Date of Award

2022

Degree Name

Master of Nursing (Research)

Schools and Centres

Nursing and Midwifery

First Supervisor

Dr. Tracey Coventry

Second Supervisor

Associate Professor Kylie Russell

Abstract

The prevention of suicide is a complex and challenging subject that can evoke fear and anxiety in health professionals who provide support for individuals at risk. Nurses working in the emergency department (ED) are at the forefront of supporting individuals at risk of suicide who present to hospital. While empirical evidence regarding ED nurses and their perceptions of the support of those at risk is available, to date, a Wheatbelt, Western Australian (WA)-specific study has not been conducted. The present study aims to understand the experiences of Wheatbelt ED nurses caring for individuals at risk of suicide. More specifically, this thesis explores what the ED nurses perceive as working well and the challenges they face in supporting at-risk individuals.

A qualitative descriptive approach was adopted in this study. A convenience sample of 13 ED nurses located at two regional hospitals in the Wheatbelt area of WA participated in a series of semi-structured interviews. Of the interviews, 12 were conducted face to face, and one was conducted via video conference. All the nurses interviewed had existing rural and remote ED experience, and all had completed their triage competency.

The findings suggested that nurses were aware of their responsibility to care for individuals at risk of suicide who attended the ED and the importance of conducting suicide risk assessments. The nurses were accustomed to dealing with large numbers of acutely ill patients, often with limited access to resources to adequately support those at risk of suicide. Nurses found the systems and pathways challenging, and this, at times, hampered their ability to provide support. This issue was compounded by the lack of mental health beds in regional hospitals in the Wheatbelt. Participants noted limited access to suicide risk assessment training and education, and nurses argued that training should be made mandatory to ensure that all iv patients are assessed in the busy ED environment. The existing ED suicide risk assessment tool was largely noted by the nurses as being difficult to use.

The results of the present study contribute to the state-wide body of mental health evidence in the WA Wheatbelt and can be used to generate improvements in the nursing management of individuals presenting to the ED at risk of suicide. Specifically, the development of policy and procedures to improve the care of these individuals could lead to better outcomes for patients, carers and service providers.

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