A patient was admitted two weeks ago with depression and suicidal ideation. As the nurse monitoring the patient, what are some "covert" statements that would cause you concern?
Explanation & Rationale
Reasoning: Choice A reason: This statement is an overt expression of future-oriented thinking and a desire for social reintegration. Asking to work on a resume indicates that the patient is planning for life after discharge, which is generally a positive prognostic sign and the opposite of a covert suicidal warning. Choice B reason: While a sudden, unexplained improvement in mood can sometimes be a red flag (indicating the patient has made a decision to end their life), "feeling so much better" is a common goal of treatment. Without further context, it is considered a general status update rather than a covert statement. Choice C reason: This is a classic "covert" or indirect statement of suicidal intent. It implies a definitive end to the patient's perceived burden on others without explicitly mentioning death. Such statements often suggest that the patient has formulated a plan and believes their internal or external "problems" are about to cease. Choice D reason: "I wish I were dead" is an "overt" or direct statement of suicidal ideation. The question specifically asks for "covert" statements, which are hidden, veiled, or indirect. While this statement is extremely concerning and requires immediate intervention, it is classified as direct communication of intent, not indirect.