Reflection on Suicide Management Incident in a Mental Health Hospital

This paper reflects on a suicide management incident in a mental health hospital, discussing the situation, feelings, evaluation, analysis, conclusion, and action plan.

In mental health Hospital, in 2015, I engaged in the incident of a suicide management
problem. Many incidents of suicide happened because of the lack of experience in both
managerial and staff and lack of education, other incidents happened due to staff nurses feeling
stressed in the unit. This paper will define such a case by the reflection model of Gibbs designed
by Graham Gibbs in 1988. It is used to encourage the systemic thinking of the individual about
their experiences. It is used during a particular situation or incident1.
Description:
During this step, the situation is described in a detailed manner without drawing any
specific conclusion2. I was assigned as a shift coordinator in a mental hospital. It has been
informed to me by the members of the unit that there is a patient, who stabbed himself. Another
patient escaped out of the unit during the incident. I immediately went there to know the exact
situation and to analyze the action taken by staff members such as how are they coping with the
situation and what are measures that have been taken. However, I noticed something different;
the Staff members were looking scared and extremely nervous. Instead of solving the issue, they
were blaming each other. The unit manager was shouting at the staff member for their careless
behavior and was warning them. In between, when the situation calmed a little, I asked the unit
manager to
meet me outside the unit. I want to know behind their irresponsible behavior and
suggested that shouting at staff members will not help. After the incident, I requested to the staff
1Husebø, Sissel Eikeland, Stephanie O'Regan, and Debra Nestel. "Reflective practice and its role in
simulation." Clinical Simulation in Nursing 11, no. 8 (2015): 368-375.
2 Nicol, Jacqueline Sian, and Isabel Dosser. "Understanding reflective practice." Nursing Standard (2014+) 30, no.
36 (2016): 34.(Husebo et al,2015)

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members of the other unit to manage this unit for a time being in order to calm the staff of this
unit. As I want to know the exact reason, I tried to comfort them so that they can share their
feeling without having any fear. I want to know the exact reason behind this failure and the risk
factor that has been ignored, which lead to this incident. One staff nurse from the unit came to
me and said “I am assigned for 4 patients and among them, 2 are on high suicidal risk and 1 is on
moderate risk. I am not able to manage all the 4 patients together". The same thing was
repeatedly said to me by other staff members that “I cannot manage”. I suggested one or two
days leave for them in order to help them in coming out of the trauma. I informed the unit
manager that the issue has been raised because of the negative impact of the situation on patients,
staff and on the whole hospital. Policies regarding suicidal observation have been formulated and
should be followed.
Feeling
During this phase, the feeling triggered during the event was discussed. Along with that,
another individual’s thought perspective was also briefed in this phase3. I felt worried about the
patient, who had killed himself by stabbing. I was also worried about the patient who was there
during the incident and later escaped out of fear. The other patients were afraid by the incident.
They were terrified by the thought that, if he can kill himself, he might harm other patients also. I
was embarrassed by the behavior of the staff and the manager of the unit. They were all
defending themselves and blaming others for the incident in front of all the patients, who were
surprised by their behavior.
3White, Paul, Julie Laxton, and Ruth Brooke. "Reflection: Importance, theory and practice." (2016).

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I was feeling miserable and helpless as I was neither able to help the patients nor the staff
members, who were depressed. I felt guilty because our nurses staff feeling depressed and
stressed.
Evaluation
In this phase of the reflective cycle, the event discussed in the first two steps is analyzed.
Experience and approach is also discussed4. From the incident, it can be evaluated that, I have
the ability to listen to the worry and pain of the staff. I reassured them that every, each and every
issue will be discussed. Another thing evaluated is the positive response of the unit manager
regarding the issues. This was because it placed the institution in the spotlight since the
reputation was tarnished.
Looking back, the experience had both great and awful components which have
prompted an expanded comprehension of the administration client experience and my job as a
shift coordinator. My role was to
• provide support to the staff, communicate assertively and provide feedback5.
• Provide support to patients by taking action to help them. I felt that I am not able to fulfill the
latter responsibility completely, as I interfered after the issue has been raised6.
More than 10 suicidal attempts were observed in three months. Along with that, two
cases of patient escaping have also been observed. Due to this, the nursing staffs were scolded by
the higher authorities of the organization.
4 Griggs, V., R. Holden, J. Rae, and A. Lawless. "Professional learning in human resource management:
problematising the teaching of reflective practice." Studies in Continuing Education 37, no. 2 (2015): 202-217.
5Gopee, Neil, and Jo Galloway. Leadership and management in healthcare. Sage, 2017.
6 Gopee, Neil, and Jo Galloway. Leadership and management in healthcare. Sage, 2017.

3
Analysis
In this phase of the Gibbs cycle, the analysis was done based on the experience from the
incident7. The incident has given insight on due diligence. From the incident, the importance of
good governance, as well as efficient management of resources is analyzed. In addition,
improving the quality of care and consumer satisfaction is extremely important in health care
organization, it is difficult to implement that.
Conclusion
In this step, the conclusion is drawn on the basis of the incident. The positive and
negative aspect of the experience is concluded8. What could have been done differently and what
skills are needed to overcome such a situation are also discussed. From the above essay, it can be
concluded that efficient management of resources is necessary to provide efficient patient care.
The incident left everyone such as patient and staff member terrified. As each nurse was assigned
to take care of more than 3 or 4 patient, they were not able to provide proper care to the patient.
The unit staff was also not well trained, they do not know how to behave in front of the patient.
They started blaming each other in front of everyone. To cope up with such situation, skills to
manage the resources and communication with patient and staff is developed
7Sicora, Alessandro. "Reflective practice, risk and mistakes in social work." Journal of Social Work Practice 31, no.
4 (2017): 491-502.
8Brown, Michelle Mackin. "Reflective Supervision." (2016).

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Action plan
In this phase, actions are developed based on the experience which might help in the
future to deal with similar situations9. From the above incident, Study all drawbacks which lead
to this incident.to prevent such incident in the future, each staff should be assigned for only one
patient if the patient is on high risk suicidal so that, they are able to provide quality care to the
patient. As I was embarrassed by the behavior of the staff member, it is suggested that proper
training should be conducted on their behavior. The staff member often gets scolding which
lowers their self-respect. Hence, it should be avoided. Resources should be managed more
effectively. Communication between the higher authorities, staff, and patient should be
improvised. Support mechanisms should be discussed to the staff to avoid or reduce experiencing
burnout.
9 Potter, Christopher. "Leadership development: an applied comparison of Gibbs’ Reflective Cycle and Scharmer’s
Theory U." Industrial and Commercial Training 47, no. 6 (2015): 336-342.

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Bibliography
Brown, Michelle Mackin. "Reflective Supervision." (2016).
Gopee, Neil, and Jo Galloway. Leadership and management in healthcare. Sage, 2017.
Griggs, V., R. Holden, J. Rae, and A. Lawless. "Professional learning in human resource
management: problematising the teaching of reflective practice." Studies in Continuing
Education 37, no. 2 (2015): 202-217.
Husebø, Sissel Eikeland, Stephanie O'Regan, and Debra Nestel. "Reflective practice and its role
in simulation." Clinical Simulation in Nursing 11, no. 8 (2015): 368-375.
Nicol, Jacqueline Sian, and Isabel Dosser. "Understanding reflective practice." Nursing Standard
(2014+) 30, no. 36 (2016): 34.
Potter, Christopher. "Leadership development: an applied comparison of Gibbs’ Reflective Cycle
and Scharmer’s Theory U." Industrial and Commercial Training 47, no. 6 (2015): 336-342.
Sicora, Alessandro. "Reflective practice, risk and mistakes in social work." Journal of Social
Work Practice 31, no. 4 (2017): 491-502.
White, Paul, Julie Laxton, and Ruth Brooke. "Reflection: Importance, theory and practice."
(2016).