Suicide among female nurses is double that of the general female population

A little while ago there were a slew of studies which concluded that female professionals were more likely to indulge in binge drinking and ideate suicide than their male counterparts. They also found that female professionals were more likely to suffer from major depressive disorder. The problems of balancing home and work, bullying by male colleagues, harassment and lack of promotion opportunities were some of the causal factors mentioned.

I was therefore fascinated by this just published study which found that female nurses are roughly twice as likely to commit suicide than the general female population and 70% more likely than female physicians. The researchers examined suicide among physicians and nurses.

What the researchers say: “It’s much higher than I expected,” said the study lead author. “The takeaway for me is we’ve focused so much on physician welfare that, historically, we haven’t paid enough attention to this huge workforce that, based on our data, is at much higher risk.”

There are roughly three million nurses working in the United States, making it the country’s largest health care workforce—85% of whom are women.

The current study did not include data from the pandemic, which means these numbers could be even higher now, the researchers note.

The researchers also found that nurses and physicians face many similar risk factors for suicide, but in nurses those risk factors are potentially exacerbated by long hours and less autonomy.

“I’m worried about two key issues in today’s workplace,” said the lead author. “First, health care systems are placing increased demands on nurses, physicians and other health care workers. Even before COVID, nurses reported substantial workplace stressors, including reduced staffing, increased complexity of care and additional bureaucratic tasks. Nurses have been working nonstop caring for seriously ill patients and facing their own exposure to this virus.

“Second, the nurses I work with routinely face tougher challenges at home that place added stress on them, such as caregiving for children or parents. You put the workplace and home stressors together and it’s no surprise that nurses are struggling. I worry that without concerted action, things may get worse before they get better.”

Among male nurses, the risk of suicide is no higher than the general male population, the study found. But the researchers were surprised by the high number of suicides among female nurses compared to physicians, and they found no difference in the suicide rates of physicians and the general public, which differs from previous studies.

There are a couple possible reasons for this, they say: It could be that the physician studies aren’t capturing the entire picture—most are small, single-state studies and dated. Or, perhaps, wellness programs targeting physicians have worked.

The researchers said that major impediments to seeking help include stigma attached to seeking help and real, justifiable fear for their livelihoods. This is something that I pointed out in a recent TR piece about female physicians, and it’s not confined to the medical profession.

The study findings illuminate the need for high-quality wellness programs for nurses: Nurses are 90% more likely to experience on-the-job problems and 20-30% more likely to be depressed than the general population.

More than half of all suicides among the general population are the result of gunshot wounds. Among nurses, however, overdose is more common. Both nurses and physicians are more likely to have antidepressants, benzodiazepines, barbiturates and opiates in their system, which suggests a need for greater behavioral health awareness among health care professionals, the researchers say.

“The reason we looked at this is because people who work in health care have easier access to medications and know how to use them to overdose, which also increases their risk,” the researchers said. “Simply not having a way to do it may be enough of a deterrent to suicide.”

So, what? Overall suicide in the US, Australia, Europe and elsewhere is on the rise. Most of it is due to work stress—including the loss or downgrading of employment.

Another reason—also highlighted in a study reported recently in TR highlighting the problem of burnout among health workers—is the dehumanization of work. We are designed to work with other human beings and our stress increases when much of the work—and thus much of our workplace social interaction—is replaced by machines.

The combination of stress and dehumanization is only going to get worse and the suicide rate will only increase.