Nursing Research Articles

Fundamentals of end-of-life communication as part of advance care planning for older people: An interview study with nursing staff

This exploratory interview study investigated nursing staff members’ perspectives on the fundamentals of end-of-life communication with older people as part of advance care planning in home care, nursing home, and hospital settings. Separate semi-structured interviews were conducted with 17 nursing staff members about their experiences, opinions, and preferences before, during, and after end-of-life conversations. Overall themes clustering the fundamentals include preconditions such as feeling comfortable talking about the end of life and creating space for open communication. Fundamentals related to the actual conversation–such as using senses and applying associative communication techniques (e.g., using understandable language), following conversation phases, and being aware of interprofessional collaboration–were also considered important. This study emphasizes the importance of moving along with the older person as well as connecting, adapting, and letting go of control over the conversation's outcome. Many fundamentals can be traced back to the basics of nursing and the humanity of conversation.

Home-based nursing care for clients carrying multidrug-resistant organisms: a focus group study

Abstract Background The growing population of vulnerable clients receiving home-based nursing care, combined with the worldwide increase in the prevalence of multidrug-resistant organisms (MDROs), poses a new burden on nursing staff. This study aimed to gain insight into the experiences, attitudes, perceptions, dilemmas in daily practice and needs of nursing staff providing home-based nursing care for clients carrying MDROs. Methods Seven focus group discussions with home-based nursing staff (N = 34) were performed in the Netherlands between April and July 2022, using a semi-structured, open-ended topic list based on the I-change model and seven domains synthesized by Flottorp et al. Data were analysed using thematic analysis. Results Home-based nursing staff often considered infection prevention and control recommendations inconsistent, unclear or inapplicable in daily practice. Although participants acknowledged the importance of these precaution measures, their proportionality was sometimes questioned. Participants indicated to be influenced by perceptions, knowledge and behaviour of their colleagues and clients. In addition, they frequently experienced untimely, incomplete or inconspicuous information transfers about clients carrying MDROs. Concerns were expressed that clients were often insufficiently informed, debating the roles and responsibilities of involved healthcare professionals in providing and exchanging information. Finally, participants elaborated on the effect of the covid-19 pandemic and expressed the need for organisational support in providing education and sufficient resources regarding MDROs. Conclusions Insights of this study have aided in aligning upcoming MDRO guidelines for home-based nursing care in the Netherlands. Organisational support in expanding knowledge and providing sufficient resources is essential and clarity about roles and responsibilities of involved healthcare professionals regarding information transfer and informing patients is needed. Key messages • Expanding knowledge, sufficient resources and adequate information transfer about MDRO carriage are essential to ultimately prevent transmission and spread of MDROs. • The specific context of home-based nursing care for clients carrying MDROs should be acknowledged in MDRO guidelines.

Home-based nursing care: what do we know about multidrug-resistant organisms in this setting?

Abstract Background The burden and complexity of home-based nursing care have intensified due to earlier discharges from hospitals and patients living longer at home with increasing co-morbidities. This growing population of vulnerable patients, combined with the worldwide increase in the prevalence of multidrug-resistant organisms (MDROs), poses a new burden on home-based nursing staff. Home-based nursing care differs significantly from hospitals and nursing homes, challenging implementation of infection prevention and control (IPC) measures. It is therefore important to gain insight into the attitudes, experiences and needs of home-based nursing staff. Also, to better understand the scope of MDRO carriage and transmission in this setting, including its challenges. Methods Cross-sectional studies were conducted in the Netherlands including a survey and focusgroup study among home-based nursing staff, supplemented by a report of cases of MDRO clusters. Results We have identified several factors adding to the complexity of responding to an MDRO outbreak with involvement of home-based nursing care. First, inapplicable recommendations in guidelines/protocols or from infection preventionists, often aimed at intramural care. Second, nursing staff questioned the proportionality of IPC measures, potentially influenced by behaviour of colleagues and patients. Third, inadequate information transfers about patients carrying MDROs. Fourth, uncertainty about the roles and responsibilities of involved healthcare professionals. Finally, the need for organisational support in providing education and sufficient resources, and clarity about financial aspects. Conclusions Insights from these studies have aided in aligning upcoming MDRO guidelines for home-based nursing care in the Netherlands, which factor in the above mentioned complexity. Furthermore, these findings can aid in future strategies to prevent or respond early in MDRO outbreaks with involvement of home-based nursing care.

Pager Explosion in Beirut: An Unprecedented Event.

On September 17, 2024, at 15:30 local time, thousands of pagers used by members of a specific party group detonated across Lebanon. As a result of the explosions, 2800 were wounded and 12 lost their lives. Almost two-thirds of the injuries were in the face, eyes, or hands. The Lebanese American University Medical Center received 38 injured and admitted 36 patients, 13 of them to the Intensive care unit. A total of 33 patients needed surgeries. All medical and nursing staff were deployed. The health care workers faced major challenges that night: the severity of the injuries and the unprecedented types of injuries with the same pattern, and the urgent need for ophthalmology and orthopedics within the hospital and across the country. Learning from the Pager Explosion, each hospital should perform assessments of their disaster response plan, develop trainings, and conduct regular exercises in preparation for future disasters.

Ready to act? Factors associated with nurses’ desire to work in Primary Health Care in Italy

Abstract Background The rapid increase in demand for primary healthcare (PHC) services after the pandemic requires reconsidering nursing staff planning and availability. The objectives of the study were to i) identify knowledge, attitudes, practices and work expectations of future nurses in primary care; ii) estimate the prevalence of nursing students who desire to be employed in PHC and Family and Community Health Nursing (FCHN) services after graduation. Methods A cross-sectional study is being conducted on a sample of nursing students enrolled in universities in the Lazio Region. A structured instrument was built based on the literature and national regulations and validated (Cronbach’s alpha=0.81). Results In this first phase, 163 nursing students were enrolled. The majority of the sample was female (N = 125, 76.7%), with a mean age of 22 (SD ± 5) years and were enrolled in the last year of degree program (N = 85, 52.1%). A total of 49 students (30%) reported adequate knowledge of PHC service reorganization policies and nursing practice in this setting. While 74% (N = 122) of the sample intended to undertake a PHC curricular internship during their degree program, only seven students (4%) participated in one. 52 individuals (30%) expressed their intention to be employed in PHCs after graduation, and 29 (17.8%) indicated their desire to work as FCHN practitioners. The main factors contributing to the undesirability of employment in PHC reported by students were: i) preferring the hospital settings (N = 53, 48%); ii) not having adequate skills to be employed in the PHC (N = 21, 19%); and iii) believing that the PHC does not offer attractive services for nursing practice (N = 14, 13%). Conclusions A multivariable analysis will be conducted to identify predictors of nursing students’ desire to work in PHCs after graduation. Preliminary results of the study showed that only one-third of nursing students indicated a desire to work in PHCs. Key messages • Only one-third of nursing students express a desire to work in PHC and in Family and Community Health Nursing (FCHN) services post-graduation. • Collaboration between the PHC workforce, academics, stakeholders, and policymakers is needed to create tailored initiatives that increase the attractiveness of PHC.

Worse cholecystectomy outcomes during the COVID-19 pandemic: were staff shortages or a change in patient case-mix the culprit?

The COVID-19 pandemic has profoundly impacted the field of surgery, mostly through infectious risks, staff shortages, reduced hospital capacities, and changed patient pathways. Prompted by an increase in wound complications, we performed an in-depth analysis of an example surgical procedure. A consecutive cohort of 195 patients undergoing laparoscopic cholecystectomy was studied retrospectively. Data of patients receiving cholecystectomy before, during, and after the peak of the pandemic were compared. The potential influence of patient characteristics, pandemic phase, and staffing level (surgeons and nurse assistants) was analyzed statistically. In the primary analyses, the composite measure of a 'textbook outcome' was examined, which was defined as no relevant complication, hospital stay < 5days, and no readmission. During the COVID-19 phase, acute biliary disease was more common than in the pre-COVID-19 phase (62% vs. 30%). In 35% of cases, no qualified operating room nurse was available. Intraoperative features and postoperative complication rates were increased (bile spillage in 46%, wound complications in 24%). A 59-year-old male admitted with acute cholecystitis during COVID-19 died of wound-related septic shock. Multivariate analysis confirmed the acuity of gallbladder inflammation (odds ratio 5.3) and old age (2.6) as risk factors for a non-textbook outcome. The absence of qualified nursing staff was clearly associated with a non-textbook outcome (odds ratio 3.3). The fact that laparoscopic cholecystectomy outcomes were worse during COVID-19 can be partly attributed to a change in patient case-mix, but the shortage of qualified nursing staff in the operating room also had a strong negative influence.

Leaders development program by 360 degree feedback: reflection on head nurses' leadership practices.

Leadership in nursing is crucial for delivering high-quality healthcare and ensuring positive outcomes for patients, staff, and institutions. Many nurses in leadership positions lack formal training, which can compromise their effectiveness. This study aims to evaluate the effect of a leadership development program utilizing 360-degree feedback on head nurses' leadership practices. A true-experimental design was employed in three healthcare institutions. The study involved 80 head nurses (40 intervention, 40 control), 240 staff nurses, and 29 supervisors. The intervention group participated in a six-week leadership development program using 360-degree feedback. Data were collected pre- and post-intervention using the Leadership Development and 360-Degree Feedback Knowledge Questionnaire and the Leadership Practices Inventory (LPI). The intervention group showed significant improvements in leadership knowledge and practices across all dimensions. Knowledge scores increased from 25.1 ± 8.8 to 93.0 ± 5.1 post-intervention, maintaining at 83.2 ± 7.1 at follow-up. Self-assessed leadership scores improved from 88.1 ± 6.0 to 97.5 ± 2.7, and 98.5 ± 2.0 at follow-up. Supervisor and staff assessments also showed substantial increases. Multiple linear regression analyses confirmed the strong positive impact of the intervention on leadership outcomes. The leadership development program using 360-degree feedback significantly enhanced head nurses' leadership knowledge and practices. The results suggest that such programs can improve leadership capabilities in healthcare settings, leading to better patient care and organizational performance. Future research should address group homogeneity and explore long-term impacts on patient outcomes.

Psychometric Quality of the Work Content Questionnaire Applied to Nursing Staff to Identify Job Stress

Objective: To demonstrate the reliability and construct validity of Karasek's Job Content Questionnaire (JCQ), which measures psychological demands, job control and social support, in nursing personnel. Theoretical Framework: In Mexico, the Federal Labor Law specifies that psychosocial risks must be kept at low or zero levels to prevent work-related stress in nursing staff. Method: The Job Content Questionnaire was applied to a sample of 181 nursing professionals from a population of 200 people. The internal consistency of the questionnaire was examined using the Cronbach's Alpha reliability coefficient, the construct validity of the questionnaire was identified through the fit indices of the confirmatory factor analysis, using the maximum likelihood method. Results and Discussion: The results obtained revealed [synthesize the main results of the research]. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The Job Content Questionnaire presented adequate internal consistency (Cronbach's Alpha=.80) and construct validity in the sample; the structural equation model presented an adequate fit: GFI=.73, RMSEA=.066, NNFI= .93, CFI=.94, PNFI=.78. These findings affirm that the Job Content Questionnaire is valid and reliable to evaluate psychosocial factors among workers who perform nursing activities in Mexico. Originality/Value: This study contributes to the literature by demonstrating the reliability and validity of the Job Content Questionnaire in nursing in Mexico. Its effectiveness is confirmed to evaluate psychological demands, work control and social support, critical aspects to mitigate stress and improve the quality of work life. The results can influence labor policies and institutional practices, promoting healthier work environments, reducing stress and improving the quality of care in the health sector, which benefits both workers and patients.

Nurses’ Views and Attitudes of the Performance Appraisal System Efficacy and Its Impact on Their Work Outcomes in a Tertiary Hospital

ABSTRACT Introduction Performance appraisal (PA) is essential for healthcare organizations. Highlighting the impact of the nursing PA system on nurses’ work outcomes has the potential to significantly improve the quality of patient care. Understanding and enhancing the performance appraisal system is key to achieving this goal. This study aimed to assess the efficacy of the nursing PA system and its effect on nurses’ work outcomes. It also compared the perceptions of PA among staff nurses (SNs), charge nurses (CNs), and head nurses (HNs), providing valuable insights into the dynamics of the nursing PA system. Method A cross-sectional, descriptive, and comparative design was adopted to assess the current nursing PA system. Results This study, which included 356 nurses, revealed significant differences in the perception of PA among nurses at all levels. The findings underscore the practical implications of the potential for more efficient use of PA to improve nurses’ performance. SNs and CNs showed significant gender-based differences in PA effectiveness (p = 0.006) and efficiency (p = 0.034). The participant’s age and years of nursing experience also had statistically significant effects on PA effectiveness (p = 0.006, p = 0.025, respectively). Conclusion This study’s findings underscore the significant impact of inappropriate PA systems, inefficient instruments, and unskilled evaluators on organizational commitment, job satisfaction, maintaining a committed nursing workforce, and high-quality healthcare. The study also highlights the importance of effective performance appraisal systems in healthcare organizations. However, the study also emphasizes the crucial role of a mutual understanding between the appraiser and the appraisee. This understanding is a key factor in enhancing the efficacy of PA, thereby emphasizing its importance in the appraisal process.

Rainbow within and beyond: A qualitative study on the experiences of lesbian, gay, bisexual, and transgender staff nurses in the Philippine hospital settings.

An individual's sexual orientation plays a fundamental role in their self-identity, relationships, and health. Years have shown both progressive and regressive responses to the LGBT community's social acceptance, particularly observable in various areas. Yet existing literature overlooks the Filipino healthcare settings, particularly with lesbian, gay, bisexual, and transgender (LGBT) staff nurses. Exploring their perspectives and experiences, whether challenges or successes, is crucial for gaining insights into occupational matters, workplace dynamics, and policy development. The research aimed to explore the lived experiences of LGBT staff nurses in the hospital settings. Husserl's Transcendental Phenomenology research design was utilized in this study. Participants included LGBT staff nurses with at least a year of experience at any hospital department. Individualized unstructured interviews were conducted with three participants interviewed face-to-face and five through online video conferencing platforms from March to April 2024. All interviews were transcribed, coded, themed, and analyzed using Colaizzi's approach. Data saturation was achieved with eight participants. Seven themes emerged, including: Recognizing Gender Stereotypes, Optimizing Nursing Care, Yearning for Acceptance, Generating Meaningful Relationships, Battling Heteronormative Gender Norms, Inspiring Potentials beyond Gender and Profession, and Valuing the Progress of LGBT Inclusivity. The study revealed that LGBT staff nurses had multifaceted experiences with patients, colleagues, and superiors in the hospital settings as their workplace. They faced gender stereotyping and battled against limits on expression but fought to defend their authentic identities. They built relationships with colleagues and strived to be defined beyond societal perceptions. As they yearn for amplified LGBT acceptance in the workplace and society, they expressed gratitude for progress towards acceptance of the LGBT community.

Ambidextrous Leadership and its Relation to Innovative Work Behavior among Staff Nurses

Ambidextrous Leadership and its Relation to Innovative Work Behavior among Staff Nurses

Culture of safety in an adult and paediatric emergency department before and after the COVID-19 pandemic

BackgroundThe WHO recognises patient safety as a serious public health problem. The COVID-19 pandemic affected adult EDs (AEDs) and paediatric EDs (PEDs) differently. We compared the culture of safety in...

Knowledge and Practices Regarding Prevention of Central Venous Catheter Removal-Associated Air Embolism: A Survey of Nonintensive Care Unit Medical and Nursing Staff.

Air embolism is a potentially serious complication of central venous catheter (CVC) use. While CVC insertion is usually performed by a trained specialist, extraction is frequently the responsibility of junior staff members. This complication can be easily prevented by following several simple measures described in common guidelines. We conducted a single-center survey to assess knowledge and practices concerning the prevention of air embolism associated with CVC removal among healthcare workers from nonintensive care units. The correct answers to the questionnaire were determined according to best-practice recommendations for CVC removal. Based on a comparison of the total sum of correct answers between the categories of groups, factors that predicted the level of knowledge were identified using an independent sample t test. Of the 156 respondents, one-third were unfamiliar with air embolism as a complication of CVC extraction. Almost 80% were unaware of the existence of a CVC removal protocol. Almost half of respondents did not follow guidelines regarding patient position when removing a CVC, 72% did not ask the patient to perform the Valsalva maneuver during the procedure, and 54% did not ask the patient to remain supine after the procedure. Adherence to the protocol was correlated with professional experience, with a lower level among those with experience of less than 1 year and, particularly, among interns. Our survey revealed inappropriately low awareness of CVC removal-associated air embolism risk and low familiarity with CVC removal best-practice recommendations among nonintensive care unit healthcare workers. Staff members with experience of less than 1 year, including interns, were found to have a lower level of knowledge. These findings emphasize the importance of development and distribution an internal hospital protocol and the integration of educational intervention into a preliminary internship program.

Poorer Nurse Staffing in Black-Serving Hospitals

Poorer Nurse Staffing in Black-Serving Hospitals

Unit Leadership and Climates for Evidence-Based Practice Implementation in Maternal-Infant Health Units: A Cross-Sectional Descriptive Study.

To describe unit leadership and climates for evidence-based practice implementation and test for differences in unit leader and staff nurses' perceptions within maternal-infant units. A cross-sectional descriptive study. A convenience sample of maternal-infant unit leaders and nurses (labour, postpartum, neonatal intensive care, paediatrics) from four Midwestern United States hospitals completed a survey including the Implementation Leadership Scale (ILS) and Implementation Climate Scale (ICS). Descriptive statistics described items, subscales and total scores. Independent t-tests with Bonferroni correction tested for differences in perceptions. A total of 470 nurses and 21 unit leaders responded, representing 17 units. Ratings of unit leadership and climates for implementation were modest at best [ICS: M = 2.17 (nurses), 2.41 (leaders); ILS: M = 2.4 (nurses), 2.98 (leaders)]. Unit leader ratings were statistically significant and higher than nurse ratings. This study is one of the first to describe unit leadership and climates for implementation in maternal-infant health. To improve outcomes and equity in maternal-infant health, attention on leadership behaviours and unit climates for evidence-based practice implementation is needed. Nurse leaders are encouraged to evaluate their leadership behaviours and the unit climates they facilitate, and work to improve areas of concern or where staff perceptions differ. Staff nurses should work with their leaders to identify resources and rewards/recognition which support and facilitate EBP implementation. This study addressed a gap in research examining the social dynamic factors of unit leadership and climate for evidence-based practice implementation in maternal-infant units. Leadership behaviours for implementation and unit climate were rated moderately by both staff and leaders. Unit leaders rated their implementation leadership and climates higher in almost all items. This study is relevant to unit leaders and nurses in maternal-infant units in the United States. This study adhered to STROBE guidelines. No patient or public contribution.

Navigating transitions: a qualitative study of nursing teams' experiences of educational and cultural transitions in Germany.

The global migration of health professionals in general and nurses in particular, has led to nursing shortages and socioeconomic impacts on health systems in both source and destination countries. Adding to the complexity of the situation is the fact that the nursing profession itself is evolving from a vocational to an academic one. Although nursing migration and academization have been studied from either an institutional or an individual perspective, there is a gap in the literature regarding how nursing teams experience these transitions. This study aims to explore how nursing teams navigate through the transitions of academization and internationalization of the current dynamic nursing landscape in Germany. Based on social constructivism epistemology this qualitative study involved face-to-face focus group discussions conducted at several hospital sites in Germany from September 2021 to May 2023. The focus group discussions were audio-recorded, transcribed, and analysed using content analysis; the four dimensions of transition theory according to Schlossberg's Four S (4S) framework (self, situation, support, and strategy) were used as a priori items to construct the coding framework. Nine focus group discussions were conducted with a total of 40 nurses from different educational and migrant backgrounds. The analysis showed that the transition experiences of the nursing teams were heterogeneous, with educational and national backgrounds playing an important role in how realistic their expectations of their professional roles and identities were. The dynamic situation characterized by a shortage of qualified nursing staff, increases the pressure on nursing teams and underscores the importance of employer-provided and peer support. Onboarding and communication are key strategies used depending on the duration of the employee turnover. This study provides insights into the challenges and coping strategies of nursing teams in the current dynamic scene of migration, academicization and professional socialisation in Germany. Extending the Schlossberg 4S framework from the individual to the team perspective provides a comprehensive view of the transitional experiences of nursing teams. Within each domain of the framework, the experiences of nursing teams are remarkably diverse. Educational background (vocational or academic) and origin (German or foreign trained) play an important role in shaping the transitional experiences of nursing teams.

Resilience, compassion fatigue, moral distress and moral injury of nurses.

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey's description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programs and initiate efforts to improve nurses' resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study.

The Workload and Stress Levels Among Staff Nurses in the Inpatient Ward of a Secondary Health Care Service in Indonesia

The Workload and Stress Levels Among Staff Nurses in the Inpatient Ward of a Secondary Health Care Service in Indonesia

Evaluation of Nurses’ practices about Umbilical Cord Care for Neonates in Neonatal Intensive Care Units

Background: The umbilical cord, made of Wharton's jelly, is a gelatinous material that extends from the fetus's umbilicus to the placenta. It consists of two umbilical arteries and one vein, and the urachus, a remnant of the allantois. Infections can lead to complications, including sepsis, abdominal button inflammation, abscess, necrotizing fasciitis, and liver abscesses. Objective(s): This study aims to evaluate nurses’ practices about umbilical cord care for Neonates. Methodology: A quantitative approach using a descriptive-analysis design was used in the present study in order to evaluate nurses’ practices about umbilical cord care for Neonates. . The period of the study was from January 13th ,2024 to May 13th, 2024 . A questionnaire was completed by 64 nurses staff from Welfare Teaching Hospital and Central Teaching Hospital of Pediatric. The sample consisted of 50 nurses. Results: The practices levels was assessed using a three-point scale. A study of nurses found that while 70% were female, the majority had a diploma in nursing and a bachelor's degree. Most had between 1 and 6 years of hospital experience and a significant number of specific NICU experience. Most nurses actively sought to update their knowledge about neonatal umbilical cord care. However, the majority of practices were rated as 'Poor', indicating a gap in compliance with established protocols and standards for umbilical cord hygiene and maintenance. The study found no significant correlation between demographic characteristics or experience in hospitals and NICUs, and suggested that knowledge alone may not translate into effective practice without continuous training and strict adherence to protocols. Conclusion: while our study agrees with some existing literature it also challenges studies indicating an interplay of factors affecting neonatal care practices beyond just the demographic characteristics of nursing staff. Future research should delve into systemic influences on practice adherence along with evaluating targeted interventions effectiveness in enhancing cord care quality, in neonatal units. Recommendation :From the results of this study and also from the previous literatures and researches its became essential to establish a mandatory training sessions for all the staff in the NICU focusing on the best practices for the care of umbilical cord, and this sessions has to include a standardized protocols to ensure that the knowledge is efficiently translated into practice.

Lethal Self-Administration of Atracurium: A Rarely Reported Case with Review of Literature.

Atracurium besylate is a nondepolarizing skeletal muscle relaxant first introduced in 1980. It is used during endotracheal intubation. It causes muscle relaxation during surgery or mechanical ventilation. When people consider suicide, they employ drugs found in their surroundings but not usually injectable muscle relaxants, which are not widely available. Studies on their use in suicide are rarely reported worldwide. This was a case of a 34-year-old male nursing staff, working in the general surgery department's operation theater complex, who was found unconscious in bed in his room in the morning with an empty syringe by the bedside. He was declared dead when brought to the emergency department. Forensic autopsy was conducted, and during the external examination, a needle puncture wound was found over the left cubital fossa. No other external other injuries were observed throughout the body. The toxicological analysis report indicated the presence of laudanosine in the vitreous humor, blood, urine, and skin from the puncture site and underneath vein. Also, the toxicological analysis of the empty syringe found at the crime scene revealed the presence of atracurium, confirming that the victim had administered a lethal dose of atracurium.