Crisis Intervention and Understanding the Suicide Epidemic

A nurses job is to __________ suicide or harm to other

PREVENT

Crisis

perceived challenge or threat that overwhelms the capacity of the individual to cope effectively

Crisis can last

up to six weeks

3 multiple choice options

Can crisis include either positive or negative outcomes, or both

both

2 multiple choice options

Phases of Crisis: Step 1

problem arises, causing increase in anxiety levels

Phases of Crisis: Step 2

usual problem-solving techniques are ineffective. Anxiety levels continue to rise

Phases of Crisis: Step 3

trial-and-error attempts fail. Anxiety escalates to severe or panic levels

Phases of Crisis: Step 4

anxiety overwhelms person, leading to serious personality disorganization

Key aspect of Crisis

State of Disequilibrium

Trust vs Mistrust

birth - 18 mo

Autonomy vs Shame and Doubt

18 mo - 3 yrs

Initiative vs Guilt

3-6 yrs

Industry vs Inferiority

6-12 years

Identity vs Role Confusion/ diffusion

12-20 yrs

Intimacy vs Isolation

20-30 yrs

Generativity vs Stagnation

30-65 yrs

Ego Integrity vs Despair

60 years - death

True or false: a crisis event typically occurs over a prolonged period of time and is associated with negative outcomes

false

1 multiple choice option

Two high school student fail a math course, One student plans to seek tutoring and plans to work harder for the second exam. The second student attempts suicide. Which of the following factors would've been influential in the development of the second student's crisis?

A lack of adequate coping mechanisms

3 multiple choice options

For the past 3 days, a student has skipped classes, cried constantly, experienced panic attacks, and is not exhibiting difficulty with short-term memory. In her assessment of this student, what crucial information should the nurse initially obtain prior to planning interventions?

The student's perception and description of the precipitating stressor

3 multiple choice options

3 types of crises

maturational, developmental, life transitions

Psychopathology

Behavior is prompted by type of disorder (bipolar, psychosis, personality)

Psychiatric Emergency

Interference with general functioning (suicidal, rage, acute psychosis)

Situational/ Traumatic Crisis

Impacts one or a small number of individuals

Is situational/ traumatic crisis expected or unexpected

unexpected

1 multiple choice option

Example of situational/ traumatic crisis

car accident, house fire

Adventitious/ Unplanned/ Societal Crisis

Catastrophic event impacting large groups of people

Can Adventitious/ Unplanned/ Societal Crisis be predicted/ controlled

no

1 multiple choice option

Examples of Adventitious/ Unplanned/ Societal Crisis

911, tsunamis, hurricanes

Nursing intervention when a patient successfully commits suicide on an inpatient unit

multiple community therapy

What does it show when a patient successfully commits suicide on an inpatient unit

shows opportunity; patients know that they aren't safe so they have opportunity to harm

Over ____ died by suicide in 2023

49,000

3 multiple choice options

Suicide is the ______ leading cause of death

9-10th

3 multiple choice options

____ regions have the highest rate of suicide

mountain

Be aware of

feeling hopeless/helpless, impulsive/anger, hx of trauma, physical/ chronic illness, previous attempts, fmhx, loss

Warning signs of suicide: Talking

Wanting to die, great guilt or shame, being burden to others

Warning sign of suicide: Feeling

empty, hopeless, trapped, having no reason to live, extremely sad, more anxious, agitated, rage, unbearable emotion and physical pain

Warning signs of suicide: Changing behavior

making plan, researching ways to die, social withdrawal, giving away items, saying goodbye, taking dangerous risks, extreme mood swings, eating/sleeping more/less, using drugs/alcohol more often

5 action steps to help someone having thoughts of suicide

ask, be there, help keep them safe, help them connect, follow-up

ASK

are you thinking of killing yourself?

BE THERE

listen without judgement and acknowledge their feelings

HELP KEEP THEM SAFE

Reduce their access to lethal items or places

HELP THEM CONNECT

call or text 988

FOLLOW UP

stay in touch to see how they're doing

Common warning signs

looking for a way to kill self, talking about feeling hopeless, talking about feeling trapped, talking about being a burden, anxious, agitated, reckless, withdrawal

Suicide Risk assessment tools

Columbia Suicide Severity Rating Scale, SAFE-T Protocol with C-SSRS, ASQ Suicide Risk Screening Tool

A nurse is engaged in case finding. Which activity would be involved?

Identifying those at risk

3 multiple choice options

Which is a misconception about suicide?

Most individuals commit suicide by taking an overdose of drugs

3 multiple choice options

Nursing Intervention

dont avoid topic, assess everyone (all ages), listen, empathize, use pt ambivalence, 1:1 status, communicate, monitor/manage, frequent assessment

True or false: women account for more cases of deaths from suicide than men

false

1 multiple choice option

A nurse is caring for an actively suicidal client on the psychiatric unit. What is the nurse's priority intervention?

Place client on suicide precautions with one-to-one observation

3 multiple choice options

Treatment Outcomes: Short term

maintain safety, avert suicide, mobilize patient resources

Treatment Outcomes: Long term

maintain pt treatment, enable patient and family to identify suicidal crises effectively, widen patient support network

A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. At this time, which is the most appropriate nursing intervention for this client?

Assist the client to develop more effective coping mechanisms

3 multiple choice options