Summary: Nursing 310: Mental Health Nursing
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Mental Health Nursing
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Cultural and Personal Considerations for Communication
-must assess patient and situation before reacting
-everyone has different spatial and personal boundaries
-when initially meeting a patient yo should evaluate their needs
-how far are they standing from you
-their interactions with others
-their actions/nonverbal behavior -
Nursing interventions for suicide
Primary - Education, programs that support suicide prevention
Secondary - The crisis, can determine life or death of the pt.
-ex: restraints
Tertiary - Supporting the significant others after a suicide occurs
-coping strategies -
Lethality of Suicide Plan
High risk (hard methods) - jumping off a bridge, poisoning, using a gun.
-Men are more likely to use these (successfully commit).
Lower risk (soft methods) - Cutting, ingesting pills.
-Women are more likely to use these (more attempts, less success).
-availability of the method to the individual
-individuals with depression and command hallucinations are at higher risk of suicide. -
Red Flags for Suicide
-Patient gives away personal possessions
-"it won't matter anymore"
-"I won't have anymore pain soon enough" - esp. chronic pain
-buys items discussed in plan for suicide -
SAD PERSONS Scale
-Assessment tool
-S = sex (male +1)
-A = age (25-44 or >65= +1)
-D = depression (present +1)
-P = Previous Attempt (present +1)
-E = Ethanol use (present +1)
-R = Rational thinking loss (psychotic +1)
-S = Social supports lacking (lacking/ recent loss +1)
-O = Organized plan (lethal method +1)
-N = No spouse (divorced, widowed, separated, single male +1)
-S = Sickness (severe or chronic +1)
(0-2): home with follow up (low risk)
(3-4): Closely follow-up, consider hospitalization
(5-6): strongly consider hospitalization
(7-10): HAVE TO Hospitalize or commit -
Risk Factors for Suicide
-having a psychiatric disorder
-loss of relationship
-financial issues
-alcohol and substance abuse and impulsivity
-Male
-family hx
-divorce
-status at work
-caucasian
-physical health
Youth Risk:
-poor problem solving and coping skills
-low self-esteem
-impulsive and or aggressive
-seeing themselves as being a burden
-Isolation
-Substance use
-Bullying - social media
-Exposure to abuse: physical, sexual, psychological -
Freud's Personality Structure
Id:Basic personality functioning, an impulse reaction seeking pleasure (Knee jerk reaction).
Ego:Problem solves situations, keeps the id in check (you should do this).
Superego: Moral component, represents what is ideal vs what is wanted or real (you shouldn't do this) (too much can lead to OCD, anxiety and criticalness of self). -
Freud's Psychosexual stages of Development
Oral stage:(0-1 yrs) Weaning, Trust in the environment vs. smoking/nail-biting
Anal stage:(1-3 yrs) Toilet-training, control over impulse vs OCD
Phallic stage:(3-6 yrs) Sexual Identity, Identify with same sex parent vs. oppositional defiant disorder
Latent stage: (6-12 yrs) learning, Skills to cope with environment vs. cannot relate to others
Genital stage:(12+ yrs) genital intercourse, ability to find pleasure in love and work -
Erikson - Stages of psychosocial development
Trust vs. mistrust - 0-1.5
Autonomy vs. shame and doubt - 1.5 - 3 yrs
initiative vs. guilt - 3-6 yrs
industry vs. inferiority - 6-12yrs
identity vs. role confusion - 12-20 yrs
intimacy vs. isolation- 20-35yrs
Generativity vs. stagnation - 35-65yrs
Integrity vs. despair - 65+ yrs -
Cognitive - Behavioral Therapy
Identifying an individuals view/need for restructuring, targeting self talk/image and inserting new and more productive way of thinking.
-Goals: recognition of thoughts based on distortions
-challenge negative thinking
-substitute negative thinking
-I am stupid.
What makes you say this?-I failed my exam.
One exam does not make you stupid - it doesn't define you as a whole-I am smart but didn't master the material for the exam.
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