Attempted Suicide Pts

triemal04 said:
Passing on info about support groups or available options is one thing (and appropriate if the info is accurate)
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Absolutely agree. I hope I made myself clear in that I am NOT attempting to fix anyone's problems. I am trying to ascertain where that patient is in terms of what they know about what is available to them and making sure that ED staff are aware of where that patient needs to go to get further help. As far as the percentage I "help" if 10% of the suicidal patients I pick up do not kill themselves because of ANYTHING I did, I am happy with that.

I also agree that education in these issues is woefully inadequate - especially if you are a graduate of a diploma mill zero to hero school. This inadequacy is something I have attempted to address personally and professionally. It does our patients no good for us to say "hey - your problem is well beyond my training level" and wash your hands of it, especially with the numbers of these patients we are seeing.

There is no doubt that the number one indication of a successful suicide is previous attempts. We got them on those previous attempts. If we are truly in this business because we are attempting to save lives, then it behooves us to do all we can to that end.
 
Kaisu said:
I also agree that education in these issues is woefully inadequate - especially if you are a graduate of a diploma mill zero to hero school. This inadequacy is something I have attempted to address personally and professionally. It does our patients no good for us to say "hey - your problem is well beyond my training level" and wash your hands of it, especially with the numbers of these patients we are seeing.
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You're right that isn't good. But saying "hey - your problem is well beyond my training level, so let's get you to the right people who have that training" is not innapropriate. In fact it's the best way to go. There's nothing wrong with letting people know what their options are, IF that information is accurate (and if it is then kudos), it's when you start doing things beyond/outside of what you know that problems come up. (that's a general you also) Once again, it comes back to the fact that we will not be able to treat everything we come across (and in this case, with our education being what it is, we shouldn't be), but what we can do is make sure that person get's to the right place and the people receiving them are aware of the issue. Which, if that's what you're doing, means that you're ahead of the curve.
 
Kaisu said:
There is no doubt that the number one indication of a successful suicide is previous attempts. We got them on those previous attempts. If we are truly in this business because we are attempting to save lives, then it behooves us to do all we can to that end.
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Simple fact is that if someone wants to commit suicide, then we are not gonna help them... becasue they succeded. The ones we transfer from Hospital to Psych Facilities were (99% of the time) crys for help. there is no way we will be "saving lives" with psych patients. Obvioulsy Paramedics and EMTs are not equipped to provide any meanigful help during a ~30 minute transport in the back of an Ambulance. I'm not saying that we "wash our hands of them", but someone here wanted to know "why shouldn't we play shrink and act like their best friend?" I think that attitude is dangerous and WAY TOO risky whe we are talking about someones emotional health. There is no band-aid treatments for this. It's not like placing an IV, ventalating a patinet, or splinting a fracture. This is serious stuff WAY BEYOND our scope of practice. We provide supportive care on transports like this, but DO NOT "play Shink".
 
This is an educational forum and kudos to the OP for asking the question. We need to do better for these patients than small talk about the weather or whatever the patient wants to talk. I hope I am not that far ahead of the curve.
 
Mountain Res-Q said:
Simple fact is that if someone wants to commit suicide, then we are not gonna help them... becasue they succeded. The ones we transfer from Hospital to Psych Facilities were (99% of the time) crys for help. there is no way we will be "saving lives" with psych patients. Obvioulsy Paramedics and EMTs are not equipped to provide any meanigful help during a ~30 minute transport in the back of an Ambulance. I'm not saying that we "wash our hands of them", but someone here wanted to know "why shouldn't we play shrink and act like their best friend?" I think that attitude is dangerous and WAY TOO risky whe we are talking about someones emotional health. There is no band-aid treatments for this. It's not like placing an IV, ventalating a patinet, or splinting a fracture. This is serious stuff WAY BEYOND our scope of practice. We provide supportive care on transports like this, but DO NOT "play Shink".
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Sometimes I wonder why I even bother to keep posting if people won't read the previous posts....
 
Kaisu said:
Sometimes I wonder why I even bother to keep posting if people won't read the previous posts....
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Because you love us! :P
 
Kaisu said:
Sometimes I wonder why I even bother to keep posting if people won't read the previous posts....
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Oh, I read them and agree wiht 95% of what you say... in therory, if not in practice. My ranting is more dirrected to those that would "play shrink" at the MFR, EMT, or even Paramedic level; jut as much as Shrinks shouldn't play Paramedic. And you will learn to love me; I wear everybody down eventually! ;)
 
Mountain Res-Q said:
Oh, I read them and agree wiht 95% of what you say... in therory, if not in practice. My ranting is more dirrected to those that would "play shrink" at the MFR, EMT, or even Paramedic level; jut as much as Shrinks shouldn't play Paramedic. And you will learn to love me; I wear everybody down eventually! ;)
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Fair enough. I guess that rant can't be said too many times. Peace - out!
 
I've got to wonder, the nature of the call doesn't automatically get them a psych eval? Here, suicide attempts are, if possible, taking to two specific hospitals with psych facilities or are later transfered to psych facilities. They've also bought themselves a baker act and a 72 hour psych hold where they will have access to, and get the help that they need.

Also a few of the standard triage questions and geared towards home abuse, depression, and suicide.

In the few assesments I've seen in hospital for a patient who attempted suicide includes finding out WHY the patient feels as if suicide is their only option.
 
Sasha said:
I've got to wonder, the nature of the call doesn't automatically get them a psych eval? Here, suicide attempts are, if possible, taking to two specific hospitals with psych facilities or are later transfered to psych facilities. They've also bought themselves a baker act and a 72 hour psych hold where they will have access to, and get the help that they need.

Also a few of the standard triage questions and geared towards home abuse, depression, and suicide.

In the few assesments I've seen in hospital for a patient who attempted suicide includes finding out WHY the patient feels as if suicide is their only option.
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You are fortunate enough to run in a part of the country where that is what is done. I wish I was. I was trained in Northern Wisconsin, where the procedure you describe was SOP. Northern Arizona was a culture shock.
 
Sasha said:
I've got to wonder, the nature of the call doesn't automatically get them a psych eval? Here, suicide attempts are, if possible, taking to two specific hospitals with psych facilities or are later transfered to psych facilities. They've also bought themselves a baker act and a 72 hour psych hold where they will have access to, and get the help that they need.

Also a few of the standard triage questions and geared towards home abuse, depression, and suicide.

In the few assesments I've seen in hospital for a patient who attempted suicide includes finding out WHY the patient feels as if suicide is their only option.
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The bases for this thread was from a transfer standpoint and not 911. I asume we are talking bout the ransfer of a attempted suicide from a ER (where the physical injuries were delt with) to a phych facility fo eval and poss treatment. For instance, in my county all attempted suicides are taken firs to the ER and then (if the situation warrents) transferred to a deidicated pysch facility, and since there are none in the county, they all get shipped out by Ambulance 1-2 hours to a facility for a 72 hour (minimum) hold. I think part of teh argument here was based on the fact that some viewed this from a 911 "they just attempted suicide standpoint" rather than a "stable patient" being taxied to a PROFFESIONAL SHRINK!
 
OOPS - I guess I should learn to read the posts huh? I was responding strictly from a 911 standpoint.... :blush: my bad!
 
Mountain Res-Q said:
The bases for this thread was from a transfer standpoint and not 911. I asume we are talking bout the ransfer of a attempted suicide from a ER (where the physical injuries were delt with) to a phych facility fo eval and poss treatment. For instance, in my county all attempted suicides are taken firs to the ER and then (if the situation warrents) transferred to a deidicated pysch facility, and since there are none in the county, they all get shipped out by Ambulance 1-2 hours to a facility for a 72 hour (minimum) hold. I think part of teh argument here was based on the fact that some viewed this from a 911 "they just attempted suicide standpoint" rather than a "stable patient" being taxied to a PROFFESIONAL SHRINK!
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I understand that, I was responding to one of Kaisu's posts a bit back.
 
Sasha said:
I understand that, I was responding to one of Kaisu's posts a bit back.
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To quote the great Kaisu.... :blush: my bad!

Hey Kaisu, what portion of Arizona, I have some family out there is the Sedona/Prescott Valley area and thought once upon a time of moving out there are doing the EMS thing out there.
 
I guess what I meant by playing shrink was asking what they were feeling and so on not diagnosing them or telling them what they should do because you are all right that most emts are not trained to do so. And why not play new best friend if it makes them feel better?
 
FTRPO said:
I guess what I meant by playing shrink was asking what they were feeling and so on not diagnosing them or telling them what they should do because you are all right that most emts are not trained to do so. And why not play new best friend if it makes them feel better?
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because you arent their friend. you are their emt or paramedic.
 
FTRPO said:
I guess what I meant by playing shrink was asking what they were feeling and so on not diagnosing them or telling them what they should do because you are all right that most emts are not trained to do so. And why not play new best friend if it makes them feel better?
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Be their friend by talking to them about unrelated topics. Be their friend by letting them know what their options are and what services are available IF you are SURE about those things. Do not try and be their friend by delving into what happened, why it happened, and how they are feeling. You do not have the background for that and may end up doing more harm than good. Know what your limitations are.
 
because you arent their friend. you are their emt or paramedic.

Right that is evident. Why not be a friend to them what will it hurt? Im not telling you to steer them down a path that you think best suits them, just be there for them. Act like you care, listen, and pretend like you want the best for them just like a friend would do. There is absolutely nothing wrong with that. There is no need to go back and forth about this, the original poster has my thoughts and yours.
 
Kaisu said:
I begin with my usual patient assessment, taking care of medical needs first. I then express sympathy and tell them that I am sorry they are hurting so badly. This usually evokes tears/gratitude for some understanding and non-judgment. I find out about their lives and what has pushed them to this point. Most are extremely grateful for the ear. I then tell them that suicide happens when the pressures to commit suicide are greater than the resources available to the individual to resist the impulse. We then discuss what they are doing (meds, therapy,etc.) and I try to suggest other tools they can add to there bag of tricks. I tell them that they have a challenging problem, but that there is hope - people heal and it won't always feel this bad.
The attempted suicides are among the most satisfying and personally fulfilling patients I run on.
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Nicely said, Kaisu.
 
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