A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement.

ABSTRACT

AIMS AND OBJECTIVES: To use a poststructuralist framework to critique historical, social and institutional constructions of emergency nursing and examine conflicting discourses surrounding suicide prevention. The aim is to also demonstrate practical guidance for enhancing emergency nursing practice and research with regard to suicide prevention. BACKGROUND: Emergency departments have been historically constructed as places for treating life-threatening physical crises, thereby constructing other "nonurgent" health needs as less of a priority. Physical needs take priority over psychological needs, such as suicide-related thoughts and behaviours, negatively impacting the quality of care that certain groups of patients receive. DESIGN: A theoretical analysis of the published literature on the topic of emergency nursing and suicide prevention was conducted and analysed using a poststructuralist framework. METHODS: Relevant literature on the topic of emergency nursing related to suicide prevention was analysed for a poststructuralist construct of power, language, subjectivity and discourse. Implications to practice and research were identified, as well as expanding emergency nursing using a poststructuralist framework. SQUIRE guidelines were used (see Supporting Information). DISCUSSION: The emergency department is a critical point of intervention for patients with urgent and life-threatening needs. However, the biomedical model and historical, social, and institutional expectations that influence emergency nurses' beliefs and values do not effectively respond to the needs of suicidal patients. One step to address this issue is to deconstruct the current understanding of emergency nursing as a treatment for only life-threatening physical crises in order to become inclusive of psychological crises such as suicide-related thoughts and behaviours. RELEVANCE TO CLINICAL PRACTICE How a poststructural framework can be used to expand emergency care is discussed. Examples include empowering nurses to challenge the "taken-for-granted" emergency nursing and recognizing the health needs that fall outside of the dominant discourse of emergency care.