This nursing care plan is for patients that are at risk for self harm. This care plan includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Psychiatric disorders such as schizophrenia, bipolar disorder, post-traumatic stress, personality disorder, or somatoform disorders.
Patients who are at risk for self harm need to be cared for in a special way compared to other patients who do not have psychiatric disorders. Patients who verbalize they are thinking about hurting themselves should be taken seriously. Most patients who commit suicide have usually told at least one person they are thinking about killing themselves before actually committing the act. In addition, if a patient has a history of hurting themselves or unsuccessful suicide attempts this patient is at risk for self harm.
Below is a case scenario that may be encountered as a nursing student or nurse in a hospital setting.
What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?
This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.
Nursing Care Plan for: Risk for Self Harm
If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.
Scenario: |
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A 26 year old female is admitted for suicide attempt. The patient is involuntary committed at this time. The patient’s mother found the patient trying to hang herself in the basement. The patient has a history of bipolar disorder, illicit drug abuse, and multiple suicide attempts during her teenage years. Currently the patient is having a manic episode. The patient is exhibiting pressured speech and is being euphoric and grandiose. There is a 1:1 sitter with the patient at all times. The patient refuses to wear telemetry monitoring and will not take any of her medications. She states she wishes her mother would have let her die so she could be free for this world. After this she states that one day she will succeed at getting out of this world.
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Nursing Diagnosis: |
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Risk for Self Harm related to feelings of helplessness, loneliness, or hopelessness secondary to psychiatric disorder bipolar disorder.
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Subjective Data: |
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She states she wishes her mother would have let her die so she could be free for this world. After this she states that one day she will succeed at getting out of this world.
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Objective Data: |
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A 26 year old female is admitted for suicide attempt. The patient is involuntary committed at this time. The patient’s mother found the patient trying to hang herself in the basement. The patient has a history of bipolar disorder, illicit drug abuse, and multiple suicide attempts during her teenage years. Currently the patient is having a manic episode. The patient is exhibiting pressured speech and is being euphoric and grandiose. There is a 1:1 sitter with the patient at all times. The patient refuses to wear telemetry monitoring and will not take any of her medications.
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Nursing Outcomes: |
| -Pt will remain free from any self harm during hospitalization.-Pt will contract to safety within 24-48 hours of hospitalization.-Pt will express her feelings about why she wants to harm herself.
-Pt’s family will verbalize 4 ways on how to recognize levels of impending self harm that may be committed by the patient. -Pt will verbalize how and when to use the 24 hour emergency hot-line when she gets feelings of self-harm at discharge. -Pt will verbalize understanding that self harm is a choice, not something uncontrollable at discharge. -Pt will assist in identifying thoughts, feelings, and behavior that leads up to her wanting to commit suicide. -Pt will verbalize 3 techniques on developing copings skills to help her handle stressful situations.
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Nursing Interventions: |
| -The nurse will make sure the patient is not left alone at any time during her hospitalization.-The nurse will assess the patient’s ability to contract for safety within 24-48 hours.-The nurse will explain to the patient what the contract of safety means for the patient.
-The nurse will encourage and listen to the patient about the reasons why she wants to harm herself. -The nurse will educate the family on 4 ways how to recognize levels of impending self harm that may be committed by the patient. -The nurse will supply the patient with the 24 hour emergency hot-line phone number and when to use it. -The nurse will educate the patient on understanding that self harm is a choice, not something uncontrollable at discharge. -The nurse will assist in identifying thoughts, feelings, and behavior that leads up to the patient wanting to commit suicide. -The nurse will educate the patient on 3 techniques on developing copings skills to help the patient handle stressful situations. |