Crisis, Grief, and Disaster Management Flashcards Preview

Nursing 2100H > Crisis, Grief, and Disaster Management > Flashcards

Flashcards in Crisis, Grief, and Disaster Management Deck (32):
1

Crisis

time-limited challenge/threat that overwhelmed the person's ability to cope
--> turning point w/positive or negative outcomes

-time limited: 4-6 weeks

-when we reach dysequilibium from stressful situaton a crisis will occur if any of these following balancing factors are absent

2

Crisis Balancing Factors

1. realistic perception
2. adequate situational support
3. adequate coping skills

3

Types of Crises

Developmental
Situational
Traumatic

4

Developmental Crisis

significant events that are a normal part of growth/require role changes

ex: marriage, leaving for college

*developmental crisis and situational crisis may be very similar

5

Situational Crisis

occur when a specific life even upsets and individuals psychological equilibrium

*situational crisis and developmental crisis may be very similar

6

Traumatic Crisis

unexpected/unusual events affecting a person/group

7

Assessment

support systems

physical condition
-emotions/strengths
-mental status
-suicide/homicide ideation

8

Diagnosis

-ineffective coping
-powerlessness
-impaired communication
-risk for violence/self harm

9

Psychological First Aid

ABCs of first aid focus on:

A: arousal
B: behavior
C: cognition

10

Intervention

-may need to be directive if problem-solving abilities are strained
-first arrange for safety/to meet basic needs (treat life-threatening injuries, arrange food/shelter, provide care for suicidal/homicidal ideation or plans)
-do not give unrealistic or false reassurance of positive outcomes
-Lorazepam (Ativan): benzo, anti-anxiety may be used
-mobilize social support

11

Grief

an intense, biopsychosocial reaction to loss of loved one, spontaneous expression of pain, sadness, and desolation

12

Bereavement

process of mourning and coping

begins immediately, but can last months/years

*anniversary reactions may occur (emotions and grief may reappear on anniversary of death...etc.)

13

Phases of Bereavement

1. Shock/Disbelieve
-hours to weeks
-varying degrees

2. Acute Mourning
-becomes gradually aware of loss (intense feeling, social withdrawal, identification w/deceased)
--includes crying

3. Resolution
-the return of feelings of well-being
-acceptance of loss

14

Dual Process Model of Grieving

another explanation of how people deal w/loss is between loss-oriented coping (preoccupation w/deceased) and restoration-oriented copying (preoccupation w/other life events)

15

Uncomplicated Grief

-physical responses
-feeling of unreality (upset stomach, headaches, feeling of unreality...)
-Intense preoccupation with deceased
-Exaggerated guilt for any small negligence
-Yearnings disbelief
-6 months may have signs of limited impairment in new situations
-May grieve more over other situations like “empty nest”
-Self esteem & competency intact & do NOT need counseling

16

Traumatic Grief

-More difficult & prolonged grief, benefits from treatment

Worse if it's sudden (lack of anticipation)

External factors influence reactions & outcomes:
1) Suddenness and lack of anticipation
2) Violence, mutilation, and destruction
3) Preventability and/or randomness of the death
4) Multiple deaths (bereavement overload)
5) Mourner experienced significant threat to personal survival, or a massive and shocking confrontation with the deaths (and/or mutilation) of others

-Reliving the traumatic death of the loved one

-Suicide survivors may feel stigma, blame, shame, guilt & rejection

-Women are more likely to confront & express negative emotions

17

Complicated Grief

-Occurs in 10-20% of people when the grieving person is stuck in a chronic state of mourning.
-Intense longing & grieving for a person who died over 6 months ago.
-Feelings of bitterness, lack of trust, life is meaningless without the deceased person.

18

Nursing Management

Assess for suicide/self-harm

assess level of coping

listen --> intervene/link support systems

refer to therapist/psychiatrist

facilitate the development of positive coping skills

19

Outcomes

return to previous/higher level of functioning

20

Disaster/Terrorism

Disaster: sudden, overwhelming, catastrophic even that causes GREAT damage/destruction

may involve mass casualties/human suffering

requires assistance from all available resources

21

Phases of Disaster

1. Prewarning of Disaster

2. Disaster event occurs

3. Recuperative effort

22

Prewarning of the Disaster

preparing victims for possible evacuation of environment, mobilization of resources, and review of disaster plans

23

Disaster Event Occurs

rescuers provide resources, assistance, and support as needed to preserve the biopsychosocial functioning/survival of victims

24

Recuperative Effort

implement strategies for healing sick

prevent complications

repair damage

reconstructing the community

25

Types of Disaster Victims

1. severe physical trauma

2. professional rescuers

3. everyone else

26

Nursing Management of Disaster

-mental status and panic reactions

-physical condition

-suicidal and homicidal ideation/plans

-unexplained physical symptoms

27

Diagnosis of Disaster

could be almost any Dx depending on situation/person's reaction

-insomnia
-risk for self harm
-relocation stress syndrome
-fear

28

Disaster Crisis Intervention

Similar to crisis interventions strategies w/following additions:
-help victims prioritize and match available resources with their needs

-the type/severity of the disaster will affect needs/resources

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When balancing factors are absent, what occurs?

1. Distorted perception
2. Inadequate support
3. Inadequate coping skills

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ABC's of psychological first aid: A

Arousal

when arousal is present, decrease excitement by providing safety, comfort, and consolation

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ABC's of psychological first aid: B

Behavior

when irrational behavior is present, assist survivors to function more effectively in the disaster

32

ABC's of psychological first aid: C

Cognition

when cognitive disorientation occurs, reality testing and clear information should be provided