Transcript for:
Crises, Loss, and Grief - Psychiatric Mental Health Nursing Principles

Hi. I'm Cathy with Level Up RN. In this video, we are going to talk about crisis management as well as loss and grief. And if you stick with me through the whole video, at the end, I'm going to give you guys a little knowledge check, a little quiz, make sure you've been listening and picking up on some of the key concepts that I'll be covering. Also, if you are new to the channel, or maybe you're not new to the channel, but haven't subscribed, be sure to subscribe to our channel. We'd love to have you. All right. Let's first talk about crisis management. A crisis is an overwhelming event that causes significant psychological stress. And there are three types of crises that we're going to talk about. The first is a maturational crisis. So this is a life-changing event that occurs as a normal part of the lifespan but causes significant stress. So examples of this could be marriage, having a baby, retirement, sending your baby to college, which is something I'm getting ready to do. These are all normal life events, but they can cause stress. And then we have a situational crisis. So this is an unexpected life event. So this could include loss of a job or the sudden death of a loved one. Then we have an adventitious crisis. So an adventitious crisis can include a natural disaster, such as a tornado, hurricane, or fire. It can include a national emergency, such as a terrorist attack, or it can include a violent crime, such as sexual assault. So in terms of nursing care, your priority always is to provide for patient safety. And then beyond that, you want to assist the patient with anxiety reduction. You want to assess the patient's support system, right, their family, their friends. And also, evaluate their coping skills and find out what coping mechanisms they have used in the past successfully so that perhaps they can use those same coping mechanisms with the current crisis. All right. Let's now transition to talking about loss and grief. So with loss, we have an actual loss and a perceived loss. With an actual loss, this is a loss that is recognized by others, such as loss of a loved one. Perceived loss is a loss that is not felt by others. So if an individual has loss of their mental acuity, that is not known to others, necessarily, but it is still a loss. All right. Grief. Let's go through the five stages of grief. The first is denial. So this is rejection of reality. So a patient who does not accept their cancer diagnosis, they are in denial at that point. Then from denial, we go to anger. During this stage, an individual may have a short temper, and they may lash out and blame others for the injustice. So that can include the provider or a higher power. Then we move to bargaining. This is where the patient is negotiating in an attempt to get control over the situation. So they may say, "Dear God, if you heal her, I promise I'll go to church every day for the rest of my life." That would be an example of bargaining. Then from bargaining, we move to depression. So during this time, the individual is sad. They may be exhibiting fatigue. And then, finally, we move to acceptance. So during the acceptance stage, the individual is able to acknowledge the loss or the impending loss. Doesn't mean they're happy about it, but they accept the reality of the situation and acknowledge that loss. All right. Now that we've reviewed the five stages of grief, let's talk about some different types of grief. So one type of grief is complicated grief, which can also be referred to as prolonged grief disorder or pathological grief. This is where an individual has intense, prolonged sorrow for more than a year that really interferes with their daily functioning. So a year after a loss, if someone is not leaving their house, not bathing, not eating properly, or taking care of themselves, then that would be indicative of complicated grief. Then we have anticipatory grief. So this is in response to an impending loss. So if an individual is given a terminal diagnosis, then that individual and his or her family members would definitely have anticipatory grief in anticipation of that loss. Then we have disenfranchised grief. So this is a loss that is not publicly acknowledged. So an example of this would be a miscarriage. Often, people don't share with all their friends and family if they've had a miscarriage, but obviously, that is still a loss, and they will be grieving the loss of their baby. Okay. It's time for a quiz. So I've got three questions for you. First question: a hurricane is an example of what type of crisis? If you said adventitious crisis, you are right. Next question: name the five stages of grief. All right. Here they are: denial, anger, bargaining, depression, and acceptance. Last question: what kind of grief is characterized by intense sorrow that lasts more than a year and interferes with an individual's daily functioning? That would be complicated grief. Hope you did great on that. And I will see you in my next video, where we will talk about defense mechanisms. Take care. I invite you to subscribe to our channel and share a link with your classmates and friends in nursing school. If you found value in this video, be sure and hit the like button, and leave a comment and let us know what you found particularly helpful.