A despondent patient says, "Nothing matters anymore.". The most appropriate response by the nurse when would be:
a. "Are you having thoughts about suicide?"
b. "I am not sure I understand what you're saying.".
c. "Try to stay hopeful. Things usually work out.".
d. "What used to matter, before the depression?"
A
The nurse must make overt what is covert, that is, the possibility of suicide must be openly addressed. The patient often feels relieved to be able to talk about suicidal ideation and tends to respond candidly to candid inquiries. Conveying that one does not understand can increase patient despair or self-loathing (for being ineffectual in communications). "Try to stay hopeful" is a cliché that suggests that staff do not appreciate how truly distressed and despondent the patient is feeling. Encouraging hopefulness and focusing on things the patient used to enjoy both serve as obstacles to the patient's efforts to convey his present feelings and interfere with addressing these feelings.
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