Nursing Care Plan (NCP) for Suicidal Behavior Disorder

Hey everyone. Today, we’re going to be creating a nursing care plan for suicidal behavior disorder. So let’s get started. First, we’re going to go over the pathophysiology. So suicidal behavior disorder describes a client who has attempted suicide in the past two years and includes unsuccessful attempts and completed suicides. Nursing considerations: you want to do a neurological assessment, one to one monitoring, create a safe environment, create a no suicide contract and administer medications. Desired outcomes: the client will not attempt suicide, will remain safe without self-inflicted harm, and will identify alternative activities or support systems to prevent future suicide attempts. 

So we’re going to go ahead and we’re going to start writing in our care plan. We’re going to have our subjective data and our objective data. So what are we going to see with these patients? So, some subjective data you’re going to see that they’re going to have moodiness and excessive sadness. Some objective data you’re going to see is withdrawal, and you’re going to probably see self harm behavior. And, some other ones: feelings of hopelessness, changes in personality, maybe some sleep difficulty, verbal or written threat of suicide, and a history of substance abuse. You’re going to see that they’re going to be giving away personal possessions – that’s a big one for them. Purchasing a firearm or any sort of weapon, changes in their personal appearance, or maybe they had just recently been released from prison. 

So what are some interventions? Well, we want to first perform a neurological assessment. So you want to do a thorough assessment to determine the baseline. If there are any other neurological conditions that are present, that may have caused some symptoms. Another invention that we want to be doing is to make sure we’re initiating one-on-one monitoring. So we want to be one-to-one, and we want to be at arm’s length per the facility protocol. You want to avoid leaving the client unattended for any reason, especially in the bathroom or the shower. We want to make sure that we are ensuring client safety and removing the opportunity to harm themselves; follow your facilities specific protocols regarding the supervision, restraints, and documentation of this. Another invention is that we want to create a safe environment for this patient. So we want to make sure we’re removing any potential weapons or objects that may inflict harm such as utensils, sharp objects, belts, ties, et cetera. We want to make sure that we’re providing safety and removing these items that are able to be used impulsively during the activity of suicidal phase. When possible, remove monitor cables and electrical cables that are not being actively used. We want to emphasize resiliency. We want the client to understand that the crisis is temporary, but their actions are permanent. We want to make sure that they know help is available and that this pain can be overcome. We want to help clients see that there are other ways of dealing with these circumstances, and we want to give them a perspective of holding on for hope. Another intervention we want to do is we want to assess for signs that the client has a plan to commit suicide. So we want to ask this client, do they have a plan? Are they suddenly calm or appear happy or relieved? Are they giving away any sort of personal possessions? So we want to ask specifically, do you have a plan? The client may even state, yeah, I’m going to take that cable and hang myself. This will allow you to remove these objects from their reach clients who have decided to follow through with the planned suicide attempt may suddenly feel calm or relieved. This can be hard for caregivers or family members. They may perceive it as the client’s getting better in those circumstances. 

Now, eventually we want to assist the client in creating and signing a no suicide contract. We want to demonstrate an alternative plan for coping when they feel suicidal, instead of acting on impulses. This allows the client to feel more in control of the actions and promotes accountability. We also want to administer medications; this could be antidepressants or anti-anxiety medications that can be given. It can help improve the client’s daily functioning ability and provide any sort of relief during the crisis. 

Alright, so we’re going to go into the key points here. So this would be describing a client who’s attempted suicide within the last two years. It includes unsuccessful attempts and completed suicides. Usually this stems from another underlying condition, such as depression, bipolar disorder, PTSD, or schizophrenia. Some subjective and objective data you’re going to see with these patients. You’re going to see excessive sadness, feelings of hopelessness, sleep difficulty, withdrawal from society, recent trauma or crisis, self harmful behavior, and possible history of substance abuse. We’re going to assess the patient, their neurological assessments, making sure we’re creating a safe environment and initiating that one-to-one monitoring. We’re going to assess for signs of the client having a plan, identify the situation or triggers for this client, and emphasize resiliency with the client to understand that the crisis is temporary And there we have a completed care plan. 

We love you guys. Go out, be your best self today. And, as always, happy nursing.