A patient is admitted to the psychiatric unit after a suicide attempt. The nurse plans to write a suicide prevention contract. To promote compliance and build a trusting relationship with the patient, the contract should

Explanation

• A contract written together will promote trust and compliance. Contracting for safety promotes an internal locus of control, reinforcing the idea that it is the patient who is ultimately responsible for making the decisions about how to cope with suicidal urges.

• The contract often includes identifying coping mechanisms and a support system available to the patient if he needs help, and an agreement to notify staff if he feels unsafe. In this way, the contract functions as a safety plan and incorporates collaborative problem-solving, which supports the nurse-patient relationship.

• A legal review showed that a contract for safety is not enough to protect staff from legal liability and must never replace a thorough assessment of a patient's suicidal risk.

• Incorrect: A contract written by the physician or social worker may not be agreeable with the patient.

• Incorrect: A contract written by the patient may not be agreeable with the staff.

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