A nurse at a community health center is caring for a client who presents in a state of acute situational crisis after experiencing sudden, unexpected financial ruin. The client is pacing rapidly, crying, and states, 'I have lost absolutely everything; I do not see a way out of this.' Arrange the following crisis interventions in the sequential order the nurse should implement them.
- 1Conduct a lethality assessment to determine the immediate risk of suicide or self-harm.
- 2Establish a therapeutic alliance through active listening and communicating empathy.
- 3Identify the specific precipitating event and assess the client's perception of the problem.
- 4Explore the client's previous coping mechanisms and available social support systems.
- 5Collaborate with the client to develop a concrete, short-term action plan.
Answer
The correct sequence for crisis intervention is to first ensure safety (lethality assessment), then build rapport (therapeutic alliance), assess the problem (precipitating event), evaluate resources (coping mechanisms), and finally plan interventions (action plan).
The established standard of care for crisis intervention follows a structured, priority-based sequence. It begins with ensuring immediate safety by assessing for lethality. Once the client is deemed safe, establishing rapport and trust is the next critical step. Following this, the nurse assesses the specific precipitating event and how the client views it. The nurse then evaluates the client's existing coping skills and support networks. Finally, utilizing these resources, the nurse and client collaboratively develop a concrete, short-term action plan to restore equilibrium.
Step-by-Step Solution
Key Concept
Prioritization and Sequencing of Crisis Intervention