What should the nurse do when a suicidal client refuses to sign a "no suicide" contract?

When a suicidal client refuses to sign a "no suicide" contract, arranging for immediate hospitalization on a locked unit is a critical and necessary response. This step prioritizes the safety and well-being of the client, as refusal to engage in safety agreements may indicate that they are at a significant risk for self-harm or suicide.

A locked unit provides a controlled and secure environment where the client can be closely monitored, and interventions can be initiated to evaluate their mental health needs. This action ensures that the client is not left alone and that they receive the necessary support and treatment to address their suicidal thoughts or behaviors.

In the context of psychiatric nursing, ensuring client safety often takes precedence over other therapeutic interventions when there is an immediate risk to the client's life. This approach aligns with prioritizing patient safety while also initiating further assessments and interventions to help the client through their crisis.