suicide vs. violence self directed

Daytonite, BSN, RN · Mar 16, 2009

this is why you need to refer to the nanda taxonomy information (definition of the diagnosis, related factors [in this case the risk factors] and defining characteristics) when diagnosing.

risk for suicide - at risk for self-inflicted, life-threatening injury (page 330, nanda international nursing diagnoses: definitions and classifications 2009-2011)
risk for self-directed violence - at risk for behaviors in which an individual demonstrates that he/she can be physically, emotionally and/or sexually harmful to self (page 333, nanda international nursing diagnoses: definitions and classifications 2009-2011) - suicidal ideation is one of the risks for this diagnosis, but this diagnosis is frequently used for people who are socially inappropriate (i.e. juvenile delinquents, abusers, people whose behavior is out of control, have temper tantrums, add, are drunk, psychotic, act on impulse, etc.)

whodunit · Mar 16, 2009

Simply put, risk for suicide is the person who has either attempted to kill themself or has verbalized the desire to kill themselves, as in overdosing or saying they are going to run their car off a cliff.Risk for violence self directed is a person who self multilates. Hope this helps you understand better. Best of luck !

ldyjstce · Mar 17, 2009

Can a person ever have both risks?

whodunit · Mar 17, 2009

Yes, over the years I 've had many pts who were admitted because of suicidal ideation or gestures ,who have after admission both attempted to kill themselves by hanging etc as well as acting out and pulling their hair out by the handfuls or using items such as paper clips to attempt to cut their wrists etc .

lwhite81 · Mar 19, 2009

I want to thank everyone who responded. I appreciate it very much...In the end I had to use Ineffective coping because the patient was in a short term stay facility.. The patient was admitted because he was telling everyone that he was going to commit suicide. He had a plan and he was just waiting for his parents to understand why he wanted to die, so they wouldn't grieve. My instructor told me that because he was in a facility, he was not at risk for suicide. He was in a mental health facility that had him under suicide precautions. Therefore the probablity for him to actually commit suicide was pretty much out of the question... So in the end the best nursing diagnosis was Innefective coping. He has a history of OCD and major depressive disorder. Let me know what you think, some of my fellow students agree and some dont. I want a good grade, so I am going to agree with my instructor!!

whodunit · Mar 19, 2009

I want to thank everyone who responded. I appreciate it very much...In the end I had to use Ineffective coping because the patient was in a short term stay facility.. The patient was admitted because he was telling everyone that he was going to commit suicide. He had a plan and he was just waiting for his parents to understand why he wanted to die, so they wouldn't grieve. My instructor told me that because he was in a facility, he was not at risk for suicide. He was in a mental health facility that had him under suicide precautions. Therefore the probablity for him to actually commit suicide was pretty much out of the question... So in the end the best nursing diagnosis was Innefective coping. He has a history of OCD and major depressive disorder. Let me know what you think, some of my fellow students agree and some dont. I want a good grade, so I am going to agree with my instructor!!

I have to disagree with your instructor,; just because the pt is in a mental health facility does not mean he/she won't try.It just means they are monitored closely usually q 15 min, sometimes 1 on 1 and as closely as staff watches, sometimes they do try and occasionally suceed.I don't know where you are from or where your instructor works but they are way off on this one.I have had pts take a paperclip and insert it in their anticubital so far that ER had to removeit or rub their wrists on the corner of the doorway until they bleed.Bottom line if a pt reports SI , they may be acting out, or they may be serious !!

Daytonite, BSN, RN · Mar 20, 2009

I'm with you, lwhite81. School is about learning. A grade is needed to get the degree so you can take the NCLEX. The main thing is that you learned something about taking care of a patient, working with a care plan and diagnosing. Your instructor is your boss until you get your own license. When you have a license and a job you can make your own independent decisions. Carry on, nurse!

RochesterRN-BSN, BSN, RN · Mar 20, 2009

You should familiarize yourself with Borderline Personality Disorder.........pts with this Dx are the ones who have self harming behaviors. However, they are generally commonly depressed as well and so they can also be at times at risk for suicide. Self harming can be in many forms--thow the most common is cutting or even burning, alcohol and drug abuse, eating disorders, permiscuous sexual behaviors, etc.

A book you may find helpful and it is a quick read-- 184 page paperback--

I Hate You, don't leave me....By Jerold Kreisman, MD & Hal Straus