Strategies to Care for Patients Being Treated in the Emergency Department After Self-harm: Perspectives of Frontline Staff

Experiences of nursing care for patients who self‐harm and suggestions for future practices: The perspectives of emergency care nurses

“…Implications include the development of several standardized measures to assess nursing staffs attitudinal beliefs such as frustrations, anger and hostility (Diana et al 2020;Rayner et al 2019). Some studies recommend improvement of the educational preparedness of nurses and clinical supervision for improving confidence in providing care to patients who self-harm in EDs (Koning et al 2018;McGough et al 2021;Rayner et al 2019;True et al 2021). Despite the well-established need for educational improvement and training of ED nurses, also in ways on how to respond to people who self-harm (Koning et al 2018;Van Der Linden et al 2019;McGough et al 2021;Rayner et al 2019), there has been limited research on the implications of the current practice in suggestions towards informing ways of organizing future care in EDs.…”

Understanding Emergency Department Healthcare Professionals' Perspectives of Caring for Individuals in Suicidal Crisis: A Qualitative Study

“…This may have been due to the differing capacity of the hospitals resulting in greater overall numbers of ED staff at ED1. While we may not have been able to capture a well-rounded experience of providing care to help seekers in ED2, the consistency across all focus groups and interviews in this study as well as with recent international research ( 20 , 47 ) suggests that the information we collected is representative of the wider service delivery.…”

“…Staff burnout appears to be linked to poor patient outcomes for help seekers (e.g., re-presentations, repeat attempts, or suicide death) ( 27 , 30 ) and while the high incidence of burn out in ED staff is well documented in the literature ( 20 , 26 , 27 , 42 ), mechanisms that contribute to burn out in relation to help seekers have not been explored. A recent meta-synthesis found that after the death of a help seeker, ED staff experience negative emotions such as shame and self-blame ( 43 ).…”

“…ED staff also report not having time to build rapport necessary for a psychological assessment ( 15 ), or to appropriately assess the risk of future suicide ( 12 , 15 , 16 ). Moreover, research has suggested that ED staff are inadequately trained in mental health ( 17 , 18 ) and suicide presentations, such as causes, crisis intervention, assessment, and appropriate referral options ( 12 , 14 , 19 , 20 ).…”

“…Systemic issues within health services are also important considerations in the provision of ED care. ED health professionals report struggling to provide care due to not being able to access to essential resources, such as patient beds ( 13 , 21 , 22 ), and internal mental health professionals to lead mental health assessments and ensure specialized care of help seekers ( 20 , 21 , 23 ). EDs are high-pressure environments and interacting with people in suicidal crisis may further exacerbate existing levels of occupational stress amongst healthcare professionals in this setting ( 24 , 25 ).…”