Job-Related Problems Prior to Nurse Suicide, 2003-2017: A Mixed Methods Analysis Using Natural Language Processing and Thematic Analysis

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Publication Date


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Journal of Nursing Regulation


mission; mission viejo; california



Nurses have a higher rate of suicide than the gender-matched general population at baseline. Quantitative data from the Centers for Disease Control and Prevention National Violent Death Reporting System have been previously analyzed to reveal that nurses have more known job-related issues prior to death by suicide. However, no known study has focused on the context of those job-related problems prior to nurse suicide.


The aim of this study was to provide context to job-related problems experienced before nurse death by suicide.


Cases were selected either because they were coded as having a job-related problem prior to death or the words “job” or “work” appeared in the case investigation narrative. Natural language processing and thematic analysis of free-text medical examiner and law enforcement investigation narratives were performed to better describe nurse deaths by suicide in cases with known job-related problems prior to death.


Narratives from a total of 203 nurse deaths from between 2003 and 2017 were included in this study. Very little was reported regarding the actual work of being a nurse. Job-related problems of these 203 deaths focused on substance use, mental health problems, chronic pain, or job loss due to investigations for substance use or diversion of medication.


Nurses who lose a nursing position or leave the profession because of substance use, mental health issues, or chronic pain are at risk for nurse suicide. Alternative-to-discipline programs for nurses with substance use disorder need to be improved and standardized. Earlier or more complete treatment for mental illness may help prevent suicide in this population.

Clinical Institute

Mental Health




Behavioral Health