Nursing Diagnosis for Suicide Prevention: Practical Guidance for Clinical Care

Suicide is the 11th leading cause of death in the United States today, and pressures surrounding healthcare can quickly erode an individual’s mental health. People with chronic or terminal conditions are 35% more likely to commit suicide, medical costs are a daily stressor for 62% of cost-insecure families, and 1-in-3 hospitalized patients show significant symptoms of depression.

Nurses are often the first healthcare workers tasked with identifying and managing risk factors in vulnerable patients, and prevention often requires urgent, coordinated action from the entire care team. Making a nursing diagnosis for suicide prevention can be the difference between life and death, and courses like Suicide Prevention for Healthcare Providers empower healthcare professionals to catch subtle signs and make meaningful interventions.

What goes into a nursing diagnosis for suicide prevention? Here are the key risk indicators and how to manage them.

Nursing Diagnosis for Suicide Prevention

Nursing diagnoses are established based on a patient's unique symptomatology and signs, fostering an individualized plan of care. These plans should include measurable goals that support the patient along their unique continuum of recovery and incorporate appropriate interprofessional care.

Nursing diagnoses that support suicide prevention should account for a wide range of preexisting and observed factors that may influence a patient's risk level. The following diagnoses highlight the various psychological and behavioral factors that can contribute to suicidal ideation and attempts at self-harm.

Risk for Suicide

“Risk of suicide” is the primary nursing diagnosis for alerting a care team that urgent action and vigilance are required. It indicates that a patient is in imminent danger of self-harm, and is often correlated with one of the following factors:

• Previous attempts
• Acute mental health disorders (depression, anxiety, etc.)
• Substance abuse and withdrawal
• Stressful life events
• History of abuse

Nurses may identify a single risk factor or a constellation that suggests a patient might be at risk for suicide, even if they haven’t explicitly stated suicidal thoughts.

Other relevant considerations can include data points like age, race, socioeconomic status, or family history. AI tools may uncover valuable insights about how these factors interact when developing a diagnosis.

Hopelessness

Hopelessness is characterized by a subjective state where an individual perceives limited or absent personal choices and is unable to advocate or take action in support of their well-being.

Persistent or acute hopelessness is a significant precursor to suicidal ideation, and early identification and intervention through therapeutic communication and cognitive behavioral techniques can be effective in addressing this issue.

Ineffective Coping

This diagnosis indicates that a person is unable to manage stressful situations, emotions, or challenges effectively, leading to potential negative consequences for their health. This can manifest in various ways, including:

• Emotional distress
• Impaired decision-making
• Maladaptive behaviors like withdrawal or substance abuse

Nursing interventions can focus on developing new skills to manage stress and emotions effectively.

Chronic Low Self-Esteem

This diagnosis reflects a persistent and pervasive negative perception of one's worth, abilities, and acceptance, often accompanied by feelings of inadequacy and self-doubt. It is characterized by a negative self-perception, difficulties with self-acceptance, and a reliance on external validation.

Low self-esteem can contribute to suicidal thoughts and is often identified over time as care is administered. Nurses will need to listen closely to patient interactions and develop ongoing assessments of how self-esteem impacts health and care goals.

Social Isolation

Social isolation is an intrinsic problem in healthcare settings stemming from loneliness and/or an objective lack of social interaction. Building and strengthening social support networks can be crucial, as well as monitoring the trajectory of a patient’s emotional well-being.

Nurses can help alleviate social isolation by encouraging the patient to engage with friends, peers, family, or support groups.

Practical Guidance for Clinical Care in Suicide Prevention

Patients with a nursing diagnosis for suicide prevention are high-risk patients, and every aspect of their care should be critically evaluated to measure impact on safety and risk mitigation. A continuous assessment of interventions and their effectiveness, running parallel to good interdisciplinary communication, should have all members preoccupied with safety.

Risk Assessment and Identification

Nurses should use validated screening tools like the Ask Suicide-Screening Questions (ASQ) toolkit or the Columbia-Suicide Severity Rating Scale (C-SSRS) to detect suicidal ideation and behaviors.

Nurses should also conduct thorough and ongoing assessments to identify suicide risk factors and protective measures on an ongoing basis, prioritizing the following:

• Direct patient communication
• Active, empathetic listening
• Non-judgemental language
• Trust-building rapport

Ensuring safety

It’s not possible to have eyes on all patients every minute of the day, so environmental safety is paramount. Nurses must appreciate the significance of assessing the environment and mitigating environmental hazards such as ligature points or access to harmful objects.

Suicide precautions should be standardized and without compromise, inclusive of close observation and collaboration.

This should include personalized safety plans outlining coping strategies, identifying support systems, and creating a crisis response plan with emergency contact information.

Therapeutic interventions and support

Nurses working with mental health patients should be trained in de-escalating crises, providing immediate support, and connecting patients with appropriate resources and care.

As trusted members of the care team, nurses can educate patients and families about suicide warning signs, risk factors, and available resources, empowering them to actively participate in their care and recovery.

Collaboration and Advocacy

Nurses collaborate with mental health professionals, physicians, social workers, and other healthcare providers to ensure comprehensive and coordinated care. As a member of the care team, nurses should engage families and support systems in the treatment process, recognizing their vital role in providing support and fostering a safe environment.

Refine Your Nursing Diagnosis for Suicide Prevention

Nurses play a critical role in suicide prevention at multiple levels, from identifying individuals at risk to providing immediate support and advocating for long-term mental health care. Continuing education is central to developing a successful nursing diagnosis for suicide prevention, with coursework surrounding a wide range of developing mental health concerns.

Premiere is committed to ensuring that nurses have the training and skills they need to be effective advocates for suicide prevention. Courses on critical mental health topics like trans youth, chronic stress, and suicide risk all provide a life-changing foundation for evaluating patients and taking effective action.

All of Premiere’s award-winning courses are developed by industry experts and make developing your career and meeting your professional obligations as easy as finding a screen.

FAQs

What is the nursing diagnosis for suicide?

To diagnose a patient for Risk of Suicide, nurses will need to evaluate factors like previous attempts, mental health disorders, substance abuse, stressful life events, and abuse.

Precursors or indicators like hopelessness, ineffective coping, chronic low self-esteem, and social isolation may all contribute to a Risk of Suicide diagnosis.

What is the role of a nurse in suicide prevention?

Nurses play a central role in evaluating patients for suicide risk. A nursing diagnosis for suicide prevention should include assessment, treatment, and management strategies.

What is the number one priority for suicide patients?

Suicide precautions should be standardized and without compromise, inclusive of close observation and collaboration. Nurses need to coordinate care teams on personalized safety plans, including coping strategies, identifying support systems, and creating a crisis response plan.