Risk of Suicide Class Notes

Risk of suicide a. Case A 21 year old female patient was taken by her family this morning to the emergency room at the Mental Hospital because she had attempted suicide by cutting her wrists. According to family information, the patient had stopped taking medication for 1 year. The patient had a history of being treated in RSJ 4 years ago due to depression and did not pass the national exam. c. Material review Suicide is any act with the aim of destroying oneself and which is deliberately carried out by someone who knows the possible consequences in a short time. In general, suicide is a way of expressing people who are full of stress. Suicidal behavior develops in a range including: 1.Suicidal ideation, At this stage it is a process of contemplation of suicide, or a method that is used without taking action, in fact the client at this stage will not express his ideas if he is not pressured. However, nurses need to be aware that patients at this stage have thoughts about wanting to die 2.Suicidal intent, At this stage the client begins to think and has made concrete plans to commit suicide, 3.Suicidal threat, At this stage the client expresses deep desires and desires, even threats to end his life. 4.Suicidal gesture, At this stage the client shows self-directed destructive behavior aimed not only at threatening his life but at attempting to commit suicide. This stage is oftencall it "Crying for help" because this individual is struggling with stress that cannot be resolved. 5.Suicidal attemptAt this stage, the client's destructive behavior indicates that the individual wants to die and does not want to be saved, for example taking deadly medication. However, many individuals still experience ambivalence about their lives. 6.Suicide. Actions intended to kill oneself. this had been preceded by several previous suicide attempts. 30% of people who successfully commit suicide are people who have attempted suicide before. Clinical manifestations ▪ Having suicidal thoughts ▪ Expresses a desire to mti ▪ Expresses guilt and hopelessness ▪ Impulsive ▪ Shows suspicious behavior (usually becomes very obedient) ▪ Has a history of attempted suicide ▪ Covert verbal (talking about death, asking about lethal doses of medication). ▪ Emotional status (hope, rejection, increased anxiety, panic, anger, and isolation). ▪ Mental health (clinically, the client is seen as a person who is depressed, psychological and abuses alcohol). ▪ Physical health (usually in clients with chronic or terminal illnesses). Purpose of Nursing Action - The patient can identify the cause of suicide/the severity of the problem that made the patient attempt suicide - The patient can mention signs and symptoms of suicide - The patient can mention the consequences of a suicide attempt - Patients can mention positive things they have - Patients can mention ways to control suicide - Patients can control the risk of suicide verbally, physically and mentally Implementation Strategy: Suicide Risk Management SP Patient Family SP 1 1. Identify the severity of the suicide risk problem: signs, threats, attempts (if attempted quick refer) 1. Discuss the problems you feel deeply nurse patient 2. Identify dangerous objects and put them away (safe environment for patients) 3. Practice how to control yourself from suicidal impulses: make a list of positive aspects of yourself, practice affirmations/thinking about positive aspects Which owned 4. Put on a schedule of positive thinking exercises 5 times per day SP 2 1. Evaluate positive thinking activities about yourself, give praise. Review the risk of suicide 2. Practice how to control yourself from suicidal impulses: make a list of positive aspects of family and environment, practice affirmations/thinking of positive aspects of family and environment 3. Include positive thinking exercises on your schedule about yourself, your family and your environment SP 3 1. Evaluate positive thinking activities about self, family and environment. Give praise. Assess risks kill self 2. Discuss hopes and the future 2. Explain the meaning, signs & symptoms, and process of suicide risk (use booklet) 3. Explain how to treat suicide risk 4. Practice how to praise the patient's positive things, provide support for achievements period front 5. Encourage helping patients according to schedule and giving praise 1. Evaluate family activities in providing praise and appreciation for the patient's successes and positive aspects. Give praise 2. Practice how to reward patients and create a positive atmosphere in the family: don't talk bad thingsmember family 3. Encourage helping patients according to schedule and giving praise 1. Evaluate family activities in giving praise and appreciation to patients and creating a positive atmosphere in the family. Give praise 2. Together with the family, discuss with 3. Discuss how to achieve expectations the patient about future hopes and and future front stepsachieve it 4. Practice ways to achieve hopes and the future gradually (step by step) 5. Include positive thinking in the training schedule about yourself, family and environment and the stages of selected activities 3. Encourage helping patients according to schedule and give praise SP 4 1. Evaluate positive thinking activities about yourself, family and the environment as well as the activities chosen. Give praise 1. Evaluate family activities in providing praise, appreciation, creating a positive family atmosphere and initial activities in achieving future hopes. Give praise 2. Practice the second stage of future reaching activities 2. Together with the family, discuss steps and activities to achieve expectations period front 3. Include positive thinking exercises on your schedule about yourself, your family and your environment, as well as the activities you choose to prepare for the future SP 5-12 1. Evaluate training activities to positively improve self, family and environment. Give praise 2. Evaluate the stages of activities to achieve expectations period front 3. Train activity daily 4. Assess independent abilities 5. Assess whether the risk of suicide is resolved 3. Explain follow up to RSJ/PKM, signs of relapse, reference 4. Encourage helping patients according to schedule and giving praise 1. Evaluate family activities in providing praise, appreciation, creating a positive atmosphere and guiding steps to achieve future hopes. Give praise 2. Assess the family's ability to care for the patient 3. Assess the family's ability to exercise control over the RSJ/PKM