Suicidal Ideation (SI) is a medical term used to describe someone’s suicidal thoughts or contemplations that can lead to death or suicide which can be seen through changes in attitude or behavior. Unfortunately, this is the condition for many individuals who arrive at the emergency room and are admitted to the hospital. According to the CDC, between 2016-2020 the annual average ED visit rate for suicidal ideation patients was 40 visits per 10,000 patients who came to the emergency department. The majority of patients who visit the emergency department have medical issues that need immediate attention. One of these types of cases includes psychiatric patients who require increased precautions to ensure the safety of the patient and other individuals. During the initial encounter with a health provider in the ED, the patient is asked questions about their medical history to be documented. One of those questions includes asking the patient if they are thinking about harming themselves. Depending on their answer, they’re documented as an SI risk, and their standards of care change. These patients have specific needs and follow different guidelines for documentation. The effectiveness of documentation among SI patients needs further discussion. The use of patient sitters, frequent checks, restraints, and documentation of care are ways to ensure that SI patients are safe and getting quality care. But is the documentation of this care accurately reflecting the patient’s condition or is there more that can be done to ensure proper care?