current issues seen by school nurses and other health care professionals like nurse practitioners (NPs), who often feel overwhelmed by the intensity of the suffering and need they are now seeing in many children.

Systems pushed to their limits.

Todd notes that existing systems are proving woefully inadequate to the growing need, with wait times increasing to see child psychiatrists, therapists, and other experts, and pediatric hospitals in several states reporting “sharp increases in ED visits for anxiety, depression, […]

2021-09-03T12:37:10-04:00September 3rd, 2021|mental illness, Nursing, pediatrics|0 Comments
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Addressing Clinician Mental Health and Suicide Risk During the Pandemic

Pandemics are known to cause panic disorder, anxiety, depression, sleep disturbances, and posttraumatic stress. Depression can lead to suicide if not treated, yet is a treatable disease. We have seen nurses die by suicide during this pandemic in Italy.

Past experience suggests that health care workers exposed to the stress of the pandemic will need help long after the pandemic is under control.

I am serving as co-chair of the Strength Through Resilience task force of the American Nurses Association, whose focus was originally to collate resources to reduce suicide among nurses. We quickly shifted gears when the pandemic hit to collate resources to optimize resiliency and mental health among nurses in relation to the projected impact of the pandemic. Curiously, these resources are virtually identical. The ANA has posted initial resources as part of their Healthy Nurse, Healthy Nation campaign and is and building more resources as quickly as possible.

Nurses already at higher suicide risk.

The added stress of the pandemic is particularly problematic because of evidence that emerged before the pandemic that nurses were at higher risk of suicide than the general public. If leaders at health care organizations have not already started proactively screening […]

2020-05-12T16:27:31-04:00May 12th, 2020|COVID-19, mental illness, Nursing, Public health|0 Comments
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Suicide Among Nurses: Poorly Documented and Unacknowledged

Photo © Wavebreakmedia Ltd UC25/ Alamy Stock Photo

When we all worked eight-hour shifts, “my” shift was evenings. Most nights I reported off to the same night nurse, a woman about my age who was an excellent nurse and also simply a nice person to be with. One evening I came to work to learn that my new friend would not be at work for a while. She had tried to kill herself.

A surprising lack of suicide data for nurses.

Did you know that there are national data on the suicide rates of physicians, teachers, police officers, firefighters, and military personnel, but none pertaining to suicides of nurses? Or that many hospitals have long offered screening for suicide risk to medical staff and medical students, but not to nurses? The lead news story in this month’s AJN, “Suicide Among Nurses,” highlights these and other findings of a recent National Academy of Medicine discussion paper, “Nurse Suicide: Breaking the Silence.”

Many reasons for this silence.

Judy Davidson, a nurse scientist at the University of California San Diego and the lead author of this paper, points out that there are many reasons for the silence around this issue. She notes that suicide data in general […]

2018-08-20T09:32:01-04:00August 20th, 2018|Nursing|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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