It’s tragic. Nurses, advance practice providers and physicians give themselves to serve others, but too often their own wellbeing suffers as a result.
You’ve likely seen the research: The suicide risk for nurses is higher than that of the general population. A recent report from the Centers for Disease Control and Prevention found that nurses had the fifth highest suicide rate for women of all professions. And some surveys indicate depression among healthcare providers is on the rise.
To make matters more challenging for individual clinicians, few facilities have resources in place to prevent such a loss and to support those affected when they do happen. In November last year, one nurse shared on Twitter a particularly harrowing story. She recalled quitting her job due to understaffing and burnout and that the response from her supervisor was, “Be tougher.” A week later, she says, a coworker died by suicide.
I quit a job I loved. The patients vulnerable, RN-pt ratios were twice what had been promised at hiring. Staff running on fumes. Supervisor told me, “it’s the way it is, you’ve got to be tougher.” For my health, I left. A week ago a colleague died by suicide.#NurseTwitter
— Melissa Crawford (@MelBCB) November 18, 2019
How to talk to a colleague with mental health struggles
Unfortunately, with organizational processes lacking, it falls on teammates to care for each other’s mental health — and to act when it seems like someone is struggling. Nathalie Martinek, PhD, wellbeing consultant for healthcare professionals and author of The Little Book of Assertiveness, sat down with Florence Health to offer some tips to do just that.
There are several signs that can be indicators of an emotional struggle that people don’t often recognize, Dr. Martinek says. Pay attention to the “high-achievers, the people who seem to have all their sh*t together, who are a valuable resource for everyone and a great team member,” she stresses. “The reality is many of these individuals aren’t looking after themselves. They’re doing everything to avoid looking inward.”
Dr. Martinek adds that there are other, more recognizable signs also worth paying attention to, such as negative talk about patients or colleagues, emotional numbness and increasingly scattered behavior. But what’s especially concerning about the former group is they rarely ask for help.
Start with an open-ended question.
When you’re worried, make time to ask the person in a non-confrontational way about the changes you’ve observed in their behavior. For example, try saying “I’ve noticed you do … when you didn’t used to. What’s been happening?” or “What’s going on?”
According to Dr. Martinek, framing the comment in this manner shows you’re concerned, but it doesn’t impose the expectation that the individual should be okay. Avoid saying “You’ve changed…”
If the person does choose to open up, that’s great, Dr. Martinek says, because it means they feel safe. “You should be quiet, listen, let them unload,” she adds. “Showing that you’re listening, that can often be enough.”
Use open body language.
This crucial to show that you’re engaged. Make eye contact, uncross your arms, lean forward, nod and mirror back body language and facial expressions.
If you do have concerns throughout the conversation, suspend them so you can stay focused on what your colleague is saying. And try not to show it with your body language. “People can tell when you’ve checked out of the conversation,” Dr. Martinek emphasizes.
Choose your words wisely.
You shouldn’t speak unless it feels appropriate. When you do, reflect your understanding of the situation, or ask questions without interrogating. Try: “Tell me what you mean by…” or “Can you expand a bit on…?”
And avoid talking about yourself unless explicitly asked. As Dr. Martinek says, “It’s not an opportunity to share your stuff. If they ask you, then share but always come back to them.”
Find out about their support systems.
Should any red flags emerge during the conversation, Dr. Martinek recommends responding in this way: “I’m hearing some things that I’m feeling concerned about. What can we do about it?” You should also ask about this individual’s support systems outside work and how you specifically can help.
Don’t feel obligated to take action.
While this might be your instinct — you chose a career in healthcare, after all — putting that pressure of yourself can detract from the dynamic, especially if you show you’re stressed about it. “You can’t always be the savior,” Dr. Martinek notes. “Also, life-and-death situations are a tiny portion of these situations.”
That said, if someone does articulate suicidal thoughts, follow the standard protocols.
What should employers do?
First and foremost, employers should accept that there are occupational hazards, both physical and mental, that come with working in a healthcare setting.
“Unless an organization is prepared to acknowledge the toxicity within their own culture and do something about it, professional development workshops on breathing aren’t going to address the underlying cause or contributing factors of depression,” Dr. Martinek asserts.
Only once a workplace decides to prioritize helping its own people can such resources make a difference. Dr. Martinek is a fan of low-cost approaches like reflective practice sessions and peer coaching. By the way, these programs should be free and integrated into the workday so employees don’t need to use their personal time to seek help.
If you’re in a management position, you can take steps on your own to break down abusive culture. If you see bullying, say something. Support clinicians who step up and say they need a break; don’t just deny leave. Avoid singling people out for negative reasons.
Ultimately, “the most powerful resource is each other,” Dr. Martinek says. “Care about each other. Notice what’s happening for each other, as well as yourself.”
“The organization can’t save you,” she adds. “Support each other, but don’t stop demanding what you need.”