Crisis Management

Comprehensive Essay Example on Crisis Management for Nursing Students

Start Assignment

  • Due Nov 13 by 11:59pm
  • Points 40
  • Submitting a text entry box, a website url, a media recording, or a file upload

Instructions

You have been working as an outpatient psychiatric nurse practitioner in a busy office for about 6 months. You have a few patients that you know quite well by this point and a few that you are getting to know. Record a video discussing how you would address a crisis with each of the two following patients.(Comprehensive Essay Example on Crisis Management for Nursing Students)

Each video should be 5-10 minutes each. Submit an unlisted YouTube link. Instructions on creating an unlisted YouTube video.

Include a word document of references utilized in your video, in 7th edition APA formatting. Utilize resources for help with proper formatting.

Patient 1: 45-year-old male who has been married for 15 years with 2 children. He has a history of MDD and pornography addiction which has been dealt with through therapy. This addiction had caused some trouble in the marriage but for the past 5 years, things have been going well in the marriage and patient denied looking at porn. MDD symptoms started in his 20s and have been well managed with citalopram (Celexa) 20mg daily. He comes in today visibly upset. He reports his wife has been cheating on him for 2 years and he found out when he came home from work to find his wife and kids gone, a note that detailed her infidelity and she took the children to live with the man she has been cheating with. Divorce proceedings are in effect. He states “I had no idea, I know I had my own problems but 2 years? I feel so stupid, I don’t know why I bothered improving myself, I don’t know how I can even go on. My work made me take some time off but I have continued to call in, I’m at risk of losing my job but I just can’t bring myself to go. The kids are my world and I haven’t even talked to them for a month”. You question him about suicidal or homicidal ideations and he replies that he has been suicidal since she left and has been drinking “at least a 6 pack” a night. He has had plans to shoot himself. When asked what is keeping him from acting on plans he said “My kids but I’m losing hope I’ll ever see or talk to them again”. What are your next steps?(Comprehensive Essay Example on Crisis Management for Nursing Students)

Patient 2: 19-year-old married female with a 2-month-old baby for her 4th visit. Her husband is present today. She presents today dressed more provocatively than you have seen her before. Her makeup is heavier than usual as well. The baby is in a carrier and is sleeping. She immediately starts discussing a video series on aliens she has been watching, her speech is rapid, loud, and tangential. She makes several looseness of associations between the video series and her baby. From her rambling, it sounds as if she believes the baby is an alien and she needs to take it to the desert and leave it on the mountain for the aliens to come and retrieve. She reports making plans to go camping with the baby and her husband this weekend. You question her about suicidal and homicidal ideations and she denies both. The husband states she has been acting “different” for a couple weeks, has never behaved like this before, and he is scared to leave her alone with the baby. She interjects that she knows the secret to world peace and giving their baby back to the aliens will accomplish it. What are your next steps?(Comprehensive Essay Example on Crisis Management for Nursing Students)

Rubric

NU675 Unit 10 Assignment – Crisis Management Rubric

NU675 Unit 10 Assignment – Crisis Management Rubric

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeContent of Video

8 pts

Level 5

Demonstrates a well-articulated understanding of the subject matter in a clear, complex, and informative manner. Develops content and theories are well. Links content to the video requirements and practical experience. Includes relevant material that fulfills all objectives of the video. Uses scholarly resources that were not provided in the course materials. Completes all instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

5 pts

Level 3

Demonstrates an understanding of the subject matter. Explains and applies knowledge of evidence-based practice, ethics, theory, and/or role. Uses a variety of scholarly resources from the course material and some that were not provided in the course materials. Includes relevant material that fulfills all objectives of the video. Completes all instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

2 pts

Level 1

Demonstrates a moderate understanding of the subject matter. Summarizes content with minimal application to evidence-based practice, theory, or role-development. Presents content but is missing depth and or development. Uses only scholarly resources that were provided in the course materials Completes most instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

0 pts

Level 0

Does not meet the section.

8 pts

This criterion is linked to a Learning OutcomeAnalysis and Synthesis of Video Content and Meaning

8 pts

Level 5

Provides critical analysis in an accurate, clear, concise, and complete presentation of the required content. Synthesizes information from scholarly resources. Provides new information or insight related to the context of the assignment with both supportive and alternative information or viewpoints. Completes all instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

5 pts

Level 3

Provides evidence of further synthesis of course content via scholarly resources. Synthesizes information to help fulfill video requirements. Supports content with at least one viewpoint. Completes all instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

2 pts

Level 1

Lacks clarification or new information. Supports content with scholarly reference without adding any new information or insight. Provides content that may be confusing or unclear, and the summary may be incomplete. Completes most instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

0 pts

Level 0

Does not meet the section.

8 pts

This criterion is linked to a Learning OutcomeApplication of Knowledge

8 pts

Level 5

Offers a multidisciplinary approach via scholarly resources. Applies practice that is accurate and plausible. Supports practice with additional scholarly resources. Answers all questions posed within the assignment in a well-developed manner with citations for validation. Completes all instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

5 pts

Level 3

Presents a summary of the video content, findings, and knowledge gained. Indicates how a crisis will be dealt with. Completes all instruction requirements.

2 pts

Level 1

Lacks objective Section. Applies superficial bridge between the assignment and the broader course content. Indicates how they will apply this new knowledge to their clinical practice in a vague manner. Completes most instruction requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

0 pts

Level 0

Does not meet the section.

8 pts

This criterion is linked to a Learning OutcomeOrganization

8 pts

Level 5

Provides well-organized content with a clear and complex purpose statement and content argument. Provides concise writing with a logical flow of ideas.(Comprehensive Essay Example on Crisis Management for Nursing Students)

5 pts

Level 3

Provides organized content with an informative purpose statement and supportive content and summary statement. Provides argument content with minimal issues in content flow.(Comprehensive Essay Example on Crisis Management for Nursing Students)

2 pts

Level 1

Provides poor organization, and flow of ideas distract from content. Provides a purpose statement. Provides narrative that is difficult to follow and frequently causes reader to reread work.(Comprehensive Essay Example on Crisis Management for Nursing Students)

0 pts

Level 0

Does not meet the section.

8 pts

This criterion is linked to a Learning OutcomeCollege-level Academic Writing

8 pts

Level 5

Includes no more than three APA, grammatical, spelling, or punctuation errors that do not interfere with the readability. Meets the assignment length requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

5 pts

Level 3

Includes no more than four APA, grammatical, spelling, or punctuation errors that do not interfere with the readability. Meets the length requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

2 pts

Level 1

Includes five or more APA, grammatical, spelling, and punctuation errors makes understanding parts of assignment difficult, but does not interfere with readability. Meets the length requirements.(Comprehensive Essay Example on Crisis Management for Nursing Students)

0 pts

Level 0

Does not meet the section.

8 pts

Total Points: 40

Comprehensive Essay Example on Crisis Management for Nursing Students

Comprehensive Essay Example on Crisis Management for Nursing Students

Patient 1

Suicide screening and assessment of patient 1 reveals an intent to harm himself and a plan. The assessment also reveals what is holding the patient back. The patient has successfully managed MDD and pornographic addiction. However, his wife cheating after all the effort to work on himself is detrimental to his mood and thought pattern. The next steps would involve interventions to stabilize the patient’s mood and thought pattern and offer alternatives. The practitioner will involve the patient in developing a care and crisis management plan.(Comprehensive Essay Example on Crisis Management for Nursing Students)

Crisis Response Plan

The Crisis Response Plan (CRP) seeks to reduce the patient’s risk of suicidal attempts. It is created collaboratively between the patient and the practitioner. The CRP acts as a checklist during periods of severe emotional distress (Rozek & Bryan, 2020). The patient will use the CRP to know what to do when emotionally overwhelmed. It includes the patient’s identification of thoughts, feelings, and experiences. It will provide options when suicidal ideations arise.(Comprehensive Essay Example on Crisis Management for Nursing Students)

Components of CRP

  • Personal warning signs: These are patient indicators of a looming emotional crisis.
  • Self-management strategies: simple to follow steps to help reduce stress and distract the patient.
  • Reasons for living: things that offer the patient a sense of purpose and meaning.
  • Social support: people who can offer support or boost the patient’s mood during difficult moments, including other family members like parents and friends.
  • Professional crisis support: include contact information for healthcare practitioners, crisis hotlines, and emergency services.(Comprehensive Essay Example on Crisis Management for Nursing Students)

These elements will help the patient cope with intense distress and provide options for what to do when experiencing suicidal thoughts.

Care Plan

The care plan includes therapeutic interventions to manage the suicidal patient. Psychotherapy

Psychotherapy will help learn ways of dealing with distress, alternative actions, and coping strategies (NIH, 2017). Psychotherapy should be collaborative and employ integrative care to decrease suicide risk effectively (NIH, 2017).

Methods

  • Cognitive behavioral therapy for suicide behavior
  • Dialectical behavioral therapy
  • The Improving Mood – Promoting Access to Collaborative Treatment (IMPACT)
  • Attachment-Based Family Therapy (ABFT)

Psychiatric Medications

  • Lithium – prescribed as a mood stabilizer
  • Antidepressants – used as the treatment of mood disorder

Patient 2

Assessment of patient 2 reveals homicidal ideation. Patient 2 has no intention to hurt herself, but she intends to hurt her baby. The next steps include the following:

  • Offering reassurance and support
  • Assessing the nature of the problem and determining the patient’s homicidal status
  • Ensuring the safety of the child, the husband, and the patient.
  • Helping the patient develop an action plan to minimize distress and commit the patient to the plan.
  • Follow-up with the patient and the family(Comprehensive Essay Example on Crisis Management for Nursing Students)

Crisis Management Plan of Care

The practitioner will develop interventions to address homicidal ideation. The first step in responding to the crisis is ensuring the patient is not left alone with the child to ensure the child’s safety. The practitioner will conduct a risk assessment to determine if the situation is a mild risk, moderate risk, or high risk. The practitioner will then collaborate with the patient and the husband to develop a crisis response plan to ensure the child’s and the patient’s continued safety.(Comprehensive Essay Example on Crisis Management for Nursing Students)

Wellness Plan

Step 1

Should the patient begin to feel an increase or feel overwhelmed by negative thoughts or feelings like anger or thought of death, she can try the following self-help measures (Campus Health Center. 2018):

  • Remove herself from the immediate stressor
  • Write in her journal
  • Engage in relaxation exercises

Step 2

The patient can reach a support system to talk about the stressor. Contact information of individuals to contact is included.

Step 3

If the patient continues to feel overwhelmed, she can reach the following for further support and prevention of harm: 

  • Counseling and psychological services contact line
  • Police contact line
  • Call nearest ER

Step 4

The practitioner and the patient should keep the next appointment scheduled for a specific date.

Additional Assistance and Support

  1. Referral for psychiatric counseling
  2. Lethal means counseling (LMC)

LMC will help reduce the risk of homicide by engaging the patient and the family in reducing access to any form of lethal means in the immediate and surrounding environment that can be used to harm the child or support the action. Harmful behavior can be controlled if the environment is secured.(Comprehensive Essay Example on Crisis Management for Nursing Students)

  1. Aggression regulation therapy

It can help with underlying trauma and negative feelings (Frelier & Holwerda, 2018). A mental health institution can be involved if the situation worsens.

References

Campus Health Center. (2018, November 27). Suicidal/Homicidal Ideation Procedures Based on Assessment of Level of Risk. https://health.wayne.edu/wp-content/uploads/2020/07/Safety-Plan-Template-Risk-Levels-Wellness-Plan.pdf

Frelier, B. S., & Holwerda, T. J. (2018). Hoe te handelen bij een patiënt die zich homicidaal uit; literatuurstudie en handreiking [How to act in case of a homicidal patient; a literature review and a practice guideline]. Tijdschrift voor psychiatrie, 60(4), 241–249.

National Institutes of Health (NIH). (2017). Suicide Prevention. https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml#part_153179.

Rozek, D. C., & Bryan, C. J. (2020). Integrating crisis response planning for suicide prevention into trauma-focused treatments: A military case example. Journal of clinical psychology, 76(5), 852–864. https://doi.org/10.1002/jclp.22920

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