P10 · Distress after a frightening event
Actual Emotions and mind
Definition
Flashbacks, nightmares, or feeling constantly on edge after trauma.- Accident
- assault
- war
- disaster
- abuse
- sudden loss
- Flashbacks
- nightmares
- startling easily
- avoiding reminders
- irritability
📋 Scenario
A road accident survivor wakes from nightmares sweating.
Subjective (S): "I keep seeing the crash."
Objective (O): Nightmares nightly; startles at noise; avoids driving; sweating.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen
Validated scales to consider: PHQ-9, GAD-7, C-SSRS
**CarePath diagnosis:** Distress after a frightening event related to accident, as evidenced by flashbacks and nightmares.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Create a safe place. | Feeling physically and emotionally safe calms the body's alarm system, which helps a person after trauma to relax and begin to heal. |
| Listen without pushing. | Pushing someone to relive the event can worsen distress, so listening at his own pace builds trust and lets him share when ready. |
| Teach grounding. | Grounding, such as focusing on the senses in the room, brings attention back to the present and can reduce the intensity of flashbacks. |
| Encourage routine. | A predictable daily routine restores a sense of order and control and supports better sleep after a frightening event. |
| Refer for trauma counseling. | Trauma-focused counselors use proven therapies to treat flashbacks and nightmares, which are more effective than routine support alone. |
**Expected outcomes**
- Within 4 weeks: sleeps through most nights, reports fewer flashbacks, uses grounding.
- Accepts counseling.
**Linking the data to the diagnosis**
The road accident survivor says, "I keep seeing the crash." The nurse records nightly nightmares with sweating, startling at noise and avoidance of driving. These signs of ongoing distress are present now, so this is an actual problem related to the accident. The plan aims, within 4 weeks, for him to sleep through most nights, report fewer flashbacks, use grounding and accept counseling. Staff offer a safe place, listen without pushing and refer for trauma counseling to support recovery.
CarePath diagnosis
Distress after a frightening event related to accident, as evidenced by flashbacks and nightmares.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Create a safe place. | Feeling physically and emotionally safe calms the body's alarm system, which helps a person after trauma to relax and begin to heal. |
| 2. Listen without pushing. | Pushing someone to relive the event can worsen distress, so listening at his own pace builds trust and lets him share when ready. |
| 3. Teach grounding. | Grounding, such as focusing on the senses in the room, brings attention back to the present and can reduce the intensity of flashbacks. |
| 4. Encourage routine. | A predictable daily routine restores a sense of order and control and supports better sleep after a frightening event. |
| 5. Refer for trauma counseling. | Trauma-focused counselors use proven therapies to treat flashbacks and nightmares, which are more effective than routine support alone. |
Expected outcomes
- Within 4 weeks: sleeps through most nights, reports fewer flashbacks, uses grounding.
- Accepts counseling.
Linking the data to the diagnosis
The road accident survivor says, "I keep seeing the crash." The nurse records nightly nightmares with sweating, startling at noise and avoidance of driving. These signs of ongoing distress are present now, so this is an actual problem related to the accident. The plan aims, within 4 weeks, for him to sleep through most nights, report fewer flashbacks, use grounding and accept counseling. Staff offer a safe place, listen without pushing and refer for trauma counseling to support recovery.