Low mood in a young adult at a primary care clinic
IENCAP OSCE practice station

The task

You are the nurse at a primary care clinic in Ontario. Chloe Tremblay, aged 24, has booked an appointment because she says she has not been coping. No other staff are in the room. Introduce yourself and build rapport. Assess her mood and her safety. Decide what you will do today and who you need to involve. Explain the plan to her. Record your risk assessment and plan on the form provided.

What this station tests

• Ask directly about suicide in plain words. Asking does not plant the idea.
• Assess plan, method, access to means, intent and timing, as well as protective factors.
• A thought-out method with access to it makes this high risk. Do not leave the client alone and arrange same-day assessment.
• Work on means safety and a written safety plan. Give 9-8-8 and 911 information.
• Respond to fear of judgment with warmth, and avoid false promises.

Sources for the clinical content

• 9-8-8: Suicide Crisis Helpline
• CAMH: Suicide
• RNAO Best Practice Guideline: Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour

An original practice scenario with invented patients. Not an exam question.