In late July, Nursing Times broke a story that made me go cold. The Nursing and Midwifery Council (NMC) is under pressure after several nurses died by suicide during lengthy “fitness to practise” (FtP) investigations. This isn’t a minor procedural hiccup. It’s a system so sluggish and adversarial that it actively compounds distress. Nurses have been waiting four, even five years for a resolution. In the meantime, their careers stall, their finances collapse, and their identities unravel. It is a horrible process which can create the worst of outcomes, as some never make it out the other side. An independent review last year confirmed what many already suspected: at least six suicides since April 2023 linked directly to FtP processes, alongside a backlog of nearly 6,000 cases and a culture described as bullying, discriminatory, and lacking compassion. One nurse put it bluntly:

“We are incredibly stressed… we’re having problems with our mental health, visas, many are leaving the profession.”

That’s not regulation, that’s harm. Let’s be clear: these deaths are not isolated tragedies. They are the predictable outcome of a structure that prioritises process over people, bureaucracy over dignity, and delay over justice. A drawn-out investigation is not neutral—it’s a psychosocial hazard.

Why this matters

For every nurse who dies by suicide in these circumstances, countless colleagues absorb the shockwaves. Teams fracture. Trust in regulators crumbles. Families are left asking how a profession dedicated to care could allow its carers to be broken by the very system meant to protect the public. While the estimated numbers vary, it is thought that between 130 and 180 people are impacted by a suicide. Within the close-knit community of a field such as nursing, this ripple effect could act like a tidal wave. If we want to understand the concept of moral injury in healthcare, look no further than an FtP process that can leave professionals suspended in limbo for half a decade. It’s the kind of nightmare that burns people out, forces them to exit the profession, and ultimately worsens the staffing crisis the NHS is already drowning in.

The Resume Project

This is exactly why I built the RESUME Project. At its heart, RESUME is about identifying the periods of heightened vulnerability nurses face across their careers—what I’ve called Increased Suicidality Vulnerability Periods (ISVPs). Whether it’s post-shift exhaustion, disciplinary investigations, or job insecurity, these are the hotspots where the risk spikes and where prevention has to be targeted. The RESUME work shows we can map these moments, anticipate the pressure points, and put in place systems of support that are fast, humane, and proactive. The simple truth is that nurses are dying or are being pushed to the point of suicidality due to a combination of internal and external pressures. The current “fitness to practise” process appears to be adding to this crisis, and needs to be reassessed for effectiveness, safety, and care.

Closing thought

In late 2024, the RCN published figures that showed that there was a 76% rise in staff seeking support for suicidal ideation in the first half of 2024, compared to 2024. We cannot keep losing nurses in this way. Investigations must be faster, fairer, and grounded in dignity. Until regulators catch up, it falls to research, practice, and community to shine a light on the hazards hiding in plain sight. I am not a nurse, but I am a specialist in suicidal action who is devoted to making a difference for thousands of nurses who work to support and save lives every day. There are always hurdles to overcome, but for me it is not just about data, but about giving voice to those who can’t afford to wait years for justice.

Ultimately, nobody should have to die waiting for the system to decide if they were fit to care.

• If you’re experiencing thoughts of suicide, it’s important you tell someone. Call the Samaritans on 116 123 or visit samaritans.org. Please try to stay safe until you can speak to someone about how you feel. If you’re at immediate risk of harm, call 999.
• You can also contact the RCN for advice here.

Interested in knowing more about our work?

The RESUME Project: Rethinking Suicide in Nursing and Midwifery Environments

The RESUME Project is my major programme of research into nurse suicide, occupational health, and systemic risk. The name captures its purpose: to resume the lives, careers, and futures of those working in health and care, by breaking cycles of silence and inaction around suicide.

At its core, RESUME addresses a brutal reality: nurses and other health professionals experience suicide at disproportionately high rates, yet occupational suicide remains an under-researched and under-acknowledged issue in the UK.

The Focus

RESUME is structured around two interlinked aims:

1. Historical and Epidemiological Analysis (1980–2025):
   • Using death certificates coded by occupation, the project identifies patterns and trends in suicide deaths among nurses, midwives, and allied health workers across four decades.
   • This builds the first comprehensive national dataset of nurse suicide in the UK, allowing us to see when, where, and under what circumstances risk has intensified.
2. Contemporary Prevention and Intervention Development:
   • Through large-scale surveys, qualitative interviews, and digital interventions, RESUME identifies the moments of heightened vulnerability in today’s nursing workforce.
   • These moments are defined as Increased Suicidality Vulnerability Periods (ISVPs): time-bound, occupationally specific hotspots where risk surges (e.g., post-shift exhaustion, prolonged disciplinary procedures, redeployment, or the aftermath of patient death).

The ISVP Concept

The ISVP model is one of RESUME’s central innovations. Instead of treating suicide as random or purely individual, it recognises that risk clusters around predictable occupational moments.

Examples include:

• Post-shift collapse: the hours after high-stress shifts, especially nights or trauma exposure.
• Disciplinary limbo: long waits in “fitness to practise” investigations.
• Career transitions: student-to-nurse, return-to-work after sickness, or retirement.
• Workload spikes: winter pressures, understaffing, and redeployment.

By mapping these ISVPs, RESUME makes suicide prevention more precise: targeting the hotspots rather than offering generic “resilience” platitudes.

The Methods

RESUME combines:

• Quantitative analysis: Survival modelling, Cox regression, and Bayesian spatio-temporal models to identify trends and predictors in suicide deaths.
• Qualitative depth: Interviews with nurses, families, and colleagues to capture lived experiences and cultural silences.
• Digital innovation: Prototypes like the ASC App, designed to offer real-time support during ISVPs, integrating trauma-informed guidance and safeguarding signposting.

Why It Matters

The project cuts across three urgent crises:

1. Workforce sustainability: The NHS cannot afford to lose experienced nurses to suicide or attrition.
2. Regulatory reform: Cases like the NMC fitness-to-practise backlog reveal how institutional processes can become psychosocial hazards.
3. Suicide prevention policy: Suicide at work is still largely invisible in UK prevention strategies, leaving occupational hotspots unaddressed.

By focusing on nurses, RESUME addresses a group at the heart of healthcare, but also builds a transferable model for other high-risk occupations (paramedics, military, offshore workers).

The Vision

The ultimate goal of RESUME is not just to document risk but to transform systems:

• Embedding occupational suicide prevention into workforce policy.
• Equipping managers with tools to anticipate and intervene during ISVPs.
• Creating a digital ecosystem of support that complements, rather than replaces, existing care.
• Building international collaboration to ensure lessons travel beyond the UK.

In Short

RESUME is about shifting the conversation: from blaming individuals for “not being resilient enough” to recognising that suicide risk is patterned, predictable, and preventable when systems take responsibility.

It’s about dignity, data, and doing better. Because nurses deserve more than empty applause—they deserve a system that protects their lives as fiercely as they protect ours.