Can you differentiate between maturational, situational, and adventitious crises? What type of crisis is Frances experiencing?
QUESTION
Case Study, Mohr
CHAPTER 35, Crisis Intervention
In completing the case study, students will be addressing the following learning objectives:
Differentiate maturational, situational, and adventitious crisis.
Apply the nursing process to a client, family, or community in crisis.
1. Frances Gordon is a 42-year-old divorced school teacher. Her 20-year-old daughter, Sarah, has developed schizophrenia and has withdrawn from college. Her youngest daughter, Glenda, is a 19-year-old unmarried mother who is living at home. Glenda has just given birth to a baby boy who has a heart defect. The baby’s father refuses to pay for any of the healthcare costs. Frances’ dire economic situation is very stressful to her. Her ex-husband refuses to help financially, and the bank has refused a second loan to Frances.
(Learning Objectives: 1) a. Can you differentiate between maturational, situational, and adventitious crises? What type of crisis is Frances experiencing?
- Discuss how to apply the nursing process in the care of Frances.
ANSWER
Nursing Process in Crisis Intervention: A Case Study of Frances Gordon
Introduction
Crisis intervention is an integral part of nursing practice, aimed at providing immediate support and assistance to individuals, families, or communities facing challenging situations. In this case study, we will examine the application of the nursing process to Frances Gordon, a 42-year-old divorced school teacher, who is currently experiencing a complex crisis involving her daughters’ mental health, financial struggles, and a newborn baby with a heart defect. By understanding the different types of crises and employing the nursing process, nurses can effectively assess, intervene, and support individuals like Frances during times of crisis.
Differentiating Types of Crisis
To differentiate between maturational, situational, and adventitious crises, it is important to consider the underlying causes and triggers:
Maturational Crisis: This crisis arises from predictable life transitions and challenges associated with different stages of personal development (Volling, 2012). Frances is not currently experiencing a maturational crisis since her situation does not directly relate to her personal growth and developmental milestones.
Situational Crisis: Situational crises occur due to specific events or circumstances that individuals perceive as overwhelming, resulting in a disruptive impact on their lives. Frances’s crisis can be primarily categorized as a situational crisis. The combined stressors of her daughter’s schizophrenia, her youngest daughter’s unplanned pregnancy, the baby’s heart defect, and her dire economic situation have significantly disrupted her life.
Adventitious Crisis: Adventitious crises are unexpected and occur as a result of natural disasters, crimes, or accidents. Frances’s crisis does not fit this category, as it is not caused by external factors beyond her control.
Application of the Nursing Process
The nursing process serves as a systematic framework for providing patient-centered care. Here’s how each step of the nursing process can be applied to Frances’s case:
Assessment: The nurse should conduct a comprehensive assessment to gather relevant data regarding Frances’s physical, psychological, social, and environmental factors (Srinath et al., 2019). This includes assessing her coping mechanisms, support systems, financial resources, and understanding her perception of the crisis.
Diagnosis: Based on the assessment findings, the nurse can identify nursing diagnoses that accurately reflect Frances’s needs. Examples may include “Risk for caregiver role strain,” “Anxiety related to financial instability,” or “Ineffective coping related to multiple stressors.”
Planning: Collaboratively with Frances, the nurse can establish realistic and achievable goals. These goals should address immediate concerns, such as securing financial assistance and emotional support, as well as long-term objectives, such as developing effective coping strategies and accessing community resources.
Implementation: In this stage, the nurse will implement the planned interventions to address Frances’s needs. This may involve providing emotional support, facilitating connections with support groups or counseling services, advocating for financial assistance, and providing education on coping skills and self-care.
Evaluation: Regular evaluation of the interventions is crucial to determine their effectiveness in meeting Frances’s goals. The nurse should reassess Frances’s progress, identify any barriers or modifications needed, and adjust the plan accordingly (Salma & Waelli, 2021). This iterative process ensures ongoing support and adaptation to her changing needs.
Conclusion
Frances Gordon’s case demonstrates the complexity of crisis intervention and the importance of applying the nursing process to provide comprehensive care. By differentiating between types of crises and utilizing the nursing process, nurses can effectively address the unique challenges faced by individuals like Frances. Through holistic assessment, accurate diagnosis, goal-oriented planning, proactive implementation, and continuous evaluation, nurses can support individuals during times of crisis, promoting resilience, and facilitating positive outcomes.
References
Salma, I., & Waelli, M. (2021). A framework for the implementation of certification procedures in nurse level: a mixed approach study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06940-0
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(8), 158. https://doi.org/10.4103/psychiatry.indianjpsychiatry_580_18
Volling, B. L. (2012). Family transitions following the birth of a sibling: An empirical review of changes in the firstborn’s adjustment. Psychological Bulletin, 138(3), 497–528. https://doi.org/10.1037/a0026921

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