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APA , Nursing

Please respond to the following discussion.

250 words, 2 references, APA format

Thank you.


A pattern which my colleagues and I have seen in the Pediatric Unit is a huge increase over the past two years of young and older adolescents needing one to one watches. This is due to attempted suicides, suicidal ideation or the possibility of harming themselves or others.  Some of us feel that the need for one to one watches has doubled or even tripled but actual data is needed to prove that. The American Foundation for Suicide Prevention statistics shows that suicide is the 3rd leading cause of death in those who are 10 to 19 years of age. (AFSP, 2022). A CDC study documented an increase in suicide attempts starting in May 2020. From February to March, 2021, emergency room visits were over 50% higher among girls aged 12 – 17 than during the same period in 2019. For boys of the same age, the increase was just under 4%. (Smith-Schoenwalder, 2021). It is believed that the isolation from the Covid – 19 virus, drug usage, bullying in school, in social situations and on social media or mental illness may be the contributing factors. As a nurse leader I want me and my team to learn as much as we can about suicide and provide additional strategies to address this serious mental health problem with our patients and their families. We do not have a psychiatric unit in the hospital so these patients must stay on the Pediatric Unit until placement in a psychiatric facility can be made which often takes a long time due to bed availability. In the time caring for these patients, the nurses need to be equipped to therapeutically support these children and their families. Unfortunately, there is a lack of in-service education for our nursing staff on mental health issues, particularly suicide and self- harm. This needs to be addressed especially due to the uptick in cases we have been seeing.  Another concern is that the patient ratio for our Pediatric Unit is supposed to be four patients to one nurse. Due to the nursing shortage on the night shift, nurses may be assigned to 6 or 8 patients especially if there are sick calls. The charge nurse usually has a patient assignment, some of whom are on chemotherapy and may also have to take new admissions. When there are patients who need to be placed on one to ones, they must be watched for the entire shift by a Certified Nursing Assistant (CNA). Most nights two or possibly three CNAs may be on duty. There are times when we may have four patients on one to one watches which means that the nurses must take on the additional duties usually performed by the CNAs. We also have to get a float CNA.  Because of the already heavy assignments, our time is further limited with the patients.  The optimal care may not be provided and this concerns us ethically. It also causes a greater chance of errors in patient care which has legal implications. This is very stressful for the nursing staff.  They feel that they are not living up to the ANA Code of Ethics or guidelines for patient ratios. The situation caused by the increase in one to one watches may improve when we have the full complement of nurses on our unit however, we will continue to get patients who need to be monitored continuously during their admissions. We can help by being better educated about suicide and self- harm. We can also provide the patients and families with education and resources related to suicide. This hopefully will contribute to the reduction of the current epidemic of adolescent suicide, suicidal ideation and self – harm. 

American Foundation for Suicide Prevention. (2022). Suicide data: United States. https://afsp,og/statistics

Smith-Schoenwalder, C., (2021). CDC study documents rise in adolescent suicide attempts during pandemic. US Newshttps://usnews.com/news/health-news/aticles/2021-06-11/cdc-study-documents-rise-in-adolescent-suicide-attempts-during-pandemic

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