Helpless and hopeless

MattiesMama · Aug 9, 2009

It depends on the underlying reason...why do they feel hopeless? You need to know the causative/contributing factors before you can start thinking about interventions.

My best peice of advice is to get a NANDA book and use that along with the information you have gathered from your assessment to come up with interventions.

laughingoutloud · Aug 9, 2009

In this case its a 40 year old female who doesnt think that there is anything good for her in life and feels if she cant fix this depression she is a failure...

FLmomof5 · Aug 9, 2009

psych consult? In FL, this would be something worthy of the Baker Act.

MattiesMama · Aug 9, 2009

Nursing priority #1 is determining the causative/contributing factors

Is her primary dx clinical depression or are there things going on in her life that are causing her to feel this way? i.e. chronic disease, physical disability, recent loss of loved one, etc. That will shape your interventions.

Nursing priority #2 is to assess level of hopelessness

What defining characteristics does she have that indicate she feels hopeless? Has she verbalized these feelings? Is she showing physiological signs of depression like loss of appetite, insomnia or sleeping all the time? Is she abusing drugs or alcohol? You need to determine how severe her depression is before you can plan interventions. Make sure you find out if she is having suicidal ideations too because that is considered an emergency and she would need to be placed in an inpatient setting.

Nursing priority #3: To assist patient to identify feelings and begin to cope with problems

This is where the real interventions would begin...a lot of this involves therapeutic communication. Many depressed people need someone to "vent" to, especially someone who is not in their "inner circle" so to speak because there is a lot of shame with depression but she might be more comfortable talking about it with a medical professional. Have her keep a journal of her feelings, make a chart of small goals that she can obtain. You can use relaxation techniques and guided imagery, refer her to support groups, to a psychiatrist if she doesn't already have one so she can get on antidepressants, etc.

Like I said, it really does depend on the patient...every one is different and especially with pyschological issues you need to tailor your care to the individual.

Daytonite, BSN, RN · Aug 11, 2009

interventions are based on the signs and symptoms that the patient has. the medical condition is depression. what are the other signs and symptoms of this depression? what is the actual nursing diagnosis you have decided upon? is it hopelessness (this is a nursing diagnosis)? are there any other psychosocial nursing diagnoses that apply here? the reason i ask is because with depression, the medical diagnosis, patients usually need to have 5 or more of the following symptoms in order for a physician to diagnose them with depression: depressed mood, anhedonia, weight loss or gain, sleep disturbance of some type, increased or decreased motor activity, fatigue, feelings of worthlessness or inappropriate guilt, the inability to think clearly and suicidal ideation or thoughts of death. each of those are symptoms that can also be classified into nursing diagnoses.

my question for you is how is the helplessness and hopelessness being manifested? helplessness implies the need for assistance with things. that's what we nurses do--assist patients with getting adls done--adls-r-us. you need to be more specific in your description of the patient's symptoms in order to find interventions that are going to be helpful. what does "nothing good in her life" and "feels she is a failure" mean? what would a "good" thing be in her life? what is she calling "failures"? a failure by her definition may not be a failure by my definition. do you get what i am saying? you need to explore her thought process a little more and describe what is going on before you diagnose it. there may be a disturbed thought process here. or, chronic low self-esteem. can't tell because there are no clear symptoms of the nursing problem. with no clear symptoms of the nursing problem you cannot begin to come up with solutions (nursing interventions). sorry, but that's how the nursing process works. you have to assess this depression she has first.

see https://allnurses.com/general-nursing-student/help-care-plans-286986.html - help with care plans for information on care plan construction and how to follow the steps of the nursing process in doing this.