Rose Lynch: parasuicide crisis support nurse for Cork city A&E departments says the key is to think systematically
My working day starts at 7.30 a.m. when I ring the three A&E departments in Cork city to see if anyone has presented to the hospital after making a suicide attempt or attempted self-harm.
I will attend the hospital to visit the patient when they are medically fit. I do a suicide risk assessment and look at issues such as hopelessness, depression and anxiety. I define the client's problems and prioritise them accordingly. This usually takes about one hour.
I also identify what we term a significant other - a family member or a friend. With the client's approval, I talk to them, just to make sure that I am getting the real picture. This meeting usually takes place face to face and may happen at the same time as the initial session with the client.
I draw up a list of goals for the client for the first week following their discharge from hospital and discuss an overall care pathway with long and short-term goals. The nurse and the client sign a therapy contract.
Our programme usually lasts six weeks. I meet the client every week for the first three weeks. We meet at our office on Penrose Road, in their home or wherever they feel comfortable.
After the third week, we meet fortnightly to encourage the clients to be independent and to wean them off the service. The treatment is action based and the client dictates the pace.
If they need more extensive supports, such as addiction, bereavement or child sexual abuse counselling, we encourage them to access them.
I also liaise with the client's GP and, after the six weeks, we discharge the patient into the care of the GP.
The service was established as a result of National Suicide Task Force. It is run by two nurses: myself and my colleague Eileen Murphy.
Since the service started on September 11th, 2001, we have treated hundreds of clients. There are equal numbers of women and men.
We have had only about 10 repeats in this time, and these would have been repeat cases anyway. It is very hard to gauge, but it seems that we are getting places.
Before this service was established, parasuicide patients were treated on an outpatient basis.
Eighty per cent didn't show for their appointments because they were embarrassed by the stigma of suicide, or didn't want to deal with the issues involved. Many then returned as repeat parasuicide patients to the A&E department.
The key is to think systemically. You can't think about the client as a person on his or her own, or just isolate their problem. There are always other factors and there is always family involved at some level.
I work outside office hours to suit my clients and often work until 7 p.m. As the service is 24-hour, I can get called in to the hospital at any time of the night. I either work from Monday to Wednesday or from Thursday to Saturday, as well as every second Sunday.
My job can be a bit complicated at times but I find it very rewarding. I enjoy bringing people to a better place.
(Interview by Fiona Tyrrell)