If a client makes a credible threat against their spouse, what should the nurse do?

When a client makes a credible threat against another person, such as a spouse, it is essential for the nurse to prioritize safety over confidentiality. The ethical and legal principles guiding psychiatric nursing practice, such as the duty to warn, come into play in these situations. When a credible threat is made, the nurse has an obligation to take action to prevent harm.

The correct course of action is to begin the process of warning the client's spouse. This response is rooted in the principles of beneficence (doing good) and nonmaleficence (doing no harm), which require the nurse to act to protect the potential victim from harm. By notifying the spouse, the nurse allows that individual to take necessary precautions, potentially averting a dangerous situation.

In this context, it is also important to note that while encouraging the client to seek counseling or discussing feelings may be beneficial actions in other circumstances, they are not adequate responses when there is an immediate threat of violence. Confidentiality cannot be upheld when there is a clear risk of harm to others, thus making the decision to warn the spouse the appropriate and justified action.