Competencies have been developed for mental health clinicians in assessing and managing suicide risk; however, there are no standard competencies for psychiatric registered nurses. Widely accepted nursing practices do not meet suicide-specific standards of care or evidence-based criteria. Therefore we propose the following essential competencies for psychiatric registered nurses working in hospital settings as a guide for practice. These competencies are based on a comprehensive review of the extant research literature (both qualitative and quantitative) relevant to assessment and management of hospitalized patients admitted to a psychiatric setting.
The role of the nurse specific to suicide prevention includes both systems and patient level interventions. At the systems level the nurse assesses and maintains environmental safety, develops protocols, policies, and practices consistent with zero suicide, and participates in training for all milieu staff. At the patient level, the nurse assesses risk for suicide, provides suicide-specific psychotherapeutic interventions, monitors and supervises at-risk patients, and assesses outcomes of all interventions. The expectation is that these essential competencies will serve to provide the foundation for training curricula and in measuring the knowledge, skills, and attitudes necessary for expert care.
The psychiatric nurse understands the phenomenon of suicide.
The psychiatric nurse manages personal reactions, attitudes, and beliefs.
The psychiatric nurse develops and maintains a collaborative, therapeutic relationship with the patient.
The psychiatric nurse collects accurate assessment information and communicates the risk to the treatment team and appropriate persons (i.e. nursing supervisor, on duty M.D., etc.).
The psychiatric nurse formulates a risk assessment.
The psychiatric nurse develops an ongoing nursing plan of care based on continuous assessment.
The psychiatric nurse performs an ongoing assessment of the environment in determining the level of safety and modifies the environment accordingly.
The psychiatric nurse understands legal and ethical issues related to suicide.
The psychiatric nurse accurately and thoroughly documents suicide risk.
Barbara J Limandri, PhD, PMHNP, BC
Cheryl Puntil, MN, APRN, PMHCNS-BC
Janet York, PhD, PMHCS, BC, FAAN
Eric Arauz, MLER
Barbara Bonney, APRN
Benjamin M. Evans, DD, DNP, RN APN, PMHCNS-BC
Pamela K. Greene, PhD, RN
Cynthia Kane-Hyman MS, RN, CNS
Dorothy Kassahn MS, MEd., RN, PMHCNS-BC
Pamela E. Marcus, RN APRN/PMH-BC
Joanne M. Matthews DNP, APRN, PMHCNS- BC
Esther Meerwijk, PhD
Charmaine Platon, BSN,RN
Amanda L. Schuh, MS, RN, PMHNP-BC
Reviewed and Validated by:
Internal Content Experts
Linda S. Beeber, PhD, CNS-BC, FAAN
Jim Probert, PhD
Laurie Davidson, MA
Jane Englebright, PhD, RN
Richard McKeon, PhD
Peter Mills PhD, MS
Jane Pearson, PhD
Caitlin Thompson, PhD
Endorsed by the APNA Board of Directors February 27, 2015.