a nurse is caring for a client who is experiencing a situational crisis This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you Crisis. Following along are instructions in the video below:
Guys who are actually in your mental health book on chapter 20 crisis and mass mass disaster. So its page 397 so go ahead and grab your book and will get started on page 397. Your book talks about three different types of crisis and so on page 391 or 99.
It talks about why do we need to study crisis and so crisis intervention is about nurses and other health care providers do to assist someone when they are in a crisis. We try to help them to cope. So first type of crisis.
Maturational crisis. This is essentially an internal crisis and its based on erickson. Its eight stages of growth and development.
So lets say for instance youre new to the developmental stage of ego integrity versus despair. What this particular christ is the saying is that we are in a new stage and the coping skills that we had for the previous stage will not necessarily work and we have to develop sufficient new coping skills and if we dont do that then we can end up in a maturational crisis. Some people move through this more quickly than others some people may for instance be inhibited or hindered by alcohol or drug addiction other personal things that are going on into their lifestyle.
But hopefully the outcome is that we have a successful resolution of our new stage. We have developed the coping skills that we need and we do not experience this particular type of crisis flip the page it talks about situational crisis. A sigil.
A situational crisis arises from an external force rather than an internal force so a situational crisis relates to an external force versus an inter such as the death of a loved one okay and this outcome is dependent upon the degree of support. The patient has their emotional and physical status their ability to understand and willingness to cope with the meaning of the stressful event and last. We talk about disasters and so a disaster is not a part of everyday life it is unplanned and it is accidental there are different types of disasters and a natural disaster such as the hurricanes weve had down in florida a national disaster such as riots airplane crashes be war and then your book goes on to identify crimes and violence it does say that terrorism is a different form of of a disaster.
And that it is committed by people who mean to harm. And kill innocent lives. And that there is no warning or expectation.
That its going to happen. No matter. What the disaster occurs from natural verses excuse.
Me natural verses national disaster. It can end up in what we call mass casualty incidents mass casualty incidents result in an excessive number of mortalities and increased morbidity and extensive damage to properties roads electrical lines etc. It depletes the local regional or states resources and they are difficult to recover from okay.
Im page 401. Again mass casualty incidents. Involve greater than a hundred people we talked about a disaster a disaster means that extra effort is involved its above an every day emergency.
We need extra help to deal with it we talked about natural versus man made and we talked about what terrorism is and were not going to be concerned with conventional and versus non conventional. Your book goes on to talk about triage a great words for triage is simply sorting sorting out zoning out with red yellow green and black and youll see that on your admission ticket that i provided and so triage.
According to your book is it is a term that means that ability to distribute casualties to the most appropriate facility or holding ground for proper care so triage were gonna sort were gonna sort out our victims involved so they can get the most appropriate care now reverse triage can be implemented. When you have a mass casualty incident and have greater than a hundred people and you cant take care of them all we do reverse triage meaning. The greatest good for the greatest number of people focusing on those individuals that can safely get themselves out such as the green and the yellow and less effort on those that are critically injured such as your reds black means that they are close to or have them died this is just a little extra.
But when youre looking at disasters. What happens with your local government is they classify them as levels levels. One two and three a level one means that the locals can deal with it so for instance.
If you had a school bus that had an accident and you had several children taken to a local hospital or hospitals. The hospital could then implement their disaster protocol and deal with it sufficiently without extra support from the community a stage. 2 requires regional help now we have multiple victims who require help we need the shelters to open for instance.
We might need the national guard to be put on alert or actually put on active duty. The governor of a state might declare the were in a state of emergency. A level two is often your hurricanes or your tropical storms.
A level 3. Is the highest level it means that theres mass casualty and increased morbidity and yes. We have to have local regional state and federal help when it can be declared a federal disaster.
Then there is increased aid thats offered to the residents. And so. When you have an intense national disaster or natural disaster.
Often it is declared a federal emergency. So you can get federal aid to help with the assistance of recovery. This is not in your book.
But i wanted to introduce it there are stages of disasters. Theres five stages one thing. A term that you might hear mitigation mitigation is a term that we use and it means.
What are we doing as a community to decrease. The ill effects of a disaster on our environment and people and so a lot of times. Youll find mitigation is wrapped and all these different stages of disasters.
Were always in the non disaster stage and in the non daans disaster stage. Whats happening is were preparing. This is where for instance hospitals have disaster drills.
Where they have a team or a community. A community or committee that actually deals with disaster preparedness.
So were preparing were stocking. Were making sure were ready not all the time do we have a pre disaster stage. But like for hurricanes.
We do this is when we know its coming so theres awareness. Theres awareness that theres a disaster coming and we do what we need to get ready for instance. The red cross might be told to go to a certain area to set up we would open schools for shelters.
We would make sure that theres plenty of food and water for individuals that might be impacted the impact stage is the actual time when the disasters hitting the hurricanes hitting the tornado is hitting and during the impact stage people need to be safe and secure and they need to stay safe and secure. And this is a form of mitigation your residents are doing what theyre supposed to do to keep themselves safe and theyre not moving about the only people that are out are your emergency personnel. This next stage.
The emergency stage is the disaster has been completed the hurricane has moved on and now were in a state of emergency. Our priority being making sure that all residents of the area affected are safe. Theyre rescued theyre triage to the appropriate area so after a tornado.
The rescue personnel go out into the community thats been affected they find their victims. They triage them appropriately to facilities. Until they can account for everybody.
The emergency stage is actually not supposed to be complete until you have a final victim count. Were all individuals have actually been accounted for then you get into the reconstruction phase. This is the rebuilding phase and obviously.
It is the longest phase. When you have a massive tornado such as the picture. I showed you and that was from moore oklahoma.
It will take them decades to rebuild that community that was flattened it took decades to get new york back to where it was before 9 11 rebuild. The levees in new orleans after the hurricane katrina. And to the reconstruction stage is often the longest and there are acts of mitigation within the reconstruction phase for instance.
The levees that broke in katrina. Hopefully. They were rebuilt in a manner and they wouldnt be breached again so we have someone thats in a crisis.
We need to one first assess we need to assess actually the patients perception of the crisis and how do they perceive the crisis. And what is their strengths not everything is viewed the same by all patients. And so we definitely have to understand and view the crisis through the eyes of the patient and we also have to assess the individual or families perception of the problem.
What is their support system. What are the resources.
Available is this individual isolated are there people that we can ask to aid them. If not is there some type of temporary support system that we could set up theres some good questions with him do you live with two whom do you talk to who can you trust who can help you and then we have to assess the persons level of anxiety. And once again.
Everybodys coping mechanisms are the same we need to assess. What are their coping mechanisms. Is it eating is it drinking is it smoking.
We need to make sure that they dont have any thoughts of killing themselves or anyone else what do they do to feel better have they tried to make whatever that is that they feel better have they tried at this time. Whats helped in the past with difficult times. Once we assess we can come up with possible diagnosis such as anxiety.
And its related to fear of whatever or compromise. Family. Coping related to whatever is the situation.
Okay so on page four or four in your book talks about planning. And it talks about disaster nursing. A lot of times include being members of a mobile crisis unit.
A group that helps provide crisis intervention you provide health education crisis prevention etc. We look at implementation one we have to make sure that our patient is safe thats first is there anything that we need to do to protect the patient that is in crisis. And what can we do to reduce their level of anxiety.
We have to make sure that the patient is in charge of his her own life is able to make decisions. And the crisis counseling relationship is one between partners. This chapter also talks about different levels of care nursing care you guys have probably learned about these in mp.
One will go back over them primary care promotes mental health and reduces mental illness to decrease. The incidence of crisis. Its one on one so we work within an individual to recognize or identify potential problems help them to identify specific coping skills and assist them in evaluating the timing of life changes secondary care is established interventions during acute crisis and its to prevent prolonged an anxiety from the crisis and this occurs in hospital and units emergency departments.
Clinics and or mental health you flip the page it talks about tertiary care and this is support for those whove experienced a crisis and theyre now recovering and this often happens in rehab centers and shelters workshops and day hospitals and outpatient clinics. Part of tertiary care is what we call critical incidents. Stress.
Debriefing and this is a intervention for a group of people. That has experienced a crisis on this page. You can see there are phases of the critical incident stress debriefing that are to be followed and you guys can read through this and then we talk about evaluation.
Were looking at the person in crisis and were following up typically four to eight weeks after the initial interview and were asking herself. Still is the patient saved have they developed more adaptive ways to cope do they have a stronger existing support system has the patient maintained an optimal level of functioning and has the patient returned to the pre cut the pre crisis level of functioning. .
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