Suicide is the intentional act of killing oneself. Suicidal thoughts are common in people with depression, schizophrenia, alcohol/substance abuse and personality disorders (antisocial, borderline, and paranoid). Physical illness (chronic illness such as HIV, AIDS, recent surgery, pain) and environmental factors (unemployment, family history of depression, isolation, recent loss) can play a role in the suicide behavior.
Nursing Care Plans
The nursing care plan for suicidal patients involves providing a safe environment, initiating a no-suicide contract, creating a support system and ensuring close supervision.
Here are three (3) nursing care plans (NCP) for suicide behaviors:
Hopelessness: Subjective state in which an individual sees limited or no alternatives or personal choices available and is unable to mobilize energy on his/her own behalf.
May be related to
- Chronic pain.
- Failing or deteriorating physiologic conditions (Cancer, AIDS).
- Long-term stress.
- Lost belief in transcendent values/God.
- Loss of significant support systems.
- Perceived hopelessness, helplessness.
- Perceiving the future as bleak and wasted.
- Prolonged isolation.
- Severe stressful events (financial reversals, relationship turmoil, loss of job).
Possibly evidenced by
- Decreased affect.
- Decreased judgment.
- Decreased problem solving.
- Impaired decision making.
- Lack of initiative.
- Lack of involvement in care.
- Lack of motivation.
- Loss of interest in life.
- Passivity, decreased verbalization.
- Turning away from speaker.
- Patient will express the will to live.
- Patient will have an expression of positive future orientation.
- Patient will have an expression of meaning in life.
- Patient will make two decisions related to his/her care.
- Patient will identify three things that he/she is doing right.
- Patient will reframe two problem areas in his/her life that encourage problem-solving alternative solutions.
- Patient will identify two alternatives for one life problem area.
- Patient will name one community resource (support group, counseling, social service, family counseling) that he/she has attented at least twice.
- Patient will state three optimistic expectations for the future.
- Patient will describe and plan for at least two future-oriented goals.
- Patient will demonstrate two new problem-solving skills that client finds effective in making life decisions.
- Patient will demonstrate reframing skills when viewing aspects of client’s life that appear all negative.
|Encourage clients to look into their negative thinking, and reframe negative thinking into neutral objective thinking.||Cognitive reframing helps people look at situations in ways that allow for alternative approaches.|
|Work with client to identify areas of strengths.||When people are feeling overwhelmed, they no longer view their lives or behavior objectively.|
|Point out unrealistic and perfectionistic thinking.||Constructive interpretations of events and behavior open up more realistic and satisfying option for the future.|
|Identify things that have given meaning and joy to life in the past. Discuss how these things can be reincorporated into their present lifestyle (e.g., religious or spiritual beliefs, group activities, creative endeavors).||Reawakens in client abilities and experiences that tapped areas of strength and creativity. Creative activities give people intrinsic pleasure and joy, and a great deal of life satisfaction.|
|Spend time discussing client’s dreams and wishes for the future. Identify short-term goals they can set for the future.||Renewing realistic dreams and hopes can give promise to the future and meaning to life.|
|Encourage contact with religious or spiritual persons or groups that have supplied comfort and support in client’s past.||During times of hopelessness people might feel abandoned and too paralyzed to reach out to caring people or groups.|
|Teach client steps in the problem-solving process.||Stress that it is not so much people are ineffective, but rather it is often the coping strategies they are using that are not effective.|
You may also like the following posts and care plans:
- Nursing Care Plan: The Ultimate Guide and Database – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
Mental Health and Psychiatric Care Plans
Care plans about mental health and psychiatric nursing:
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 6 Care Plans
- Personality Disorders | 4 Care Plans
- Schizophrenia | 6 Care Plans
- Sexual Assault | 1 Care Plan
- Substance Dependence and Abuse | 8 Care Plans
- Suicide Behaviors | 3 Care Plans
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans