Sunday, 12 November 2017

You too can train in approaches to suicide prevention: it’s not just for nurses

One of the advantages of being both retired and able to use digital communications technology is that I can now attend meetings from the comfort of my living room. Fortunately the 2 teleconferences I took part in this week were audio only, so nobody could see me sitting there in my shorts and t-shirt, my hair looking like I had been dragged through a hedge backwards (we have strong winds up here in the North!). The teleconferences were a wonderful way to be able to participate in what is being called the Consultation Assimilation Teams (CAT) for the Nursing and Midwifery Council (NMC). CAT are sub-sets of the NMC Thought Leadership Group (TLG), which is a group I have been a member of for the past 2 years.

The work of the TLG has been to look at the scope of practice for a graduate nurse in 2030 and what might be the most effective way of preparing them for that role. It has been a great group to work with. There are representatives from all 4 nations of the UK. The TLG is made up of academics, senior nurses, and student and early career nurses. The membership of the group spans all areas of health and care practice. It has that tangible depth and richness of quality and confidence that comes from a collective experience reperesnting 35 years of nursing practice, research and education.

The CAT teleconferences provide an opportunity for the TLG to revisit the draft standards of proficiency. These are what potential nurses will need to demonstrate they have met in order to gain registration and be considered a capable and safe practitioner. The proficiency standards have been grouped under 7 headings which describe the key components of the roles, responsibilities and accountabilities of registered nurses. It is anticipated that at the point of registration, graduate nurses will: be an accountable professional; promote health; assess needs and care plan; provide and evaluate care; lead nurse care and work in teams; improve safety and quality of care; and coordinate care.

These proficiency standards are just one of a suite of interrelated pieces of work being undertaken by the TLG. Other strands of work include: standards for education and training (with particular emphasis on how learning will be assessed); the requirements for future pre-registration and prescribing programmes; and medicine management. It is a very interactive process, with much consultation being undertaken across a wide variety of stakeholders. Last Tuesday I travelled to London to join the rest of the TLG for a day of consolidation and up-dating on progress so far. It was an exciting day, and it was good to see the data that was gathered through the consultation activities.

However, unlike the teleconferences, attending the TLG required a train journey to London, which was fine going down. Later that day and some 10 mins after leaving London to return to Manchester, the train stopped and didn’t move. After some 30 mins we were told by the train manager that sadly there had been a fatality in Bletchley, just outside Milton Keynes and as a consequence we could expect a great deal of disruption to our journey. Eventually we did re-commence the journey, which instead of taking 2 hours actually took nearly 5 hours.

Of course the temporary inconvenience we as passengers experienced on the night would be nothing compared to the distress, pain and shock the family and friends of the person who died will have to deal with. They will have to deal with it for the rest of their lives. My thoughts were also with the train driver and those from the emergency services who attended the scene. I don’t travel to London very often these days, but this is the second time this year the train I was on has been delayed because of a fatality. Sadly it’s a fairly common occurrence. The latest figures (2015/16) for the number of overall fatalities on British railways was 297, and although these data won’t be officially updated until December, so far the 2016/17 figure is 276 deaths. 

The person who died last Monday did so by suicide. 252 of the 297 deaths on British railways in 2016/17 were as a result of suicide. Each of these deaths is very sad, and each will have its own circumstances and complexities. Sadder still is that 4 people have chosen death by suicide at or near the Bletchley Station in the last month and 7 people have died in this way since July. Reassuringly, work is being undertaken to address this problem, and large numbers of Network Rail staff and Transport Police are attending a suicide prevention programme run by the Samaritans. See here for more information.

The programme teaches rail staff how they can respond if they see someone looking vulnerable in or around the station itself, a railway crossing bridge or the general station environment. They are taught what to say and how to start a conversation. There is much evidence to support the notion that talking is often the first and important intervention in saving someone’s life is such a situation. It is a simple step to take, and for those people perhaps fearful of saying the wrong thing, the Samaritans programme has proven to very helpful in raising self confidence and challenging the stigma sometimes associated with dealing with suicide. I would also suggest that the programmes information is helpful for all of us too, and that will, in time include the graduate nurse of 2030.