Crisis Intervention Nursing Care

A crisis is a self-limiting and stressful event that upsets a person’s homeostasis and isn’t resolved by the person’s usual coping mechanisms.

Crisis intervention can be used by healthcare professionals as a short-term management method for patients experiencing a crisis.

Now, when a person experiences a crisis, they typically progress through six stages. Let's take a closer look at each stage with your patient, Jimmy, who just went through a breakup with his romantic partner.

The first stage of crisis is perception, which occurs when the event is perceived as a crisis. In Jimmy’s case, he experiences this when his partner ends their relationship, which is seen as a threat to his emotional well-being.

The next stage is denial, where the person is unwilling to believe the situation is happening. For Jimmy, denying that the relationship has ended is a protective coping mechanism to shield himself from the overwhelming stress and reality of the breakup.

Then, as denial and other attempts to cope with the crisis fail to resolve the problem, the person enters the third stage, known as crisis.

During this stage, anxiety and discomfort continue to rise as Jimmy understands the reality of his situation and begins to exhibit maladaptive behaviors, like projecting his frustrations onto those around him.

The fourth stage, disorganization, is where preoccupation with the crisis impacts the person’s activities of daily living, or ADLs, and quality of life.

During this stage, continuing anxiety can result in unpleasant physical symptoms, such as sweating, shaking, and increased heart rate, and even thoughts of self-harm.

At this point, Jimmy could either continue with maladaptive behaviors, or he might reach out for help. This is when Jimmy can receive effective crisis intervention and move to the fifth stage: recovery.

During recovery, Jimmy uses successful coping mechanisms like physical activity, meditation, or support systems, such as family, friends, or a spiritual advisor, to process his breakup.

The final stage is reorganization, where Jimmy reengages with his daily roles and routines and begins to move on with his life.

He can take what he learned from dealing with his breakup and can even function at a higher level than before the crisis started.

On the other hand, if Jimmy fails to learn and grow from his crisis, he may experience a pseudo-resolution. This is where a new crisis triggers unresolved conflicts from his previous crisis, impairing his ability to successfully resolve the new crisis.

Now, as the nurse caring for a patient during a crisis, you’ll collaborate with the registered nurse to perform crisis intervention.

First, take steps to maintain your patient’s safety by determining whether they’re at risk of harming themselves or others.

If they express suicidal or homicidal ideation, immediately notify the registered nurse and healthcare provider. You’ll also intervene to prevent harm to your patient and healthcare staff.

After safety has been established, you can gather information about the crisis. Assist your patient to describe the situation by asking them about the events leading up to the crisis, if there were any precipitating factors, details about the stressful event, and if others were affected.

Also encourage them to verbalize their feelings about the problem. Once you understand the issue, collaborate with the registered nurse to develop a treatment plan and reduce your patient’s anxiety.

Ask them about coping mechanisms they've used in the past when experiencing difficult situations, help them to identify the strengths and limitations of these past coping mechanisms, and reinforce positive coping mechanisms they've used.

Provide them with emotional support and reassurance, and administer the prescribed psychotropic medications, as needed, to promote safety and emotional recovery.

Finally, once your patient is stabilized, refer them to appropriate resources, such as counseling, community support groups, or a social worker, as needed.

After the initial treatment, be sure to follow-up with your patient to ensure they’re receiving the care and support necessary to continue their recovery.

Remind them to use the successful coping mechanisms they’ve identified, as well as resources to help resolve future crises.

If they continue to have difficulty managing their crises or experience suicidal or homicidal ideation, stress the importance of immediately contacting emergency mental health services.

Alright, as a quick recap...A crisis is a self-limiting and stressful event that upsets a person’s homeostasis and isn’t resolved by the person’s usual coping mechanisms.

Crisis intervention is a short-term management method to assist patients experiencing a crisis. As the nurse caring for a patient during a crisis, you’ll collaborate with the registered nurse to perform crisis intervention.