Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Practice Recommendations
  1. The nurse will take seriously all statements made by the client that indicate, directly or indirectly, a wish to die by suicide, and/or all available information that indicates a risk for suicide.
  2. The nurse works toward establishing a therapeutic relationship with clients at risk for suicidal ideation and behaviour.
  3. The nurse works with the client to minimize the feelings of shame, guilt and stigma that may be associated with suicidality, mental illness and addiction.
  4. The nurse provides care in keeping with the principles of cultural safety/cultural competence.
  5. The nurse assesses and manages factors that may impact the physical safety of both the client and the interdisciplinary team.
  6. a. The nurse recognizes key indicators that put an individual at risk for suicidal behaviour, even in the absence of expressed suicidality. For individuals who exhibit risk indicators, the nurse conducts and documents an assessment of suicidal ideation and plan.
    b. The nurse assesses for protective factors associated with suicide prevention.
    c. The nurse obtains collateral information from all available sources: family, friends, community supports, medical records and mental health professionals.
  7. The nurse mobilizes resources based upon the client’s assessed level of suicide risk and associated needs.
  8. The nurse ensures that observation and therapeutic engagement reflects the client’s changing suicide risk.
  9. The nurse works collaboratively with the client to understand his/her perspective and meet his/her needs.
  10. The nurse uses a mutual problem-solving approach to facilitate the client’s understanding of how they perceive his/her own problems and generate solutions.
  11. The nurse fosters hope with the suicidal client.
  12. The nurse is aware of current treatments in order to provide advocacy, referral, monitoring and health teaching interventions, as appropriate.
  13. a. The nurse identifies persons affected by suicide that may benefit from resources and supports, and refers as required.
    b. The nurse may initiate and participate in a debriefing process with other health care team members as per organizational protocol.
  14. The nurse seeks support through clinical supervision when working with adults at risk for suicidal ideation and behaviour to become aware of the emotional impact to the nurse and enhance clinical practice.