Nurse Amy is receiving a change-of-shift report on an inpatient psychiatric unit and learns that nurse Barbara on the previous shift negotiated a no-suicide contract with a client and increased the client's level of restriction to the unit

Nurse Amy's plan of care for the client is based on the understanding that these interventions indicate which of the following? a. The client has improved ability to control impulses.
b. There is increased likelihood that the client will attempt self-harm behaviors.
c. Eventual completed suicide by this client is inevitable.
d. The client is simulating discharge conditions on a trial basis.


B
Drew (2001) studied the use of no-suicide contracts in psychiatric inpatients units and found that clients with no-suicide contracts in and with higher levels of ward restrictions on the unit had a higher likelihood of self-harm behaviors. This research indicates that in the inpatient setting, negotiations of a contract are probably a reflection of staff assessment that the client risk of self-harm was higher.

Nursing

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