Universal Experiences Flashcards
what is the universal experience of “crisis”
- stress, anxiety
- Tips scale towards illness side of wellness-illness continuum
- Conceptualized as a stimulus, a process, a response, & a state – it may be more accurate to describe stressors as stimuli and stress as a response or reaction to them
- Subjective
- Caused by internal and external factors
- A response to demands that exceed ones ability to cope
- Occurs on a continuum with anxiety and crisis
what are the 3 components of the stress response
- physiological
- cognitive
- emotional
types of crises: (2)
- Developmental (usually short lived) – retirement, empty nest, puberty
- Situational – illness, death of a loved one, separation or divorce, loss of job, moving, traumatic experience, unplanned pregnancy
crisis intervention
- Early intervention, stabilization, facilitate understanding, problem solving, encourage self-reliance
role of RPN in crisis
- Establish a therapeutic relationship
- Gather relevant data
- Bear witness to their pain
- Validate their feelings
- Provide education
- Teach new coping skills
- Offer hope
physiological response: general adaptation syndrome (SELYE)
stage 1: alarm reaction
Stage 2: resistance stage
Stage 3: exhaustion stage
Physiological component of stress response
a. i.e. sweating, increased heart rate, increased adrenaline, cortisol etc.
b. Important for life threatening evolutionary responses
Cognitive component of stress reaction
a. Stress impairs the more complex part of your brain
b. Not focused on thinking about problem
c. Physiological response takes over
emotional component of stress response
a. Triggers stress
b. Emotional component -> cognitive offline -> physiological component -> emotional component
body functions/systems affected by stress
cardiovascular, respiratory, GI, MS, GU, dermatological
cognitive component of stress response considers what
considers the appraisal of stressors and how they influence the stress response
what is the Lazarus & Folkman: Cognitive Appraisal Theory:
- the person is under stress only if they perceive themselves to be
- primary appraisal: what does this situation mean to me
- secondary appraisal: can I cope with it
The cognitive-behavioural triangle of the emotional component of stress
emotions – thoughts – behaviour
Anxiety in the emotional component of stress
apprehension or dread in response to internal or external stimuli that can be experiences in physical, emotional, cognitive (e.g., distorted negative thoughts), and/or behavioural ways (e.g., avoidance, procrastination)
Levels of anxiety:
- Mild: slight arousal that enhances perception, learning and productivity
- Moderate: increased arousal with tension, nervousness and perception is narrowed
- Severe/pain: it is consuming, poor focus, very uncomfortable and requires intervention. Overpowering & frightening
what influences how someone will cope with stress and anxiety
- Coping can be affected by biology, environment, education and awareness, models of healthy coping mechanisms
describe adaptive coping
- strategies that minimize/reduce or eliminate the stress response
- Strategies can be short-term/immediate, or longer-term adaptations
- E.g., sleep (behavioural), meditation (cognitive + physiological ), journaling/for self-awareness (cognitive), exercise (physiological, phycological, spiritual), nutrition (physiological), music (spiritual)
describe maladaptive coping
- may temporarily be “effective”, but cause longer term negative consequences and results in worsening distress
- Defense mechanisms – denial, projection, regression etc.
- E.g., substance use, binge eating, overexercising
define comfort and pain
The capacity to self soothe emotional/cognitive challenges
Factors that influence the experience of pain & comfort:
physiological, psychological, developmental, sociocultural & spiritual factors
- Physiological e.g., high tolerance to pain - biological
Comfort & the role of the RPN:
- Comfort is closely related to caring
- An essential part pf our role as RPN
- May involve consolation, support or assistance to promote well-being
- Comforting is not pitying
Hope (hopelessness) =
hope is the anticipation of a continued good or of an improvement in, or lessening of something unpleasant
Power (powerlessness) =
the perception & process of gaining or maintaining control or influence over aspects on one’s environment
- A client receiving mental health treatment can at times feel powerless. What are some circumstances or experiences that contribute to this? – marginalized population
- We must recognize &minimize the power differential inherent in our therapeutic relationships and our practices as RPNs
- The goal is to empower our clients by mobilizing their strengths
what are the 4 concepts of loss
- grief
- actual loss
- perceived loss
- bereavement
grief
the emotional response (subjective) to the perception of loss
actual loss
A loss of a person or object that can no longer be felt, heard, known or experienced
perceived loss
a loss that cant be seen by others
Bereavement
the response to the loss or death of a loved one
Common symptoms of Grief
- Feeling physically drained
- Cant sleep
- Forgetful, cant think clearly
- Appetite changes
- Physical symptoms: chest pains, headaches
- Poor concentration
- Senses or dreams about the deceased
- Guilt
- Tearfulness
- Sadness that comes in waves
- Numbness
Factors that impact grieving
The grieving perons:
- Personality and temperament before the loss (external vs. internal locus of control)
- Degree of attachment with the person who died
- Culture & religious
- Nature of the loss e.g., sudden or traumatic
- Presence of preexisting mental illness & coping skills
- Amount of support they have
- Number of previous losses person as experienced (grief is cumulative)
- The bereaved person feels responsible in some way for the loss
Differentiating Normal Grief from Depression
- Normal Grief:
o Self-esteem intact
o Good days and bad days
o Maintains feelings of hope
o Able to experience pleasure
o Accept comfort from others
o Physical symptoms are transient - Clinical depression:
o Self-esteem is disturbed
o Feels persistent dysphoria
o Feelings of hopelessness
o Anhedonia is prevalent
o Does not response to support from others
o Expresses chronic physical complaints
Complicated Grief =
stuck in the grieving process. Defined as unhealthy mourning following a death, lasts at least 6 months
signs of complicated grief
o Pt doesn’t progress through the stages of grief
o Preoccupation with the deceased or death
o Recurrent intrusive images
o Avoidance of painful reminders of death
o Grief response continues to impact daily living
o Seek to isolate or avoid support systems
o Extreme feelings of guilt/worthlessness
o Meet criteria for major depression
Anticipatory grief =
the emotional experience of the normal grief response before the loss occurs
Role of the RPN: GRIEF
- Assess the client’s stage in the grief process (gather acute baseline)
- Develop trust. Show empathy and unconditional positive regard
- Provide ongoing support (friends, support groups etc)
- Help client actualize the loss by talking about it (reviewing events of the loss helps increase awareness)
- Help client identify and express feelings (repressed feelings of guilt/anger can stall grieving)
- Understand and explain in the normal grief process
- Be present and bear witness to their pain
- Identify maladaptive coping strategies (avoidance of pain can stall grieving)
Integrity (death, dying, acceptance)
- Integrity stems from the latin word ‘integer’ which means whole & complete
- The quality of having an inner sense of wholeness and consistency of character
- you demonstrate consistency in your values, beliefs, and actions in all areas of your life
- satisfaction of attaining own life goals
- integrity contributes to trust and authenticity
- maintaining patient sense of integrity is a key role of the nurse e.g., dying patient, grieving patient
what are the 7 universal experiences
- hope
- crisis
- comfort
- connectedness
- loss
- power
- resiliency
