A mother who delivered a baby 4 weeks ago says, "I'm hanging on by a thread to keep my wits about me." Which nurse response would be therapeutic?

• A. I'm sure you'll cope without any help.
• B. That sounds tough but this will pass.
• C. Can you share with me more specifically how you feel that you're hanging on by a thread? Are you having thoughts of hurting yourself?
• D. You should try to stay busy to take your mind off it.

Answer: (C)

When a new mother expresses profound distress, therapeutic communication involves inviting her to share more about her feelings and assessing safety. This approach validates what she’s going through and opens the door to understanding the severity of her mood, including the possibility of thoughts of self-harm.

The best response uses open-ended, reflective questions to elicit detail: asking specifically how it feels to be “hanging on by a thread” helps the nurse gauge the level of distress and identify whether thoughts of hurting herself are present. This is essential for safety planning and timely intervention, as it directly addresses risk and demonstrates genuine concern.

Other responses fail to engage her feelings or to assess safety. They minimize distress, dismiss the seriousness of her experience, or offer generic advice without exploring what she’s experiencing or whether she’s at risk. Open-ended questioning paired with a suicide risk screen is the appropriate, supportive next step in this moment.