An emergency department nurse is caring for a client who recently experienced a devastating house fire. The client is trembling, disorganized, and repeatedly states, "Everything is gone. I should have just stayed in the house." Arrange the following crisis intervention steps in the correct order from first to last.
- 1Assess the client's immediate risk for self-harm or suicide.
- 2Establish a therapeutic relationship by communicating empathy and support.
- 3Explore the client's perception of the precipitating event.
- 4Identify available situational supports and personal coping mechanisms.
- 5Collaborate with the client to develop a short-term action plan.
Answer
The correct order is to first assess the risk for self-harm, establish a therapeutic relationship, explore the client's perception of the event, identify supports and coping mechanisms, and finally collaborate on a short-term action plan.
In crisis intervention, the nurse must follow a structured approach to ensure client safety and promote stabilization. According to established crisis intervention models, the first priority is always a lethality and safety assessment, particularly when the client expresses thoughts of wishing they were dead. Once safety is confirmed, the nurse establishes therapeutic rapport to build trust. Following this, the nurse assesses the client's perception of the precipitating event (the problem) and then explores available situational supports and coping mechanisms. Finally, the nurse and client collaborate to formulate a concrete, short-term action plan to restore equilibrium.
Step-by-Step Solution
Key Concept
Crisis Intervention Sequencing