RN, ADN
Have you ever heard the saying that children are gifts? I have, and I believe that as such, they should be treasured. However, it can be hard working with children. It was one of the hardest parts of working in the ER for me.
Children, depending on their age, don’t always understand what’s happening to them in a hospital. That can be hard to see. It can be hard to impossible to communicate with them, which can be frustrating to everyone involved.
Like me, one may find working with children and adolescents hard work, but we must make sure that we are keeping a close eye on them.
One study indicated that children ages 10-14% were self-harming with more lethal means than has previously been noted. Additionally, it stated that the rate of self-harm had increased 22%. This was between 2007-2016. It will take years to know how the pandemic has impacted these rises in rates.
But children are not only at an increased risk of self-harm. They are at an increased rise of dying by suicide. For children ages 5-11, suicide is the 8th leading cause of death.
To think that kids so young are capable of taking their own life is almost unbelievable. Twenty five percent of these children had experienced some form of trauma in their short lives, and forty percent of them had experienced multiple traumas!
These children tended to commit suicide alone, but 60% did so while an adult was in the next room while an adult was in the next room.
Suicide death rates increase by age, and for 15-24 year olds, teen suicide becomes the 2nd leading cause of death.
Additionally, 20% of high school students seriously consider suicide and 9% of high school students actually make a suicide attempt.
Our children, of all ages, are suffering.
So, what can we, as nurses and other healthcare professionals do?
Well, there is no easy solution. However, we can help by being more diligent.
In my experience, ER nurses feel uncomfortable asking young children about suicide. But the statistics don’t lie; even young ones are capable of taking their own lives.
So, we must talk to them about self-harm and suicidal ideation. We must realize, too, that talking about depression, self-harm, and suicide will not put such thoughts in their heads if they aren’t there to begin with. It’s not going to promote that behavior.
If in doubt, always ask.
First, we must better utilize the screening tools we do have. Using adult self- harm and suicide risk assessments are not ideal, but it is better than nothing.
Hopefully, in your practice with working with children, you’ve gained skills, so you can adapt it to the child.
Next, we need to advocate for pediatric self-harm and suicidal ideation tools. Kids don’t think the same way adults do, so they may be having thoughts of suicide, but may not have the understanding to convey their feelings in an adult way.
I don’t shy away from talking to kids about suicide, but depending on the age, some children don’t understand. I’ve had to adapt, but it would be much easier with a pediatric specific tool. So advocating for pediatric tools is highly important.
I recommend start by having a conversation with your charge nurses, if you work in a department with children. Then, go up the chain and talk to your Nursing Manager or Nursing Director. Perhaps show them this article.
Small changes, such as ensuring that children 5-12 are being screened using a pediatric model, and then that 13–18-year-olds are also being screened, using an adult scale such as the Columbia Suicide Risk Assessment Scale.
This can be easy to enforce. There are always ways to make certain questions mandatory. We must find the right person to get it done.
What about the nurses who complain about “having to do one more thing?” Well, this isn’t about them. This is about keeping our children safe. This one thing can save lives, and that’s what we do as nurses. We save lives. And if we can stop a problem in its tracks, before we have to engage in life saving measures, well—that’s even better. Let us remember that children are our future. So, let’s make sure they get there.
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