Suicidality in women nurses: A critical interpretive synthesis.

Background: The suicide rate among women nurses in the global north is considerably higher than the rate among male nurses and among women in other occupations. Research in this area is expanding but often appears similar because it is dominated by quantitative methodologies. This dominance is troublesome because quantitative approaches limit the questions asked, focusing on what is happening, rather than why it is happening. Individual-level explanations similarly dominate, sidelining both structural factors and lived experience. These limitations produce incomplete evidence that can lead to ineffective policy. Objective: To present a critical interpretive synthesis that aimed to identify how suicidality in women nurses is represented in research, the gaps within this representation, and the political, social, and personal consequences of these gaps. The occupational disparities women nurses face have been overlooked by previous researchers. Design: A critical interpretive synthesis approach was used with collaborative involvement from nurses who had relevant lived experience. These contributors participated throughout data extraction, interpretation, and synthesis to ensure that practical insight and real-world understanding informed the findings. Settings: Texts were included if they referred to nurses working in any form of health care setting across the globe. Participants: The review team consisted of seven members. Four were nurses with lived experience of suicidality who contributed contextual and analytic expertise. Methods: A total of 11,188 texts were screened. Reviewers completed full text assessments of 498 articles. Studies were organised by methodology, and a sampling frame was used to ensure balanced representation from a range of methodological traditions and discussion papers. Fifty studies were included in the final synthesis. Data extraction was guided by critical questions and an intersectionality checklist. A meta matrix was used to compare interpretations across studies. Results: Most studies used quantitative methods and presented suicidality as an individual problem associated with pathology or personal weakness. Recommendations commonly focused on screening or resilience training. Structural contributors, such as workload, staffing pressures, discrimination, psychological safety, and migration-related challenges, were often overlooked. Interactions between gender, ethnicity, and social position were rarely explored. Real life experience perspectives were under-represented. Conclusions: Individualisation, responsibilisation, and pathologisation obscure the root causes of distress and place the burden of blame on nurses. The result is poor quality and unrepresentative evidence that contributes to policies and practices that do not prevent suicide among women nurses.Registration: osf.io g74uk, OSF Registries, Registered 01/07/2024.