Community Mental Health Nursing (RCMN)
HOME VISIT TO A CLIENT WITH SUICIDAL IDEATION
It is a purposeful visit by the RCPN to the home of client suffering from suicidal tendencies. The nurse renders care with respect to the client's and family identified health needs.
Purpose
- Meet the specific health needs of the client and family in their home environment
- Monitor the client's home environment for safety
- Assess client for immediate referral to the nearest health facility when necessary
- Maintain continuity of care
- Assess and identify stressors in the environment
- Maximise client, family and societal level of independence of health or wellbeing
- Ensure compliance
- Build confidence and boost self-esteem of the client and family
Indications
- Home visits to a client with suicidal ideation.
- Assessing risk, monitoring the home environment for safety and arranging immediate referral when necessary.
- Maintaining continuity of care and boosting the confidence and self-esteem of the client and family.
Equipment
- A Well-Equipped Home Visit Bag
- Community Map and or GhanaPost Global Positions System (GPS)
- Area Register
- Means of Transportation
Preparation
- Read the community map or GPS and identify the home of the client.
- Carry a well-equipped home visit bag and arrange transportation.
Procedure steps
- Read map of the community to identify the home of the client
- Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
- Explain the purpose of your visit
- Establish rapport (refer to procedure) and enquire about the general health of client
- Approach client in a calm and respectful manner to gain trust
- Ensure privacy and confidentiality by asking client to identify a suitable place for the interaction
- Involve caregiver in the interaction with the consent of client
- Assess the client perception about self, life and future
- Assess for signs of previous suicidal attempts by client, risk factors and methods used
- Enquire about the history of suicide and or suicidal attempts in the family
- Enquire and Counsel on:
- Health of client and relatives
- Occupation and or schooling
- The current state of the client from family/other tenants (if necessary)
- Personal and environmental hygiene needs and safety
- Nutritional needs of the client
- Provide reassurance and respond to concerns from client and family tactfully
- Educate client and family on the condition emphasizing on:
- Signs and symptoms of relapse
- Adherence to treatment regimen
- Effective communication
- Good interpersonal relationship
- Teach and encourage family/caregivers on the need to be supportive, observant and or not to leave client alone
- Inform client and family about other social support systems available in the community such as self-help groups, NGOs and suicide hot lines
- Encourage client to share concerns with trusted family members and or significant others
- Educate family/caregivers to monitor client's mood, behaviour, speech and gestures
- Educate clients to keep thought diary, manage negative automatic thoughts, and the use of effective coping mechanisms
- Encourage client to honour review dates or appointments to a health facility
- Refer problems beyond scope to the nearest unit or health facility
- Inform client/family about your next visit
- Leave your contact with client/caregiver and encourage them to call in case of emergency
- Document the care and findings in the report book
- Express appreciation and depart
Precautions
- Approach the client in a calm and respectful manner to gain trust.
- Never leave a client at imminent risk of self-harm alone; involve caregivers in observation.
- Assess for previous suicidal attempts, risk factors and methods used.
- Refer problems beyond scope to the nearest unit or health facility without delay.
Aftercare
- Inform the client and family about the next visit.
- Leave contact details with the client or caregiver for emergencies.
Nursing considerations
- Assess the client's perception of self, life and the future.
- Inform the client and family about social support systems such as self-help groups, NGOs and suicide hotlines.
Patient education
- Teach the family or caregivers to be supportive, observant and not to leave the client alone.
- Educate the family to monitor the client's mood, behaviour, speech and gestures.
- Encourage the client to keep a thought diary, manage negative automatic thoughts and use effective coping mechanisms.
Documentation
- Document the care and findings, including the risk assessment, in the report book.
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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