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Tuesday, June 5, 2012

Psychiatric Nursing: Suicide


  1. Gen. Information.:
    1. Ideation: verbalization of wish to die
    2. Gestures: engaging in nonlethal behaviors
    3. Actions: engaging in behaviors or planning to engage in behaviors that have potential to cause death
    4. May or may not be associated with a psychiatric disorder

  1. Assessment findings
    1. Verbal cues
                                               i.     Overt: I’m going to kill myself
                                             ii.     Disguised: I have the answer to my problems
    1. Behavioral cues
                                               i.     Giving away prized possessions
                                             ii.     Getting financial affairs in order, making a will
                                            iii.     Suicidal ideation/gestures
                                            iv.     Indication of hopelessness, depression
                                              v.     Behavioral and attitudinal changes

  1. Nursing Intervention
    1. Contract with client to report suicide attempt
    2. Assess suicide risk
    3. Keep client under constant observation
    4. Remove any objects that can be used in suicide attempt
    5. Therapeutic intervention
                                               i.     Support aspect of wish to live
                                             ii.     Use one-to-one nurse/client relationship
                                            iii.     Allow client to express feelings
                                            iv.     Provide hope
                                              v.     Provide diversionary activities
                                            vi.     Utilize support groups
    1. Following a suicide
                                               i.     Encourage survivor to discuss client’s death, their feelings and fears
                                             ii.     Provide anticipatory guidance to family
                                            iii.     Hold staff meetings to ventilate feelings


S- ex - Male (more successful); female (hesitant)
A- ge – 15-25 y/o or above 45 y/o
D- epression
P- atient with previous attempts (will try again)
E- thanol (Alcoholics)
R- ational (opposite)
S- ocial support (lacks)
O- rganized plan (greater rik)
N- o family
S- ickness (terminal stage)
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