Nurse suicides have been high during the pandemic, but the feared wave never materialized

According to a large retrospective cohort study, female nurses’ suicide risk remained higher but did not become worse than that of other women due to the COVID-19 pandemic.

Female nurses had 21% and 41% higher suicide rates than their counterparts in the general population in the pre-pandemic years of 2018 and 2019, respectively, researchers led by Judy E. Davidson, DNP, RN, of the University of California at San Francisco found Diego.

During the pandemic, incidence rates were in the same range: 26% higher for female nurses versus female non-nurses in 2020 and 35% in 2021. All comparisons between the two groups were statistically significant.

By comparison, suicide rates among male nurses were similar to those among male non-nurses during the period covered by the study published in the Journal of Nursing Administration.

Given the overwhelming stress of the pandemic, “we expected an increase,” Davidson said via email. The lack of a pandemic-related increase in suicides among female nurses could be due to a host of factors, she said.

“You can imagine from the early pandemic there was a lot of angelic and heroic praise… that could have been temporarily protective,” Davidson said. MedPage Today. Furthermore, “those who ‘caught the fire’ could have been stronger and less burned out, diluting the overall risk of others,” she noted.

Another “troubling possibility” is a potential protective effect of courts closing early in the pandemic, temporarily pausing nursing discipline, she said.

In her group’s study of the CDC’s National Violent Death Reporting System (NVDRS) data, nurses were more likely to experience mental health problems, work problems prior to suicide, and poison themselves, with adjusted odds ratios of 1.28, respectively. 1.60 and 1.54. (all P

Work-related problems, which have also been linked to suicide among nurses in previous studies, often involve discipline by nurses or employers and premature separation from the workforce, Davidson pointed out.

She wondered whether a more “holistic treatment first” approach, such as those involving treatment leave, would reduce the number of suicides linked to substance abuse and the disciplinary process.

An important next step will be to study treatment policies versus termination, she said.

Davidson also urged reauthorization of the Dr. Lorna Breen Health Care Provider Protection Act to renew funding for evidence-based strategies to prevent suicide and address burnout, mental health issues and substance use disorders.

At the very least, any drug abuse disciplinary policy needs a “baked-in” suicide prevention plan and psychological support for everyone involved in an investigation, she said.

In addition, she urged nursing boards to adopt licensing questions that are consistent with the Americans With Disabilities Act (ADA) protections against discrimination for physical and mental disabilities. A 2019 survey found that 22 of 30 nursing boards ask non-ADA-compliant questions, and a 2024 survey found the situation has not improved.

K. Jane Muir, PhD, RN, FNP-BC, of ​​the University of Pennsylvania School of Nursing in Philadelphia, emphasized the need to strengthen safeguards for nurses, given their higher suicide rates than the general population.

“Support by employers of nurses through safe nurse staffing levels and improving reporting and prevention of workplace violence are actionable solutions,” she noted, as are flexible schedules, generous family leave policies and financial incentives for difficult serviceable employees. shifts.

The retrospective cohort study was based on suicide data from the NVDRS from 2017 to 2021, which drew from death certificates, medical examiner reports, and law enforcement reports for an anonymous dataset detailing demographics and the substances used in suicide.

A total of 1,368 suicides among nurses and 104,576 suicides among the general population among persons aged 21 years and older were identified by reported gender and state. Relatives for whom gender information was missing were excluded.

A limitation of the study was that the analysis included a limited number of jurisdictions that met the NVDRS reporting threshold – 30 states – and only limited information collected from death investigations, so it may not be nationally representative. Additionally, normal sources of NVDRS data may have been overwhelmed during the pandemic, leading to coding errors or underreported suicides.

The authors suggested that further research on survivors of suicide attempts could help clarify the risk and protective factors.

If you or someone you know is considering suicide, call or text the 988 Suicide and Crisis Lifeline.