What should a nurse do first if a client verbalizes suicidal ideation with a specific plan?

When a client expresses suicidal ideation accompanied by a specific plan, the immediate priority is to ensure the client's safety. Placing the client in a safe environment is crucial because it addresses the most pressing concern: the risk of self-harm. Creating a secure setting prevents the client from accessing means to carry out their plan and allows healthcare professionals to monitor the situation closely.

Once safety is established, a thorough psychiatric assessment can be conducted to gather more information about the client's mental state and the ideation. Engaging with the family and documenting the statements are also important but are secondary to the urgent need to prevent potential harm. The intervention focused on safety reflects a fundamental principle in psychiatric nursing, emphasizing the need to address the most immediate threats to a client's wellbeing before proceeding with further assessments or family involvement.