A patient with a history of fractured psychosis has been admitted for suicidal ideation. The patient says, "God is telling me to kill myself right now." What is the nurse's best response?

Correct option is C

Answer: (c) I understand that God's voice is real to you, but I can't hear anything. I am with you.
Explanation:
When a patient is experiencing auditory hallucinations commanding them to harm themselves, the nurse must respond empathetically and provide emotional support while ensuring patient safety.
· (c) "I understand that God's voice is real to you, but I can't hear anything. I am with you."
· This response validates the patient’s experience without reinforcing the delusion.
· It also establishes a therapeutic relationship, providing emotional support while ensuring that the patient does not act on suicidal thoughts.
· By saying, "I am with you," the nurse reassures the patient of their presence, reducing the sense of isolation and distress.
Other Options Explained:
· (a) "Don't worry; Voices are part of your illness."
· While it acknowledges the hallucinations, it dismisses the patient's distress without addressing their immediate safety concerns.
· (b) "All the voices are in your imagination; Think something else and you will stop hearing it."
· This invalidates the patient’s experience and is not helpful because patients with psychosis cannot simply "stop" hearing voices.
· (d) "Don't think anything now; Just go and relax."
· This is dismissive and does not address the seriousness of the patient's suicidal ideation.
Best Approach:
· Acknowledge the patient's experience without reinforcing the hallucination.
· Provide reassurance and ensure safety.
· If the patient is actively suicidal, immediate intervention and monitoring are required.
Thus, the best response is (c) as it provides empathy, validation, and safety assurance.