A Ventricular Assist Device Recipient and Suicidality: Multidisciplinary Collaboration With a Psychiatrically Distressed Patient.
Wendy E Balliet, Alok Madan, Michael L Craig and 7 others
PMID 26422637WHAT IT FOUND
A patient with a ventricular assist device stopped taking medications out of hopelessness, not active suicidal intent.
Multidisciplinary communication and psychotherapy helped him regain trust and adhere to his regimen, highlighting that non-adherence can signal severe emotional distress.
Key findings
01The patient discontinued all medications, including anticoagulants, due to indifference and a desire to control his situation, rather than active suicidal ideation.
02Weekly phone calls from nurse coordinators and direct communication between the mental health and cardiology teams were critical in managing his risk and restoring adherence.
03The patient’s depression interfered with his ability to appreciate the serious medical consequences of stopping treatment, complicating the assessment of his decision-making capacity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The findings are based on a single case, so they cannot be generalized to all VAD recipients. The report relies on self-reported adherence and mood, which may be subject to bias. The specific contributions of different team members to the outcome cannot be isolated.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a patient denying active suicidal ideation is safe. This patient refused medications out of hopelessness and a desire for control, which placed him at imminent risk of death. Passive suicidal behavior can be as dangerous as active intent.