Time: 8:15 Am
Number of participants: 62
Learning Theories: Ausubel: Emphasized the use of advance organizers which he said was
different from overviews and summaries. His use of an advance organizer acted as a bridge to
the chasm between learning material and existing related ideas. The advanced organizer used;
sought to bridge new knowledge with what was known (sometimes what is known is uncertain
and not concrete). Although he specified that his theory applied only to reception learning in
school, it was utilized because it introduced the topic and aid the sequence of the information to
be imparted. (Ormrod & Rice, 2003). Rogers- Dealt with adult learner, he posited that learning
is student centered and personalized and the educator’s role is that of a facilitator. Affective and
cognitive needs are central and the goal is to develop self-actualized people in a cooperative,
supportive environment. (Quinn, 2010). Bruner- who belief that learners are not blank slate but
brings past experiences to a situation, he also states that new information is linked to prior
knowledge, thus mental representations are subjective. Bruner: Discovery learning is an inquiry-
based, constructivist learning theory that takes place in problem solving situations where the
learner draws on his or her own past experience and existing knowledge to discover facts and
relationships and new truths to be learned. (Quinn, 2010). Students interact with the world by
exploring and manipulating objects, wrestling with questions and controversies, or performing
experiments. As a result, students may be more likely to remember concepts and knowledge
discovered on their own (in contrast to a transmissionist model). (Quinn, 2010). Models that are
based upon discovery learning model include: guided discovery, problem-based learning,
advantages of this theory are encourages active engagement, promotes motivation, a tailored
creativity and problem solving skills. (Quinn, 2010). Vygotsky: Posited that both learners and
teachers learn from each other through a socialization process, this he term social interaction.
Aim of activity: To educate students on the nursing management of the suicidal patient
Scientific Principle: Homeostasis: The concept of homeostasis is widely used in physiology and
1. Define the term suicide according to Frisch & Frisch (2010) and The Merriam-Webster’s
Dictionary
2. Explain the four (4) categories of suicide as cited by Frisch and Frisch, (2010); Klonsky,
May and Saffer, (2016); Giner, Guija, Root and Baca Garci, (2016); Nock and
Kessler (2010)
3. Outline the etiology/risk factors for suicide as indicated by Evans, Nizette and O’Brien
(2016)
4. Discuss at least seven preventative measures for the client with suicidal
5. Describe the nursing management for the client with suicidal ideations as put forth by
Schultz and Videbeck (2013); Doenges, Moorhouse and Mishler (2014); Ackley,
Evaluation: Formative and Summative. Questions will be asked following each objectives and a
References:
10.3109/01612840903267612.
Ackley, B & Ladwig,, Makic. (2017). Nursing diagnosis handbook: Nursing care plans
Amsterdam: Elsevier
Birckhead, Loretta.M. (1989). Psychiatric mental health nursing. The therapeutic use of self.
Doenges, M., Moorhouse, M & Murr, A. (2014). Nursing diagnosis manual, planning,
Evans, K., Nizette., D & O'brien, A. (2016) Challenging behaviours, risks and responses in
https://www.researchgate.net/publication/311226140_Challenging_Behaviours_Risks_an
d_Responses
Frisch, N & Frisch, L. (2010) Psychiatric Mental Health Nursing. New York: Thomson Delmar
Learning
Giner, L., Guija, J., Root, C & Baca Garcia, E. (2016). Understanding Suicide. Nomenclature
Hagen, N & Russell, A. P. (2016). Student Suicides: A tragic silent issue and potential solutions.
http://bonoi.org/basicpage/student-suicides-tragic-silent-issue-and-potential-solutions-ft
Klonsky, E. D., May, A. M & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal
and suicidal behavior: results from the National Comorbidity Survey Replication. Mol
Ormro d, J & Rice, F. (2003). Lifespan development and learning. Boston MA: Pearson
Publishing.
Quinn, F. (2010). The principles and practice of nurse education. London: Stanley Thornes
The Free Dictionary (2017). Homeostasis. Retrieved on February 02, 2017 from
http://www.encyclopedia.com/topic/Homeostasis.aspx
http://www.merriam- webster.com/dictionary/suicide
Videbeck, S. (2018). Psychiatric mental health nursing. (7th). Philadelphia: Wolters Kluwer
OBJECTIVES CONTENT TEACHER’S LEARNER’S EVALUATION
ACTIVITY ACTIVITY
ICE BREAKER: Ausubel: A patient ran off the mental health bus in a Teacher will ask Students will attempt
Emphasized the use of advance mad rush and shouted, “Suicidal!” Guess
students to read ice to read the ice breaker
organizers which he said was what happened to him?
different from overviews and breaker and attempt and attempt to identify
summaries. The advanced
to identify today’s topic for todays lesson
organizer used, seeks to bridge
new knowledge with what is topic
known He
was promptly admitted without any
questioning, for fear of the inevitable!!
1. Define the term suicide Suicide is the intentional killing of Teacher will ask one One participant will Participants will be
according to Merriam oneself.(Merriam-Webster’s Dictionary) participant to define define suicide in own able to define suicide
Webster’s Dictionary; suicide in own words. stating at least two
Frisch and Frisch The purposeful taking of one’s own life words. specific words from
(2010). (Frisch & Frisch, 2010) the definition such as:
Teacher will define Participants will sit “purposeful taking of
the term suicide attentively and listen to one’s own life or the
according to the the definition of intentional taking of
content. suicide. one’s self…”
2. Explain the four 1. SUICIDAL IDEATION: this is Teacher will ask Two participants will Participants will be
categories of suicide as when a client tells you that voices two participants to attempt to give one
able to explain the
cited by Birckhead are telling him to kill himself. give one category category each for
four categories of
(1989); Frisch & 2. SUICIDAL ATTEMPT: this is a each of suicide. suicide.
Frisch, (2010); self-destructive act with the intent suicide by utilizing
Klonsky, May & to die by methods such as shooting, Teacher will explain Participants will look,
terms such as
Saffer, (2016); Giner, stabbing, hanging, jumping and the four categories listen and follow on
“Suicidal Ideation,
Guija, Root & Baca drug over dose and so on (Frisch & of suicide according PowerPoint as the four
Garci, (2016); Nock & Frisch, 2010; Klonsky, May & to the content using categories of suicide Suicidal Attempt,
Kessler, (2010, p. 616) Saffer, 2016) PowerPoint as an are explained.
Suicidal Threat and
3. SUICIDAL THREAT: this is aid
Suicidal Gesture…”
when the client verbally says he is
going to kill himself. Three participants will
Teacher will ask
explain any two
4. SUICIDAL GESTURE: this is a three participants to
category of suicide
explain any two
self-destructive act where lethality according to the
category of suicide
content
is low e.g. superficial wrist according to the
content.
laceration and self-inflected
cigarette burns. (Birckhead, 1989;
Frisch & Frsich, 2010; Klonsky,
May & Saffer, 2016; Giner, Guija,
Root & Baca Garci, 2016).
“self-injury in which there is no
intent to die, but instead an intent to
give the appearance of a suicide
attempt in order to communicate
with others”
(Nock & Kessler, 2010)
3. Outline the There is no single cause for suicide Teacher will ask one A male participant will Participants will be
etiology/risk factors for Depression is the condition most male participant to attempt to state at least able to correctly
suicide as indicated by associated with suicide and its state at least one one etiological and one outline the
Evans, Nizette and attempts, it is often undiagnosed etiology or one risk risk factor suicide etiology/risk factors
O’Brien (2016) and untreated factor suicide for suicide utilizing
Other conditions such as; key words such as
Anxiety, and substance use Teacher will outline Students will look, “There is no single
especially if not addressed increase the etiology/risk listen and ask cause for suicide;
the risk for suicide factors utilizing questions as teacher Depression is the
WARNING SIGNS PowerPoint outlines the etiology condition most
A change in behaviour or new presentation risk factors for suicide associated with
behaviours especially if it is related suicide and its
to a painful experience, loss or Teacher will ask one One student seated on attempts, it is often
change (Evans, Nizette, & O’Brien, student seated on the left will outline the undiagnosed and
2016) the left to outline etiology or risk factor untreated…”
Most people who take or make an one etiology or risk for suicide according
attempt on their lives exhibit factor for suicide to the content
warning signs through either talk or according to the
action content
TALK
Killing self
Feeling hopeless
Having no reason to live
Being a burden to other
Feeling trapped
Unbearable pain
BEHAVIOUR
Increased use of alcohol/drugs
Looking for ways to end their lives
(internet)
Withdrawal from activities
Sleeping too much or too little
Visiting or calling people to say
goodbye
Giving away personal possessions
Fatigue
Aggression
(Evans, Nizette, & O’Brien, 2016)
MOOD – one or more of the following is
displayed
Depression
Anxiety
Loss of interest
Irritability
Humiliation
Agitation
Rage
RISK FACTORS
Health factors
Mental health conditions
Depression
Substance use
Bipolar disorder
Schizophrenia
Anxiety disorder
Aggressive personality
traits
Serious or chronic health
conditions and or pain
(Evans, Nizette, & O’Brien, 2016)
Environmental factors
Access to lethal means (guns,
knives, ropes)
Prolonged stress (harassment or
bullying, employment or relational)
Stressful life events (divorce, death
of job loss)
Exposure to another person’s
suicide
Historical Factors
Previous suicide attempt
Family history of suicide
Childhood neglect, abuse or trauma
(Evans, Nizette, & O’Brien, 2016)
PREVENTATIVE MEASURES
Suicidal clients are restricted on the
unit/ward.
The staff informed of client’s
suicidal precautionary status;
instructed in appropriate ways of
interacting with clients.
Suicidal clients not allowed access
to knives other sharp objects.
Observe for and remove potentially
harmful objects in environment;
shoe lace, belt, bottles and ropes
(Hagen 2016)
Suicidal clients monitored by staff
at least every15 minutes or if
available one to one staff coverage.
If suicidal clients are agitated or
presenting management problem,
they may be placed in seclusion
area/room to calm them.
Restraint is usually a last resort.
(Frisch et al, 2010; Alflague &
Ferszt. 2010).
4. Discuss at least seven PREVENTATIVE MEASURES Teacher will ask the The two tallest Participants will be
precautionary/preventat Suicidal clients are restricted on the two tallest students students in the class able to state at least
ive measures for unit/ward. in the class to name will attempt to name five of the seven
suicide as postulated by The staff informed of client’s two preventative two preventative precautionary
Hagen (2016); Frisch & suicidal precautionary status; measures each for measures each for measures when
Frisch (2010); Alflague instructed in appropriate ways of suicide suicide caring for the suicidal
& Ferszt. (2010). interacting with clients. clients by using terms
Suicidal clients not allowed access Teacher will discuss Participants will listen such as “clients are
to knives other sharp objects. the precautionary attentively to the restricted on the
Observe for and remove potentially measures for the precautionary unit/ward; clients not
harmful objects in environment; suicidal clients measures and ask allowed access to
shoe lace, belt, bottles and ropes using PowerPoint questions. knives other sharp
(Hagen 2016) presentation and objects; Observe for
Suicidal clients monitored by staff answer questions and remove
at least every15 minutes or if asked. potentially harmful
available one to one staff coverage. Teacher will ask objects in
Three participants will
If suicidal clients are agitated or three participants to environment; shoe
recall one
presenting management problem, recall on lace, belt, bottles and
precautionary measure
they may be placed in seclusion precautionary ropes; clients
each when caring for a
area/room to calm them. measure each monitored by staff at
suicidal client
Restraint is usually a last resort. according to the least every15 minutes
according to the
(Frisch et al, 2010; Alflague & content or if available one to
content.
Ferszt. 2010) . one staff coverage
5. Discuss the nursing ASSESSMENT CRITERIA (RISK Teacher will ask Participants will break Participants will be
Management for the FACTORS) - MANIFESTATIONS participants to form out into three groups of able to discuss at
suicidal client Suicidal ideas, feelings, ideation, at least three groups at least 20 and least six of the nine
according to (Doenges, plans, gestures, or attempts of 20-and brainstorm at least nursing management
Moorhouse, Muir 2014; Lack of impulse control brainstorm at least three possible nursing for the suicidal
Ackley & Ladwig, Lack of future orientation three possible interventions and clients by using
2017; Schultz, J. M. & Self-destructive tendencies nursing discuss their findings nursing diagnoses
Videbeck, S. L. 2013; Feelings of anger or hostility interventions and with the class. such as “Risk for
Townsend, 2015). Agitation discuss their suicide, Ineffective
Aggressive behavior findings with the Coping, High risk for
Feelings of worthlessness, class. violence, Risk for
hopelessness, or despair mutilation, Ineffective
Guilt Teacher will discuss Participants will listen, family coping; Low
Anxiety the possible nursing follow and ask self-esteem, Spiritual
Sleep disturbance diagnoses nursing questions from distress….”
Substance use and interventions PowerPoint and white
Perceived or observable loss for the suicidal board as the nursing
Social isolation clients using the diagnoses and
Problems of depression, withdrawn white board and interventions are
behavior, eating disorders, PowerPoint as aids. presented.
psychotic behavior, personality
disorder, manipulative behavior, Teacher will ask Four participants will
post-traumatic stress, or other four participants to give two interventions
psychiatric problems give two each for the suicidal
NEED (Maslow’s Hierarchy) – Safety & interventions each clients according to the
Security for the suicidal content.
At risk for self-inflicted, life- clients according to .
threatening injury. the content.
NURSING DIAGNOSIS
QUIZ
QUESTIONS
ANSWERS
1. Suicide is the intentional killing of oneself (Merriam-Webster’s Dictionary) or the purposeful taking of one’s life
2. Suicidal Ideation: When the client tells you that voices are telling him to kill himself
3. Suicidal threat: when the client threatens to kill himself
4. Suicidal Gestures: when the client gets involved in self destructive/inflicting acts with low levels of lethality-
5. Suicidal attempt: self-destructive act with the intent to die by methods such as: shooting, stabbing, hanging, jumping and drug
over dose
Management methods
Nursing management