TOPIC 8 - crisis nursing Flashcards
what is a crisis
acute, time limited occurrences experienced as overwhelming emotional reactions to a stressful situational event, developmental event, or the persons perception of an event
crisis will result in which two responses from the person experiencing crisis
fall apart and decompensate or problem solve and grow through the process
what impacts the outcomes of crises
individual, family, and community perception of the response
coping abilities and resiliency
availability and outside supports
factors that limit coping and problem solving abilities
mental illness, substance abuse, history of poor coping, diminished cognitive ability, preexisting physical health problems, limited social supports, developmental and or physical changes
clients with the best outcomes …
feel safe, connected, calm and hopeful
have access to social, physical, and emotional supports
find ways to help themselves
developmental crisis
have to do with the predictable transitions that individuals experience as they move from one stage to another
examples of developmental crises
getting married, starting college, retirement, becoming a parent
situational crisis
arise suddenly and unexpectedly from an external source and are events or circumstances that threaten the physical, social, and psychological integrity of individuals , frequently involving grief or loss
examples of situational crises
being forced to retire, financial distress, illness, death of a loved ones, going through divorce
adventitious or social crisis
rare, unexpected events that affect a group or community
not part of everyday life
examples of adventitious crises
natural disaster, terrorism, pandemics, flood, earthquake, active shooter
existential crisis
inner conflicts, often centered around life’s purpose and spirituality
examples of existential crises
what is my calling in life? midlife crisis, am i making a difference? does god really exist?
phase 1 of psychological crisis
Person confronted by conflict; responds with increased anxiety.
phase 2 of psychological crisis
If usual defensive responses fail and threat persists, anxiety escalates. Trial-and-error begins.
phase 3 of psychological crisis
If trial-and-error attempts fail, anxiety can escalate to severe & panic levels.
phase 4 of psychological crisis
If the problem is not solved and new coping skills are ineffective, anxiety can overwhelm the person & lead to serious illness; assess for suicidal thoughts.
crisis interventions need to be …
bold, creative, flexible
strategies of primary level of care
Promote mental health before crisis strikesProvide education, information & resource listings
goals of primary level of care
Improve clients’ coping ability &Decrease incidence of crises
strategies of secondary level of care
Prevent prolonged anxiety during acute crisis
goals of secondary level of care
Ensure client safety & Shorten duration of client distress
strategies of tertiary level of care
Provide support during recovery from crisis
goals of tertiary level of care
Facilitate optimal client functioning & prevent further emotional disruption
example of tertiary care
critical incident stress debriefing
objectives of CISD
-lessen the impact of the traumatic event
-facilitate recovery process and restore adaptive functioning in psychologically healthy people in distress by the crisis event
-screen for and identify community members who might benefit from additional support services/provide referrals for those who need it
best effects of CISD happen when
there is enhanced group cohesion and unity performance
CISD should be part of a broader crisis support system
who benefits from CISD
staff members and clients after an incident of violence or trauma
crisis hotline volunteers
rescue and health care workers who respond to traumatic situations
phase 1 - introduction
the team members introduce themselves and describe the process. They present guidelines for the conduct of the CISD and they motivate the participants to engage actively in the process.
set the tone of the session
phase 2 - facts
Only extremely brief overviews of the facts are requested. Excessive detail is discouraged. This phase helps the participants to begin talking. It is easier to speak of what happened before they describe how the event impacted them.
overall view point of what happened
phase 3 - thoughts
The thought phase is a transition from the cognitive domain toward the affective domain. It is easier to speak of what one’s thoughts than to focus immediately on the most painful aspects of the event. The typical question addressed in this phase is “What was your first thought or your most prominent thought once you realized you were thinking?
phase 4 - reactions
The reaction phase is the heart of a Critical Incident Stress Debriefing. It focuses on the impact on the participants. Anger, frustration, sadness, loss, confusion, and other emotions may emerge. The trigger question is “What is the very worst thing about this event for you personally?”
phase 5 - symptoms
Team members ask, “How has this tragic experience shown up in your life?” or “What cognitive, physical, emotional, or behavioral symptoms have you been dealing with since this event?” The team members listen carefully for common symptoms associated with exposure to traumatic events. The CISM team will use the signs and symptoms of distress presented by the participants as a kicking off point for the teaching phase.
phase 6 - teaching
provide explanations of the participants’ reactions and provide stress management information. Other pertinent topics may be addressed during the teaching phase as required.
phase 7 - re entry
The participants may ask questions or make final statements. The CISD team summarizes what has been discussed in the CISD. Final explanations, information, action directives, guidance, and thoughts are presented to the group. Handouts maybe distributed.
4 primary categories of abuse and neglect
emotional
physical
sexual
neglect
among who is abuse and neglect prevalent
all social divisions : ethnic, religious, age, social, and socioeconomic groups
what does the intergenerational theory of family violence believe ?
It is most likely the interaction of societal, cultural, psychologic, and neurobiological factors. Child learns violence as a behavioral norm through Role modeling, Identification and human interaction within the family unit.
However, not all abused children become abusers.
