|APNA Facilitators with Board of Directors in June|
Hear from the Nurses Newly Trained as Facilitators of the APNA Competency Based Training for Suicide Prevention
Thanks to 32 newly trained nurse facilitators, psychiatric-mental health nurses across the country will now have access to evidence-based nursing knowledge and best practices for preventing the 10th leading cause of death in the US: suicide. “This training is so vital to both the development of our nurses and the care of those we serve,” says Tina Aown, MSN, RN-BC, CNML. “I am also hoping that other nurses will want to become facilitators. We have a lot of ground to cover. Through reinforcing the standard of practice and raising the standard of care, this training will save lives.” Aown is one of the 32 newly announced facilitators, or instructors, now authorized to deliver the APNA Competency Based Training for Suicide Prevention.
The seeds of the APNA Competency Based Training for Suicide Prevention lie in the Psychiatric-Mental Health Nurse Essential Competencies for the Assessment and Management of Suicide Risk which APNA released in 2015. A key element of APNA’s position regarding the competencies is that their dissemination will “improve outcomes in suicide risk assessment, prevention, and intervention, ultimately increasing safety.” Death by suicide is believed to be mostly preventable if the person at risk receives proper screening, identification, and prompt intervention from competent mental health professionals. The APNA Competency Based Training for Suicide Prevention is the framework for translating the competencies into each nurse’s daily practice to improve outcomes.
In honor of National Suicide Prevention Awareness Month, we spoke with this first class of APNA facilitators to learn a little bit more about the program and their plans going forward. They are all incredibly committed to sharing best practices in suicide prevention: this interactive training program took place over several months and featured meticulous readings, discussion, case studies, and more. But as Meg Sherlock, RN, MA, PMHCNS-BC, will tell you, it was worth it: “This training offers a standardized, evidence based approach that can build clinical confidence and provide the nurse with a humanistic and effective response to suicidal thoughts and behaviors. My experience as a trainee was terrific - the training is rigorous, but so worth it!”
Marsha Lastique Asher, MSN, RN shares a similar perspective. “When I was a new nurse I did not receive suicide risk education,” she says. “I realize [now] how important it is for every nurse to be provided with this education. [It] not only provides nurses with the skill needed to perform an adequate assessment for suicide risk, but it also teaches nurses how to use critical thinking and their clinical judgement during the assessment.”
Now that they are validated APNA facilitators for the competency based training, the nurses are making plans to disseminate it. Most will begin with their own facilities. Fran Zucco, BSN, RN-BC and Kristina Koeppl, BSN, RN-BC from a hospital in Illinois are looking forward to sharing their expertise in the form of a hospital-wide education campaign. “[It will] give our nurses the tools they need to properly assess, intervene and plan the care of our patients,” says Zucco. For Lastique Asher, the program fits in perfectly with her organization’s current priorities: “My organization is currently looking for ways to improve staff education for staff to better recognize suicide risks, and this program helps to provide this,” she says.
As a part of their training, facilitators recorded themselves delivering sections of the material. John Mader BSN, RN-BC used colleagues as his audience. In addition to helping him develop his presentation skills, they also responded positively to the content, he says. “When reviewing Chronological Assessment of Suicide Events and denial of specifics [a section of the curriculum], many staff indicated that they would have stopped the assessment as soon as the patient verbalized that he had not thought of any other ways of killing himself,” he explains as an example. “The use of the denial of specifics technique facilitated the disclosure of many other ways the patient in our role play had considered killing himself.” Mader will be delivering the Competency Based Training for Suicide Prevention with another Facilitator, Barbara Bonney, this October 19th in Hartford as an pre-cursor to the APNA Annual Conference.
Lisa Farmer, BSN, RN-BC, LMSW is a facilitator and the director of psychiatric services at a large children’s hospital in Fort Worth, Texas. “Sadly, major depression and suicide attempts are a very relevant occurrence in child/adolescent behavioral health,” she says. “We are most thankful to be a part of a healthcare system that values and supports the entire continuum of behavioral healthcare.” She will be rolling out the curriculum to psychiatric nurses at her own facility and the community this month. “We are including Emergency Department nurses who see patients at risk and medical surgical nurses who treat youth who have attempted suicide and are being medically stabilized prior to transfer to an inpatient psychiatric unit,” she adds. Shirlee Davidson MSN, RN agrees with this approach: "The skills learned in this class are needed by all nurses to build trust, encourage hope and save lives,” she says. “I hope schools, institutions and agencies throughout the country will support their faculty and staff members in attending these trainings to enhance their competence in suicide prevention. The need for this type of training is NOW!"
Bringing the Training to Singapore
As a PMHNP, I’ve had a special interest in suicide; trying to understand the phenomena and what we can do as nurses to better manage clients who are in the brink of suicide. I was delighted when I read the APNA Position Statement about 2-3 years ago that spelled out the gaps in current training for nurses in managing suicide and the importance of a competency based training for nurses to assess and manage inpatients who are suicidal. I kept updated on this topic and followed the discussion by APNA on implementation of the training.
Pamela Greene introduced the program and competencies to us in Singapore during her visit in 2015. I learned that we would benefit from this training for our nurses who manage acutely suicidal patients but may not have the full training in providing the care required. Through discussions with Pam Greene, 3 of us were enrolled in the facilitator training.
One of the key highlights and take away from the program was the framework for determining acute versus chronic suicide risk. This is an area which, if not done correctly, could be life threatening – and nurses may not deliver the appropriate level of care required. The other area which stood out for me was the safety planning and engaging the client to be involved in designing the safety plan.
We plan to roll this program out and train about 300 RNs working in a state tertiary psychiatric hospital in the next 5 years.
- Raveen Dev