Ch. 26 Crisis and Disaster
A crisis is self-limiting and usually resolves within how many weeks
4 to 6 weeks.
A category 5 hurricane destroys homes and businesses in a community. How would this crisis be classified
Adventitious
Crisis results from a natural disaster (flood, fire, earthquake), a national disaster (act of terrorism, war, riots, etc), a crime or violence (rape, assault, or murder)
Adventitious
Unplanned and accidental: Natural disaster National disaster Crime of violence (Terrorism, bombimngs, lava flow on big island, tsunami, etc)
Adventitious Crisis
Crisis Intervention - Teritary Care:
After the event - provides support to this who have experienced a severe crisis and now recovering from a disabling mental state
Crisi Theory: 7 stage model for crisis intervention
Albert R. Roberts
defined by the struggle for equilibrium and adaptation in its aftermath and not the experience itself
Crisis
normal coping mechanisms fail, profound disruption of normal psychological homeostasis
Crisis
Crisis Theory: 2 nurses - crisis management and interventions for nurses
Donna Aguilera and Janice Mesnick
Crisis Theory: debrief people after crisis and see how coping (1940's)
Erich Lindemann
Evaluating the response effort to prepare for the future
Evaluation
everyone in groups says what did you see happen - what facts are and their invovlement in the incident
Fact
Cries Theory: built on theories to lindemann and improve intervention strategies
Gerald Caplan
Nursing diagnosis for crisis
Ineffective coping
person doing debriefing is leader
Intro
New developmental stage is reached (leaving home, empty nest syndrome, etc) Old coping skills no longer effective Leads to increased tension and anxiety
Maturational Crisis
critical period of increased vulnerability and, at the same time,, heightened potential
Maturational crisis
Attempt to limit a disaster's impact on human health and community function
Mitigation
Two initial goals of crisis intervention:
Patient safety & Anxiety Reduction
Conflict or problem Self-concept threatened Increased anxiety Use of problem-solving techniques and defense mechanisms Resolve conflict or problem Reduce anxiety
Phase of Crisis: Phase 1
Defense mechanisms fail Threat persists Anxiety increases Feelings of extreme discomfort Functioning disorganized Trial-and-error attempt to solve problem and restore normal balance
Phase of Crisis: Phase 2
Trial-and-error attempts fail Anxiety can escalate to severe level or panic Automatic relief behaviors mobilized (i.e., withdrawal and flight) Some form of resolution may be devised (i.e., compromising needs or redefining situation)
Phase of Crisis: Phase 3
Problem is unsolved and coping skills are ineffective Overwhelming anxiety Possible serious personality disorganization, depression, confusion, violence against others, or suicidal behavior
Phase of Crisis: Phase 4
The protective plan designed before the event to structure the response, assess risk, and evaluate damage
Preparedness
Crisis Intervention - Primary Care:
Prevention - before it happens work with patient to recognize potential problems by evaluating patient's experience of stressful events, teach the patients specific coping skills, could work with patient to plan changes to decrease negative effects of stress.
checking in, how is it working for you, what kind of support do you have, hwo are you going to handle it if symptoms re appear (cope)
Re-entry
- gets into emotions (what is the most painful part of this incident
Reaction
Actions focus on stabilizing the community and returning to its previous status
Recovery
Actual implementation of the disaster plan
Response
Crisis Intervention - Secondary Care:
Screening - establishes intervention during an acute crisis to prevent prolonged anxiety from diminishing personal effectiveness and personality organization
What term is most applicable to crisis?
Self-Limiting
Crisis: loss or change of job, the death of a loved one, an abortion, a change in financial status, divorce, and severe mental or physical illness
Situational Crisis
Type of Crisis: Arise from events that are: Extraordinary External Often unanticipated (Illness, divorce, abortion)
Situational Crisis
describe any symptoms felt after incident (headahce, body aches, passing out, etc) all symptoms are ok nothing is funny/unacceptable in crisis
Symptom
might not be the only symptoms you experience might start to have nightmares, and flashbacks. teach how to cope (support groups, diary, journal, who to talk to when return from incident)
Teaching
what was your first thought?
Thought