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1. 2min To introduce INTRODUCTION : Writing Listening White

the topic to the Human being has to maintain balance in life. topic on the board
students. Whenever people exposed to stressors or stressful white board
situations they will try to overcome it by his own way of
dealing with the problem, by adopting adequate coping
strategies, with the help of situational support, people
will try to overcome it. “stress” is always essential for the
individual to lead qualitative life, but when an individual
is exposed to many stressors at a time, even with the
utilization of balance factors adequately also or due to
one or more absence of balancing factors results in
disequilibrium & it may lead to crisis.
2. 2min The students DEFINITION : Explaining Listening and Roller What is crisis?
will be able to Crisis is a state of diseqilibrium resulting from the making notes board
define the interaction of an event with the individual’s or family’s
crisis. coping mechanisms, which are inadequate to meet the
demands of the situation, combined with the
individuals’s or family’s perception of the meaning of the
event ( Taylor 1982).

“A crisis is an international disturbance caused by a

stressful event or a perceived threat to self. Simply stated,
crisis is defined as a point that requires a change in the
usual method of functioning.”
- Lalitha , 2011.
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3. 3min The students CHARACTERISTICS OF A CRISIS: - Asking Listening and Leaf Can any have
will be able to According to Aguilera (1998), Kaplan question and answering lets any idea about
describe the A number of characteristics have been identified. They explaining the
characteristics include the following: characteristics
of a crisis.  Crisis occurs in all individuals at one time or of crisis?
another and is not necessarily equated
with psychopathology.
 Crises are precipitated by specific identifiable
events.
 Crises are personal by nature. What may be
considered a crisis situation by one
individual may not be so for another.
 Crises are acute, not chronic, and will be resolved
in one way or another within a
brief period.
 A crisis situation contains the potential for
psychological growth or deterioration.
Disorganization of biological, cognitive,
emotional and behavioral experience.
 The person in crisis becomes less able to problem
solve and accurately interpret the circumstances
of crisis event.
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 Individual who are in crisis feel helpless to
change. They do not believe they have the
resources to deal with the precipitating stressor.
 Levels of anxiety rise to the point that the
individual becomes non functional, thoughts
become obsessional.
 The feeling is overwhelming and may affect the
individual physically as well as psychologically.
 There will be a precipitating event of actual or
perceived losses, or challenges.

4. 4min The students TYPES OF CRISIS: Listening Listening and Hand Can you say
will be able to making notes outs about the types
enumerate the There four types of crisis are explained. They are of crisis?
types of crisis.
 crisis Situational crisis
 Maturational crisis
 Adventitious crisis
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Other types are:
 Dispositional crisis
 Crisis of anticipated life transition
 Crisis resulting from traumatic stress
 Crisis reflecting from psycho pathology
 Psychiatric emergencies
Situational crisis:

The majority of the crisis that nurses experience on the

job can be classified as situational crisis which result
from an external event or environmental influence that
upsets the individuals or groups bio- psycho-social
equilibrium
Situational crisis are characterized by a sudden,
unexpected onset and generally have a singular, rather
than multifaceted origin.
Eg: an accident , a diagnosis of a terminal illness ,
unexpected pregnanacy, a death of loved one, changes in
employment status.
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Maturational crisis:

A maturational crisis is a stage in person’s life

where adjustment & adaptation to new responsibilities &
life patterns are necessary. The transition points where
individuals move into successive stage often generate
equilibrium. Individuals are required to make cognitive
& behavioral changes & to integrate those physical
changes that company development.
Maturational crisis are developmental events or
life transitions, requiring significant role changes.
Maturational crisis occurs in predictable successive
stages of growth and development. Infancy, and early
childhood, preschool, puberty, adolescence, adulthood
and old age.
Erik Erikson described eight stages of
development from infancy to old age and the relationship
of each stage to the ones before and after. Each stage
presents a problem or task that the person must complete
before moving on to the next change.
Examples; transition from being a student to an
employee, entering marriage.
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Adventitious crisis:

Adventitious crisis is described as accidental,

uncommon and unexpected tragedies that disrupt entire
communities, often natural disasters such as fires,
tsunami, floods and earth quakes. Shock and anxiety
strike the entire community. If left un treated the effect of
these may lead to acute or post traumatic stress reactions.
Socio-cultural crisis;

Socio cultural crisis is described as one arising

from the cultural values that are embedded in the social
structure. The loss of a job stemming from discriminatory
practices based on age, race, sex, sexual preference, or
class is a primary example of a socio cultural crisis.
Examples: job loss due to illness or poor performance,
deviant acts of others whose behavior violates social
norms, such as robbery, rape.

According to Baldwin (1978)has identified five more

types of crisis that is
Dispositional crisis : An acute response to an external
situational stressor.
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Crisis of anticipated life transition : Normal life cycle

transition that may be anticipated but over which the
individual may feel a lack of control.

Crisis resulting from traumatic stress : crisis

. precipitated by unexpected external stresses over which

the individual has little or no control and from which he
or she feels emotionally overwhelmed and defeated.

Crisis reflecting psychopathology : Emotional crisis in

which preexisting psychopathology has been
instrumental in precipitating the crisis or in which
psychopathology significantly impairs or complicates
adaptive resolution.

Psychiatric emergencies: crisis situations in which

general functioning has been severely impaired and the
individual rendered incompetent or unable to assume
personal responsibility.
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5. 7min The students . PHASES IN THE DEVELOPMENT OF A CRISIS Explaining Listening and OHP Can any one
will be able to According to Kaplan (1964) four specific making notes with discuss about
enlist the phases through which individuals progress in response to transp the phases in the
phases in the arance development of
a precipitating stressor and that culminate in the state of
development sheets a crisis?
of crisis. acute crisis.

Phase 1:- The individual is exposed to a precipitating

stressor.
Anxiety increases; previous problem-solving techniques
are employed. Or a traumatic event causes an initial rise
?
in the individual’s level of anxiety. The individual
responds with familiar problem solving mechanism in an
attempt to reduce or eliminate the stress and
discomfort .If coping mechanism are effective the crisis
is averted.

Phase 2:- When previous problem-solving techniques do

not relieve the stressor, anxiety increases further.
The individual begins to feel a great deal of discomfort at
this point. Coping techniques that have worked in the
past are attempted, only to create feelings of helplessness
when they are not successful. Feelings of confusion and
disorganization prevail.
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Phase 3:- All possible resources, both internal and

external, are called on to resolve the problem and relieve
the discomfort.
The individual may try to view the problem from a
.
different perspective, or even to overlook certain aspects
of it. New problem-solving techniques may be used, and,
if effectual, resolution may occur at this phase, with the
individual returning to a higher, a lower, or the previous
level of pre-morbid functioning.

Phase 4:- If resolution does not occur in previous phases,

Kaplan states that “the tension mounts beyond a further
threshold or its burden increases over time to a breaking
point. Major disorganization of the individual with
drastic results often occurs.”
Anxiety may reach panic levels. Cognitive functions are
disordered, emotions are labile, and behavior may reflect
the presence of psychotic thinking.
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6. 6min The students CRISIS CONTINUUM : Explaining Listening and Pamp Can you discuss
will be able to 1.Potential Crisis State : whenever any acute problem making notes hlets about the crisis
brief out the or serious threat occurs, individuals will become tense continuum?
crisis
and employs emergency problem solving methods to
continuum.
resolve crisis, but it is ineffective.
2. Pre-crisis state : when person has high probability of
exposure to stressful events , in an adequate support, lack
of coping abilities, poor history of handling stress will be
more upset and enter into a state of disequilibrium.
3.Immediate Crisis State : an tension continue to build,
they mobilize all internal and external resources to
restore the equilibrium .
4. Intermediate crisis state :The problem may be re-
evaluated and attacked from a new angle or the problem
may be distorted and viewed as unsolvable.

5. Advanced crisis state : persons who have continued

to draw all inner resources, have continued failing in
attempts to resolve the problems , emotional pressures
continue to build and people become completely
disorganized or immobilized owing to serve anxiety or
depression state .
6. full crisis state : Person, who has failed in all attempts
to solve the problems believes that all resources have
been used feels more stress.
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7. 4min The students SIGNS AND SYMPTOMS: Discussing Listening and leaflet What are the
will be able to  Heavy burden of free floating anxiety, and answering s signs and
list out the explaining symptoms of the
Eg: heightened emotional tension, the drive to act.
signs and crisis?
symptoms of  Depression
crisis.
 Anger, guilt, tension,fear.
 Neglects in performing self care activities
 Irrational and blaming others
 Helplessness , hopelessness,uselessness
 Panic
 Low self esteem
 Uncontrollable crying
 Lack of confidence
 With drawal behavior,
 Irritable
 Rigid in nature, denial
 Disorganized behavior unable to think
realistically
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 Impaired judgement
 Lack of self control

8. 6min The students PROCESS OF CRISIS: Explaining Listening Ohp Can any one
will be able to cum with describe the
explain the Healthy resolution of a crisis depends upon thr following discussion transp process of
process of three factors: arence crisis?
crisis. sheets
1. Realistic appraisal of the precipitating event, i.e
recognition of the relationship between the event
and feelings of anxiety is necessary for effective
problem-solving to occur.
2. Availability of support systems.
3. Availability of coping measures over a life- time.
There are three ways by which the individual may
resolve the crisis.

 Pseudo –resolution
 Unsuccessful resolution
 Successful resolution
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 PSEUDO RESOLUTION:

In this, the individual uses repression and pushes out

consciousness the incident and the intense emotions
associated with it, resulting in the individual functioning
at the same earlier level. But in future, if and when a
crisis occurs, the repressed feelings may surface and may
influence the feelings aroused by the new crisis. In such a
situation, the particular crisis may be more difficult to
resolve because the feelings associated with the earlier
crisis are neither expressed nor handled at that time.

 UNSUCCESSFUL RESOLUTION:

In this, the victim uses pathological adaptation at any

phase of crisis, resulting ina lower level of functioning.
The victim, rather than accepting the loss and
reorganizing his life, keeps ruminating over the loss. An
example is prolonged grief reaction, which results in
depression.
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 SUCCESSFUL RESOLUTION:
In this, the victim may go through the various phases of
crisis, but reaches phase III where various coping
measures are utilized to resolve the crisis situation. The
individual develops better skills and problem solving
ability, which can be and will be used in various crisis
situations in future.

BALANCING FACTORS:-
Every attempt is made to stabilize and regain
equilibrium. Aquilera (11994) discusses the balancing
factors that contribute to the return to equilibrium and
states the strength or weakness in any of these factors
could precipitate a crisis or contribute to resolution.
These factors include the :-
- Perception of the event
- Situational supports
- Coping mechanisms
When the individual perceives the situation to be
overwhelming and is unable to use the usual coping skills
and systems of support effectively, the stress and
discomfort continues to escalate. As a result, the
individual is unable to regain balance without significant
external intervention.
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Caplan (1964) reported that left without
intervention, the crisis situation will resolve in 5 to 6
weeks.
9. 3min The students CRISIS INTERVENTION: Discussing answering Power Can you say
will be able to Crisis intervention is a technique used to help an and point about the
discuss the individual or family to understand and cope with the discussing presen principles of
principles of tation crisis
intense feelings that are typical of a crisis.
crisis intervention?
intervention. Principles :
Because each individual’s tolerance for stress is
idiosyncratic and finite , emotional crises have no
relationship per see to psychopathology and occur
even among the well adjusted.
Emotional crises are self- limiting events in which
crisis resolution , either adaptive or maladaptive ,
takes place within an average period of 4 to 6
weeks.
During a crisis state , psychological defense are
weakened , or absent , and the individual has
cognitive or affective awareness of issues and
memories previously well defended against and.
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less accessible.

During a crisis state , the individual has enhanced

capacity for both cognitive and affective learning
because of the vulnerability of this state and the
motivation produced by emotional disequilibria.
A small external influence during a crisis state
can produce disproportionate change in a shorter
period than therapeutic change that occurs during
non-crisis states.
Resolution of emotional crisis is not necessarily
determined by previous experience or character
structure but rather is shaped by current socio-
psychological influences.
Every emotional crisis in an interpersonal event
involving at least one significant other person
who is represented in the crisis situation directly
or indirectly.
Effective crisis resolution prevents similar future
crisis by removing vulnerabilities from the past
and by increasing the individuals coping skills
that can be used in such situations
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10. 6min The students Explaining Listening Hand Can you discuss
will be able to TECHNIQUES OF CRISIS INTERVENTIONS outs the techniques
state the Abreaction: of crisis
techniques of The release of feelings that take place as the individual intrevnetion?
crisis
talks about emotionally charged areas .The nurse
intervention.
encourages abreaction by asking the patient how he feels
about his situation, recent events and significant people
involve in the crisis.
Clarification:
Encouraging the client to express more clearly the
relationship between certain events in his life. For eg:
helping the client see that it was after he was passed over
for a promotion that he began feeling too sick to go to
work in clarification.
Clarification helps the gain a better understanding of his
feelings and how they led into the development of a crisis
3.Suggestion;
Influencing an individual so that he accepts an idea or
belief, particularly the belief that the nurses can help and
that he will feel better.
Nurse influences the client to see her as a
confident ,calm, hopeful, empathic leader who can help,
the client feels optimistic and in turn will feel less
anxious.
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4.Manipulation :

Using the client’s emotions, wishes or values to his

benefit in the therapeutic process Manipulation is a way
of influencing the client. For eg: the nurse may want to
point out to the client who prides himself on his
independence that he is responsible for much of the work
of solving his problem.

5.Reinforcement behaviour:

Giving the client positive responses to adaptive

behaviour.

6.Support of defences:

Encouraging the use of healthy, adaptive defences and

discouraging those that are unhealthy or maladaptive
Defense mechanism are indirect behaviours used to cope
with stressful. The purpose of defense mechanism is to
maintain self-esteem and ego integrity. The nurse
encourages the client to use adaptive defenses and
discourages those which are maladaptive.
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7.Raising self esteem:

Helping the client to regains feelings of self worthThe

nurse helps the client to regain his feelings of self worth.
She does this by communicating her confidence that the
client can participate actively in finding solutions to his
problems. The nurse also communicates to the client that
he is a worthwhile person by listening to him, accepting
his feelings and relating to him with respect.

8.Exploration of solutions:

. Examining alternative ways of solving the immediate

problems. It is essential because crisis intervention is
geared toward solving the immediate crisis. The nurse
and the client actively explore solutions to the crisis. For
eg:a client who has lost his job and has not been able to
find a new one may become aware of the fact that he
knows many people in his fields of work whom he could
contact to get information regarding the job market and
possible openings.
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11. 2min The students TYPES OF CRISIS INTERVENTION Answering Leafle Can you say
will be able to PROGRAMMES Questioning and ts about the types
classify the  Setting-hospital, clinic, mental health centres and discussing of crisis
types of crisis Discussing intervention
community setting-home ,street.
intervention programmes
programmes  Crisis counselling: brief problem focused
therapy works on solving the immediate problem.
 Mobile crisis team: the goal is to assess,
evaluate, manage crisis, and give referrals.
Telephone counselling and hot line: supportive
interventions and guidance are given.
Disaster response and critical incident stress
debriefing: Disaster response is an organized planning
intervention provided to large segments of the population
following such as floods or accidents.
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12. 5min The students NURSING DIAGNOSIS: OHP Can you list out
will be able to Ineffective coping related to (possible) negative role Asking Discussing with the nursing
apply the modeling evidenced by hitting others, and temper questions transp interventions?
nursing tantrums as expressions of anger. arence
process for sheets
INTERVENTION RATIONALE
crisis.
1.Remain calm when Anger expressed by the nurse
dealing with an angry will most
client. likely incite increased anger in
2. Set verbal limits on the client.
behavior. Clearly delineate 2. Consistency in enforcing
the consequences of the consequences
inappropriate expression is essential if positive
of anger and always outcomes
follow through. are
3. Have the client keep a to be achieved. Inconsistency
diary of angry feelings, creates
what triggered them, and confusion
how they were handled. and encourages testing of
4. Avoid touching the limits.
client when he or she 3. This provides a more
becomes objective measure of
angry. the problem.
5. Help the client 4. The client may view touch
determine the true source as threatening
of and could become violent.
the anger. 5. Many times anger is being
displaced on to a safer object
 or person occur

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OBJECTIVES ACTIVITY ACTIVITY AIDS
NURSING DIAGNOSIS:
Risk for self-directed or other-directed violence related to
(possibly) having been nurtured in an atmosphere of
violence.

INTERVENTION RATIONALE
1.Observe client for 1.Violence may be prevented
escalation of anger (called ifrisks are identified in time.
the prodromal syndrome):
increased motor activity,
pounding, slamming, tense
posture.
2. When these behaviors 2. The initial consideration
are observed, first ensure must be having enough help to
that sufficient Staff are diffuse a potentially violent
available to help with a situation. Client rights must be
potentially violent honored, while preventing
situation. harm to client and others.
least restrictive means.
3. Techniques for dealing
with aggression
include:
a. Talking down ay, “John, 3. Aggression control
youseem very angry. Let’s techniques promote safety and
go to your room and talk reduce risk of harm to client
about it.” (Ensure and others:
that client does not which promotes a trusting
position self relationship and may prevent
 between door and nurse.) the client’s anxiety from
escalating.

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OBJECTIVES ACTIVITY ACTIVITY AIDS
NURSING DIAGNOSIS:
Anxiety related to the real or perceived threat to physical
well being as evidenced by the persistent feelings of
apprehension.
INTERVENTION RATIONALE
 1.determine the degree 1.clearly understanding
of anxiety. clients perception.

2.create as quiet an area 2. need more intensive

as possible. maintain a intervention.
calm, confident manner.
3.developing trusting3.decreases sense of
relationship with the confusion or
client. overstimulation.
4.determine presence of 4.trust is the basis of a
physical symptoms. therapeutic nurse-client
relationship.
5.Identify psychological 5.responses at the time of
responses. the trauma, they will
recycle again and again.
6.discuss with the client 6.increases the ability to
about the perception of connect the symptoms to
causing anxiety. subjective feeling.

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OBJECTIVES ACTIVITY ACTIVITY AIDS
NURSING DIAGNOSIS:
Risk for post trauma syndrome related tonserious threat
or injury as evidenced by the inadequate social support.
INTERVENTION RATIONALE
 1.determine 1.close involvement with
involvement in the victims affects individual
event. responses and may prolong
emotional suffering.
2.evaluate current 2.affect clients reaction to
factors associated with current event and is basis
the event. for planning care.
3.listen for comments of 3.statements such as thses
taking on responsibility. are indicators of and
blaming self for actions.
4.identify the clients 4.noting positive and
current coping negative coping skills.
mechanism.
5.provide information 5.awareness of these factors
about the signs and Helps individual identify
symptoms of post need for assistance when
trauma response. signs and symptoms
occurred.

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OBJECTIVES ACTIVITY ACTIVITY AIDS
13 1min To summarize
the topic SUMMARY :
Till now we have discussed about the crisis definition,
types, phases, process, signs and symptoms, and about
Clarifying Asking
crisis intervention principles, techniques ,and nursing doubts
 interventions.
CONCLUSION:
14 2min To conclude It is very important to know about crisis, in an individual
the topic
life, so it is necessary to study the crisis and its
intervention to provide effective care in all health setting.

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OBJECTIVES ACTIVITY ACTIVITY AIDS

EVALUATION:
I FILL IN THE BLANKS: 5 MARKS
1. Types of crisis are____
2. Phases of crisis are____
 3. Signs and symptoms of crisis are_____
4. Any two techniques of crisis intervention____
5. Process of crisis are____
6. ANSWERS:
1. Maturational, social, situational
2. Phase I,II, III, IV
3. depression, anger
4. catharsis, clarification
5. pseudo, unsuccessful, successful
II Write an assignment on nursing diagnosis and
their interventions? 10 marks.
Date of submission : 22-6-2015
Venue: Room no 16

BIBLIOGRAPHY:

TEACHERS REFERENCE:

1.AHUJA VYAS, “ A Text book of psychiatric nursing”, 2nd edition. Jaypee publications, page no. 421-430.
2. DR. (MRS.) K.LALITHA, “Mental health and psychiatric nursing an Indian perspective”, VMK Book house publishers ,2005,2 nd edition,
Bangalore, PP: 442-449.
3. MARRY.T.TOWNSEND, text book of “mental health and psychiatric nursing”, 6th edition, Jypee brother publications, New Delhi, 2010),
pp246 – 257.

4. R SREEVANI, text book of “Mental health and psychiatric nursing”, 3rd edition, JP brother publication, Chennai, (2010), pp190-202.

STUDENTS REFERENCE:

1.AHUJA VYAS, “ A Text book of psychiatric nursing”, 2nd edition. Jaypee publications, page no. 421-430

2.R SREEVANI, text book of “Mental health and psychiatric nursing”, 3rd edition, JP brother publication, Chennai, (2010), pp190-202.

NET REFERNCE:

1. www.wikipedia of crisis.com retrived on 7/5/15

2. Www. Pubmed crisis intervention.com retrived on 8/5/15

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
CRISIS

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 18-11-2023

OBJECTIVES:
 GENERAL OBJECTIVE:-

The students will be able to gain in depth knowledge regarding crisis and develop desirable attitude and skill in identifying and providing care
for patients with crisis in all health care settings.

SPECIFIC OBJECTIVE:

At the end of the class the students will be able to

 define crisis
 describe the characteristics of crisis
 enumerate the types of crisis
 enlist the phases of crisis
 brief out the crisis continuum
 list out the signs and symptoms of crisis
 explain the process of crisis
 discuss the principles of crisis intervention
 state the techniques of crisis intervention
 classify the types of crisis intervention programs.
 apply the nursing process for crisis.

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
CONCEPT OF HEALTH AND DISEASE

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 16-02-2023

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
UNDER FIVE CLINIC

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 21-02-2023

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
RNTCP

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 20-02-2023

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
BIO MEDICAL WASTE

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 23-02-2023

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
WATER PURIFICATION

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 23-02-2023

JEEVAN JYOTI INSTITUTE OF NURSING AND

PARAMEDICAL SCIENCES
 SUBJECT- NURSING EDUCATION
LESSON PLAN
ON
ARTHROPD BORNE DISEASE (DENGUE, MALARIA, FILARIA)

SUBMITTED TO SUBMITTED BY
MR.ABHISHEK MASIH AMAN JAMES
ASST. PROF M.SC(N) 1st yr
SUBMITTED ON : 14-02-2023