Chapter 17 Crisis And Disaster

Front 1

acute, time-limited event experienced as overwhelming emotional reaction

Back 1

Crisis

Front 2

Crisis is self-limiting ; how many weeks

Back 2

(4 to 6 weeks)

Front 3

Goal of crisis intervention

Back 3

return individual to previous level of functioning
Deal with person’s present problems: “here and now”
Nurse takes active, directive role when intervening
Important to set realistic goals

Front 4

Related to identified developmental stages occurring throughout life
Each new stage requires new coping mechanisms

Back 4

Maturational
Examples
Marriage, birth of a child, retirement

Front 5

Arises from external rather than internal source; usually unanticipated

Back 5

Situational

Front 6

Examples of situational

Back 6

Loss of job, death of loved one, change in financial status, divorce

Front 7

Crisis or disaster not part of everyday life

Back 7

Adventitious

Front 8

Phases of Crisis
person is confronted by conflict or problem that threatens self-concept and causes anxiety

Back 8

1

Front 9

Phases of Crisis
if usual defensive response fails and threat persists, anxiety continues to rise

Back 9

2

Front 10

Phases of Crisis
if trial-and-error attempts fail, anxiety can escalate to panic levels

Back 10

3

Front 11

Phases of Crisis
if problem is not solved and new coping skills are ineffective, anxiety can overwhelm person
Serious personality disorganization, depression, confusion, violence against self/other can occur

Back 11

4

Front 12

Common nursing diagnoses

Back 12

Risk for self- or other-directed violence, Spiritual distress, Hopelessness, Anxiety (moderate, severe, panic), Disturbed thought processes, Ineffective coping, Risk for post-trauma syndrome

Front 13

Outcomes identification

Back 13

Outcomes need to realistic
Patient and family need to be involved in identifying outcomes
Outcomes need to be congruent with patient’s values, cultural expectations

Front 14

Planning
Nurse plans interventions via variety of modalities

Back 14

Disaster nursing, mobile crisis units, group work, health education and crisis prevention, victim outreach programs, telephone hotlines

Front 15

Common Nursing Interventions for Patient in Crisis

Back 15

Assess for suicidal or homicidal thoughts
Ensure patient safety
Listen carefully to patient’s perceptions of problem
Use directive and creative approaches in intervening

Front 16

Common Nursing Interventions for Patient in Crisis

Back 16

Identify patient support systems and mobilize these
Plan with patient interventions acceptable
Plan regular follow-up to assess patient’s progress toward established goals

Front 17

Levels of Nursing Care for Crisis Intervention
Promote mental health and decrease incidence of crisis

Back 17

primary

Front 18

Levels of Nursing Care for Crisis Intervention
Interventions to prevent prolonged anxiety and personality disorganization

Back 18

secondary

Front 19

Levels of Nursing Care for Crisis Intervention
Support for those who have experienced severe crisis and are recovering
Goal: facilitate optimal level of functioning

Back 19

tertiary

Front 20

what is Critical Incident Stress Debriefing (CISD)

Back 20

Used to assist a group that has experienced a crisis
Consists of seven-step procedure offering individuals opportunity to share thoughts and feelings in safe and controlled environment

Front 21

CISD used in following situations

Back 21

Debrief staff following patient suicide
Help staff/students following incident of school violence
Debrief rescue personnel who responded to disaster

Front 22

Successful intervention characterized by:

Back 22

Patient’s anxiety and ability to function has returned to pre-crisis level