Crisis Management and Loss & Grief

Crisis Management

Definition:
- An overwhelming event causing significant psychological stress.
Types of Crises:
1. Maturational Crisis:
  - Life-changing events as part of the normal lifespan.
  - Examples: Marriage, having a baby, retirement, sending a child to college.
2. Situational Crisis:
  - Unexpected life events.
  - Examples: Loss of a job, sudden death of a loved one.
3. Adventitious Crisis:
  - Includes natural disasters (e.g., tornado, hurricane, fire), national emergencies (e.g., terrorist attack), violent crimes (e.g., sexual assault).
Nursing Care Priorities:
- Ensure patient safety.
- Assist with anxiety reduction.
- Assess the patient’s support system (family, friends).
- Evaluate past coping skills and mechanisms for current crisis application.

Types of Loss:
1. Actual Loss:
  - Recognized by others (e.g., loss of a loved one).
2. Perceived Loss:
  - Not felt by others (e.g., loss of mental acuity).
Five Stages of Grief (by Kübler-Ross):
1. Denial: Rejection of reality (e.g., not accepting a diagnosis).
2. Anger: Short temper, blaming others or a higher power.
3. Bargaining: Negotiating for control (e.g., promising to change behavior in exchange for a favorable outcome).
4. Depression: Sadness, fatigue.
5. Acceptance: Acknowledgment of the loss.
Types of Grief:
1. Complicated Grief:
  - Also known as prolonged grief disorder or pathological grief.
  - Intense, prolonged sorrow lasting over a year, interfering with daily functioning.
2. Anticipatory Grief:
  - Response to an impending loss (e.g., terminal diagnosis).
3. Disenfranchised Grief:
  - A loss not publicly acknowledged (e.g., miscarriage).

Question: A hurricane is an example of what type of crisis?
- Answer: Adventitious crisis.
Question: Name the five stages of grief.
- Answer: Denial, anger, bargaining, depression, acceptance.
Question: What kind of grief is characterized by intense sorrow lasting more than a year?
- Answer: Complicated grief.