What should be the nurse's priority when caring for a client hearing voices telling them to do harmful things?

The priority in this situation is to assess the nature of the commands by engaging the client in conversation about what the voices are saying. This assessment is critical for several reasons. First, understanding the specific content of the hallucinations can help determine the level of risk the client may pose to themselves or others. It’s essential to gauge whether the commands are directing the client to harm themselves or others, which would necessitate a different level of intervention.

Furthermore, by asking about the voices, the nurse opens a dialogue that can facilitate trust in the therapeutic relationship. It allows the client to feel heard and understood, which is pivotal when dealing with hallucinations. This dialogue can help the healthcare team formulate an effective and personalized care plan.

Assessing the situation before intervening with medications or providing reassurance is crucial because the therapeutic approach may differ depending on what the client reports. This prioritization aligns with best practices in mental health nursing, where safety and effective communication are fundamental components of care.