Urgent assessment of a woman with persistent low mood
NMC OSCE practice station

The task

You are a registered nurse working in a community mental health team. Siobhan Keane, aged 44, has been low for two months and her GP has referred her for urgent assessment. She is alone in the room. The on-call psychiatrist can be reached by phone. Introduce yourself, carry out a focused assessment of her mood and of any risk to her safety, and agree a plan for the next 24 hours. Record your risk assessment on the form provided. Say aloud what you are asking and why.

What this station tests

• Ask about suicide directly, then explore plan, means, intent and timing.
• Risk changes over time. Record what raises it, what protects the person and your reasons, rather than relying on a score or a low, medium or high label.
• Reduce access to means with the person's agreement and involve family or friends.
• Do not leave someone at immediate risk alone while you arrange help.
• Escalate the same day with SBAR and agree a safety plan and follow-up.

Sources for the clinical content

• NICE NG225: Self-harm: assessment, management and preventing recurrence
• NICE NG222: Depression in adults: treatment and management
• NMC: The Code

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

Practise next

• Assessment of a young woman with episodes of sudden fear
• Mental state examination of a withdrawn patient
• De-escalating an agitated patient on a mental health unit