A school nurse is approached by a student who says that her friend has been cutting herself on the arms. The student asks the nurse not to tell anyone. Which response by the nurse is correct?

  • “I have to notify her parents, because this affects her personal safety.”
  • “I won’t tell anyone, but let me know if she starts talking about suicide.”
  • “I will call the hospital and let them send a psychiatrist to do an evaluation on your friend.”
  • “I will make it a point to run into her in the hall and notice the cuts on her arms so I can ask about them.”
Number 1 is correct.
The nurse has a duty to protect the client when self-harm or suicidal behavior is present. Self-harm could lead to suicide, and the nurse must inform the parents immediately. HIPAA and client privacy take a back seat to client safety. Asking the student to inform the nurse if the friend attempts suicide delays seeking help and allows the self-destructive behavior to continue. Calling the hospital and asking for a psychiatric consult is not the appropriate way to manage the situation. Telling the student that the nurse will just run into the friend in the hall is not feasible and delays getting appropriate care for the friend.