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Running head: NURSES DEPRESSION AND SUICIDE Critical care nurses depression/suicide compared to medical telemetry Jesus G Rebolledo The University of Texas at Rio Grande Valley NURS 6302.90L Dr. Linda Eanes March 06, 2019 1 NURSES DEPRESSION AND SUICIDE 2 Abstract Critical care nurse provides attention for life-threatening conditions that require advanced care in the Intensive Care Units (ICU). In a hospital setup, critical nurses comprise 37% of the number of all nurses and offer attention to patients in critical states through advocacy. This advocacy calls for respect to for patients even if they make life decisions that are against the nurse views, act as an intermediary between care team and patient as well as offering interventions other patient's affiliates who are acting against patient's interest. On the other hand, medical telemetry nurse is concerned with observations and readings of the telegraphic machines where cardiovascular patients are placed. Unlike the critical care nurse, the patients are not necessarily in critical conditions and may not be placed the ICU. Generally, patients die in the watch of nurses and they are expected to handle critical information and covey in a most professional manner. This situation has resulted in depression and suicide cases among nurses when they are subjected to ideal conditions but are expected to remain calm. However, there is a variation of the extent of stress that is faced by the critical care nurse as compared to the medical telemetry nurses. NURSES DEPRESSION AND SUICIDE 3 Critical care nurses depression/suicide compared to medical telemetry Introduction According to the American Association of Critical Care Nurses (AACN), critical care nurses have 9 advocacy roles to address. The rights of the patients, intermediary and intervention roles are the first duties to be delivered by nurses. Additionally, they are expected to monitor the quality of care provided, assist patient when provided facility fails and act as champions where patients are unable to speak for themselves (Nagy et al., 2015). Other duties are representing the patient's needs to a medical doctor, supporting patient's spokesperson and assisting in transfer care. Some working conditions like cleaning patient's wounds, tracking life support are among duties delivered by critical care nurses. Just like the family members of the patient's critical care nurses are subjected to emotional stress especially when a critical patient succumbs to death. Cardiovascular is the leading killer disease according to the American report on the leading cause of death. Patients are admitted to hospitals where they are placed under the care of medical telemetry nurses. These nurses observe, analyze and record patients progress on the electrocardiogram and report vital signs to the in charge. Additionally, the ensure quality care provisions, assist patients when the machine fails and convey information from the patient to the medical team. This progressive nurse is required to assist family members in delivery emotional support to the patients thus exposing them to stress and depression just like the family members. According to reports on trends in nurses, stress and depression originating from the working environment have led nurses to commit suicides. Equal the extent of this problem has not been established since this two types of nurses’ addresses similar situations and are subjected to emotional stress just like the families to the patients (Cummins et al., 2015). However, the professional requirements outline that nurses should conceal information and leak it to the family NURSES DEPRESSION AND SUICIDE 4 members appropriately. In some cases, the patient’s survival may be impossible but the nurses must remain composed. This situation forms the basis of this study that will be conducted in Arizona State among 100 participants who will be selected at random in a stratified study. Background problem Nurses are professionals trained to save human lives. Both critical care nurses have duties to save patients' lives as well as addressing issues professionally in information delivery on the progress of patients. Consequently, addressing patients' issues requires the highest application of emotional intelligence. On the other hand, nurse job description requires appropriate decision when support machines fail to respond as well as influencing the patients to make positive decisions that will lead to preserving life and reducing deaths (Khan et al., 2019). However, this job is facing threat as nurses are subjected to depression that leads to suicidal cases in some regions. Causes of depression among nurses arise from their working environments. Taking, for example, the critical care nurses witness deaths of patients admitted at the ICU on daily basis. According to a report provided by expert analysis, about 10 patient dies while under the care of nurses in the ICU. On the other hand, medical telemetry nurses form a vulnerable group that attends to patients with heart complications. According to the Forbes report, cardiovascular heart disease is the leading killer disease among Americans. Medical Telemetry nurses are supposed to monitor patients' conditions as well as making decisions on providing alternatives when support machines fail. From these incidents, research has proved that nurses suffer depression that leads to loss of life through suicidal cases. On the other hand, performance at work as well as making effective decisions are affected by depression facing nurses (Ranse, 2019). Deterioration of NURSES DEPRESSION AND SUICIDE 5 nurses' mental intelligence is bringing a threat to the wellbeing of patients admitted hospitals. This formed the background of this study to identify the most vulnerable group that suffers depression and to some extent suicidal cases between the critical care nurses and the medical telemetry nurses. The findings from the study will help in enhancing parent care conditions provided by nurses. The purpose problem statement, research question, the significance of the problem and hypothesis. During the study, the general objective that will lead the research is to identify the type of nurses exposed to frequent death of patients leading to depression and suicide. The specific objectives will be to obtain statistics on the number of nurses lost to depression and suicide, to establish the number of deaths that the critical care nurses are exposed to as well as that of medical telemetry nurses. Additionally, the research will be objected to establishing the relationship between depression and nurses' suicidal cases instead of seeking alternative measures. According to the objectives of the study, the research question will be: Are critical care nurses exposed to frequent death of patients at risk of major depression and suicide as compared to medical telemetry with less exposure to deaths? This question will analyze the similarity in nurses working conditions and the number of deaths recorded per group. On the other hand, it will answer the question of increased risks of depression and suicide and associate it to mental issues that arise when nurses witness patients dying. The research question will also answer the question on the most vulnerable group of nurses that needs attention to improve services provided by nurses in hospitals. The hypothesis of the study will be medical telemetry nurses are not depressed. NURSES DEPRESSION AND SUICIDE 6 Literature review. According to the World Health Organization, about 15% of individuals in a given age group suffers from clinical depression in their lifetime. In addition to this, 5% of the affected individuals are males while 9% of the population is made up of females. According to studies conducted, one of the causes of depression is an imbalance that originates from the neurotransmitters. The experts explain that neurotransmitters coordination may experience a shortage in supply thus leading to the occurrence of clinical depression in an individual (Brown, 2019). This type of depression is chemically triggered. Another cause of depression is sexual hormones that exist in an individual. Women tend to suffer depression more than males. The influx in female hormones trigger depression as experienced during the menstrual period, childbirth and perimenopause stages of their lives. According to doctor's reports, depression among females affects them from teenage until the latter stages of their lives. The seasonal affective disorder is a type of depression that is caused by disturbance on the normal cardiac rhythm of the body. Disturbance in circadian rhythm is triggered by light entering the eye, which is experienced in winter seasons. People residing in colder regions suffer this type of depression. Poor nutrition can trigger depression in an individual. Studies have revealed that diets low in omega-3, fatty acids or imbalance ratios of omega six are associated with increased rates of depression (Coppens et al., 2018). On the other hand, taking too much sugar from junk foods may trigger depression. Poor nutrition is normally influenced by mental conditions that symbolize the early symptoms of depression in an individual. Stressful events in life such as death may overwhelm an individual leading to depression. According to studies on life events related stress, hormone cortisol is scattered during stress leading to the production of serotonin by neurotransmitter which results in depression. Grief and NURSES DEPRESSION AND SUICIDE 7 loss of loved one contribute to grief and feeling of emptiness. This results in troubled sleep, poor appetite and low interest in normal activities. Continuous feelings of grief and loss result in depression that may affect an individual. Depression is a serious issue that affects lives in society and will result in suicide or death. Conceptual framework According to Bell et al. (2018), depression is a common bet serious mood disorder affecting how we feel, think or carry ourselves in daily activities. According to this definition, forms of depressions are persistent depressive disorder, postpartum disorder, and psychotic depression. Another definition of depression is that it is illness marked by sadness worthless and hopelessness arising from problems surrounding an individual (Oliveira, 2018). According to this argument, depression can be caused by environmental factors that limit an individual's capacity to concentrate on daily activities like work or leaning. According to this definition, a model is provided to illustrate how different factors of the environment will influence an emotional intelligence and lead to worthlessness as well as hopelessness that leads to individual's ending his/her life. A model is applied to explain how stress develops in an individual and affects the life of the person in the future as follows. Figure 1: Showing model of the life of an individual NURSES DEPRESSION AND SUICIDE 8 Assumptions and limitations During the study, limitations will be on the study topic to avoid additional expenses that will be incurred in the evaluation of other parameters. This will involve an evaluation of activities managed by critical care nurse and medical telemetry that may lead to depression or suicide among patients. On the other hand, during the study, limitations will be considered on the geographical scope where related risks that will contribute to the development of stress among nurses. The study will apply random sampling but limitations will be allowed where participants will be allowed to recommend other participants based on their experience. According to the planning of the research, the allocated time to evaluate risks associated with depression and suicide will be one month. However, other issues associated with depression and health-related risks may involve analysis of finer details that will provide the required evidence to show the vulnerable group. NURSES DEPRESSION AND SUICIDE 9 During data collection, some respondents may be hostile and reluctant to provide essential information on the risk factors. This will entail provisions to attempt the questions or walk out of the study. Additional participants will be recruited in the course of the study to meet the required numbers for the collection of comparative data. Researchers may be exposed to critiques from the respondents on questions asked against their expectations. This will involve linking findings provided to make conclusions. From the data collected, assumptions will be made that the information collected is provided in an honest opinion. The study will apply both qualitative and quantitative research approach where analysis will involve making assumptions on missing links across depression causative factors and the group that is likely to be affected the most. Assumptions will be made after considerations made on primary data to enhance reliability and validity. Research methodology procedures and analysis Collection of data will apply a cross-sectional study because it is the most commonly used and participants have an understanding of how it works. On the other hand, both quantitative and qualitative analysis will be applied to gather the required information for the study. In this case, qualitative research will produce numerical facts that will be analyzed using mathematical formulas to arrive at conclusions. Similarly, surveys, counting, and counting will be applied to collect information on a number of victims affected, the extent of depression and the number of nurses from both sides of the study. Meta-analysis will be applied to secondary data to calculate data gathered from the parameters. Collected data will be analyzed using graphs, and cluster analysis for testing the hypothesis. Tables will be applied for making entries on numerical information gathered from the field. NURSES DEPRESSION AND SUICIDE 10 Qualitative research will involve seeking opinions on how and why depression affects critical care nurse and medical telemetry nurse. Since this study will be general in data to be collected, techniques that will be applied for data collections are interviews, focused group discussions as well as direct observation of parameters. Postcards will be applied to inform of small written questionnaires while secondary data will be collected through photographs on the occurrence of events during the study. Since general data will be collected, coding will be applied to enhance analysis other statistical tools provided by a computer such as SPSS, and Microsoft Excel will be applied for further analysis to provide a comparative analysis on the study parameters involved for data collection. The analysis from both qualitative and quantitative data will be used for drawing conclusions. Expected results and conclusions Upon completion of the research, this study will be of benefit to critical care nurses as well as medical telemetry nurses in managing depression that may lead to suicidal thought. The most critical group will be highlighted on measures to be taken to manage depressions occurring following exposure to deaths. On the other hand, this information will be provided to the less vulnerable group for addressing stress and depression arising from their working environment. The local authorities responsible for the development of a work plan will be able to realize working environments that affect the lives of nurses and formulate improvements on how to provide effective care. On the other hand, medical doctors will be able to understand conditions that are critical to nurses and create a counseling plan to address depression and related cases among the critical group identified. This will help in improving patient care as well as reducing suicidal cases among nurses in society. NURSES DEPRESSION AND SUICIDE 11 Depression management is a critical step to ensure among nurses. When patients are admitted in a health facility, their hope remains on the nurse who is committed to handling duties diligently. On the other hand, family members of the patients depend on the nurse to make decisions on how the patients will be managed. However, depression affects how humans think. This will affect the capacity of the assigned nurse to act effectively following feelings of hopelessness. To secure the future of our nurses as well as ensuring effective attention offered to the patients, there is a need to motivate nurses for an improved outcome. This improvement involves identification of the most critical group then recommending best practices to manage depression that may end in suicide. Taking this step will not only enhance nurse performance but also save a life. NURSES DEPRESSION AND SUICIDE 12 References Bell, C. M., Ridley, J. A., Overholser, J. C., Young, K., Athey, A., Lehmann, J., & Phillips, K. (2018). The role of perceived burden and social support in suicide and depression. Suicide and Life‐Threatening Behavior, 48(1), 87-94. Brown, K. M., Jones, M. B., Moore, L., Meliones, C., Montgomery, J. A., & Ascenzi, J. (2019). Advanced Nursing Practice in Pediatric Cardiac Critical Care. In Critical Heart Disease in Infants and Children (pp. 82-93). Elsevier. Coppens, E., Van Audenhove, C., Gusmão, R., Purebl, G., Székely, A., Maxwell, M., ... & Hegerl, U. (2018). The effectiveness of General Practitioner training to improve suicide awareness and knowledge and skills towards depression. Journal of Affective Disorders, 227, 17-23. Cummins, N., Scherer, S., Krajewski, J., Schnieder, S., Epps, J., & Quatieri, T. F. (2015). A review of depression and suicide risk assessment using speech analysis. Speech Communication, 71, 10-49. Khan, N., Jackson, D., Stayt, L., & Walthall, H. (2019). Factors influencing nurses' intentions to leave adult critical care settings. Nursing in critical care, 24(1), 24-32. Nagy, C., Suderman, M., Yang, J., Szyf, M., Mechawar, N., Ernst, C., & Turecki, G. (2015). Astrocytic abnormalities and global DNA methylation patterns in depression and suicide. Molecular Psychiatry, 20(3), 320. Oliveira, J. M., Sobreira, G., Velosa, J., Telles Correia, D., & Filipe, P. (2018). Association of isotretinoin with depression and suicide: a review of current literature. Journal of cutaneous medicine and surgery, 22(1), 58-64. Ranse, K., Delaney, L., Ranse, J., Coyer, F., & Yates, P. (2019). End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice. Australian Critical Care, 32(1), S16. ...
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Profshyile
School: Cornell University

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Running head: NURSES DEPRESSION AND SUICIDE

Critical Care Nurses Depression and Suicide compared to Medical Telemetry
Jesus G Rebolledo
The University of Texas at Rio Grande Valley
NURS 6302.90L
Dr. Linda Eanes
March 06, 2019

1

NURSES DEPRESSION AND SUICIDE

1.0

2

Abstract

Nurses are professionals trained to save human lives. A large number of nurses experience
depression and some even end up committing suicide thanks largely to their exposure to frequent
patient deaths. The purpose of the proposed research project is to use the case-control design to
compare three different groups of nurses working in different areas within an acute care hospital
on their risk of depression. The three groups include nurses in the telemetry unit, intensive care
unit, and medical-surgical unit. To measure the depression experienced by the nurses, the Beck
Depression Inventory would be used. The statistical tool that would be employed is ANOVA.
The expected result is that nurses in the ICU department have the highest risk of depression and
therefore suicide due to the fact that they witness more patient deaths than nurses in the other
departments. The expected conclusion is that ICU nurses are at a greater risk of depression
followed by telemetry nurses. The risk of depression is lowest among nurses in the medicalsurgical unit since patient deaths are lowest in this department.

NURSES DEPRESSION AND SUICIDE

3

Critical Care Nurses Depression and Suicide compared to Medical Telemetry
2.0

Introduction

According to the American Association of Critical Care Nurses (AACN), critical care
nurses have 9 advocacy roles to address. The rights of the patients, intermediary and intervention
roles are the first duties to be delivered by nurses. Additionally, they are expected to monitor the
quality of care provided, assist patient when provided facility fails and act as champions where
patients are unable to speak for themselves (Nagy et al., 2015). Other duties are representing the
patient's needs to a medical doctor, supporting patient's spokesperson and assisting in transfer
care. Some working conditions like cleaning patient's wounds, tracking life support are among
duties delivered by critical care nurses. Just like the family members of the patient, critical care
nurses are subjected to emotional stress especially when a critical patient succumbs to death.
Cardiovascular disease is the leading killer disease according to the American report on
the leading cause of death. Patients are admitted to hospitals where they are placed under the
care of medical telemetry nurses. These nurses observe, analyze and record patient progress on
the electrocardiogram and report vital signs to the in charge. Additionally, they ensure quality
care provisions, assist patients when the machine fails and convey information from the patient
to the medical team. This progressive nurse is required to assist family members in delivery
emotional support to the patients thus exposing them to stress and depression just like the family
members. According to reports on trends in nurses, stress and depression originating from the
working environment have led nurses to commit suicides (Cummins et al., 2015). In some cases,
the patient’s survival may be impossible but the nurses must remain composed. This situation
forms the basis of this study that will be conducted in Arizona State.

NURSES DEPRESSION AND SUICIDE
3.0

4
Background problem

Nurses are professionals trained to save human lives. Critical care nurses have duties to
save patients' lives as well as addressing issues professionally in information delivery on the
progress of patients. Consequently, addressing patients' issues requires the highest application of
emotional intelligence. On the other hand, nurse job description requires appropriate decision
when support machines fail to respond as well as influencing the patients to make positive
decisions that will lead to preserving life and reducing deaths (Khan et al., 2019). However, this
job is facing threat as nurses are subjected to depression that leads to suicidal cases in some
regions.
Causes of depression among nurses arise from their working environments. Taking, for
example, the critical care nurses witness deaths of patients admitted at the ICU on daily basis.
According to a report provided by expert analysis, about 10 patients die while under the care of
nurses in the ICU (Cummins et al., 2015). On the other hand, medical telemetry nurses form a
vulnerable group that attends to patients with heart complications. According to the Forbes
report, cardiovascular heart disease is the leading killer disease among Americans. Medical
Telemetry nurses are supposed to monitor patients' conditions as well as making decisions on
providing alternatives when support machines fail.
From these incidents, research has proved that nurses suffer depression that leads to loss
of life through suicidal cases. Depressed nurses also tend to make ineffective decisions and have
poor work performance (Ranse, 2019). Deterioration of nurses' mental intelligence is bringing a
threat to the wellbeing of patients admitted hospitals. This formed the background of this study
to identify the most vulnerable group that suffers depression and to some extent suicidal cases

NURSES DEPRESSION AND SUICIDE

5

between the critical care nurses in the ICU, medical-surgical nurses, and the telemetry nurses.
The findings from the study will help in enhancing parent care conditions provided by nurses.
4.0

Purpose, Problem Statement and Significance of the Problem

During the study, the general objective that will lead the research is to identify the type of
nurses exposed to frequent death of patients leading to depression and suicide. The specific
objectives will be to obtain statistics on the number of nurses lost to depression and suicide, and
to establish the number of deaths that ICU nurses, telemetry nurses, and medical-surgical nurses
are exposed to. Additionally, the research will seek to establish the relationship between
depression and nurses' suicidal cases instead of seeking alternative measures. In line with the
objectives of the study, the research question will be: Are critical care nurses in the ICU who are
exposed to frequent patient deaths at higher risk of major depression and suicide than medicalsurgical nurses and telemetry nurses who have less exposure to patient deaths?
This question will analyze the similarity in nurses working conditions and the number of
deaths recorded per group. On the other hand, it will answer the question of increased risks of
depression and suicide and associate it to mental issues that arise when nurses witness patients
dying. The research question will also answer the question on the most vulnerable group of
nurses that needs attention to improve services provided by nurses in hospitals. The hypothesis
of the study is that nurses in the medical-surgical unit and telemetry unit are not as highly
depressed as nurses in the ICU department.

NURSES DEPRESSION AND SUICIDE
5.0

6
Literature Review

According to the World Health Organization, about 15% of individuals in a given age
group suffer from clinical depression in their lifetime. In addition to this, 5% of the affected
individuals are males while 9% of the population is made up of females. According to studies
conducted, one of the causes of depression is an imbalance that originates from the
neurotransmitters. The experts explain that neurotransmitters coordination may experience a
shortage in supply thus leading to the occurrence of clinical depression in an individual (Brown,
2019). This type of depression is chemically triggered. Another cause of depression is sexual
hormones that exist in an individual. Women tend to suffer depression more than males. The
influx in female hormones trigger depression as experienced during the menstrual period,
childbirth and perimenopause stages of their lives. According to doctor's reports, depression
among females affects them from teenage until the latter stages of their lives.
The seasonal affective disorder is a type of depression that is caused by disturbance on
the normal cardiac rhythm of the body. Disturbance in circadian rhythm is triggered by light
entering the eye, which is experienced in winter seasons. People residing in colder regions suffer
this type of depression. Poor nutrition can trigger depression in an individual. Studies have
revealed that diets low in omega-3, fatty acids or imbalance ratios of omega six are associated
with increased rates of depression (Coppens et al., 2018). On the other hand, taking too much
sugar from junk foods m...

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Anonymous
Excellent job

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