Citation

Masuku S. Br. J. Nurs. 2019; 28(22): 1468-1476.

Affiliation

Lecturer, Mental Health Nursing, Department of Nursing Midwifery and Healthcare, Northumbria University, Newcastle upon Tyne.

Copyright

(Copyright © 2019, Mark Allen Publishing)

DOI

10.12968/bjon.2019.28.22.1468

PMID

31835948

Abstract

Addressing the rising incidence of self-harm and the demand this places on emergency departments (EDs) are UK Government healthcare priorities. A history of self-harm is linked with suicide risk, so self-harm is a public health issue. The ED is the first point of contact for many people who self-harm so it plays a pivotal role in access to services. Research has highlighted difficulties around triage and assessment in EDs of patients who self-harm, especially frequent attenders. The evidence base on patient experience related to addressing negative staff attitudes is lacking, despite their potent nature and impact on care. Limited knowledge of self-harm aetiology and clinical inexperience have been found to be fundamental to nurses' negative attitudes when dealing with patients who self-harm. This has been linked to negative patient outcomes, including a reluctance to engage with services. This article acknowledges positive changes that have been made and highlights the importance of the triage stage, which is a potential service improvement area, where it would be possible to start and drive positive change in the care of people who self-harm. To address knowledge gaps in education and management, clinical understanding of the aetiology of self-harm should be improved with the aid of education on self-harm cycles. Nurses should also be made aware of common myths surrounding self-harm, as these are barriers to care. Recommendations for practice include partnership working and the urgent need for formal education on this topic for all health professionals working in EDs.

Language: en

Keywords

Emergency department; Mental health; Nurse education; Partnership working; Self harm; Service improvement