A patient reports feeling tired and expresses a wish for life to end. What should be your first action?

The first action of evaluating the patient for depression is crucial in this scenario for several reasons. When a patient expresses feelings of tiredness and a desire for life's end, it often indicates possible underlying emotional distress or a mood disorder, such as depression. The symptoms of depression can include fatigue, hopelessness, and a diminished interest in life, all of which align with the patient's reported feelings.

By conducting a thorough evaluation for depression, you can determine the underlying causes of these feelings, which may include not just emotional factors but also psychological and situational components. Addressing depression early can significantly enhance the patient’s quality of life, guide treatment decisions, and ensure that any necessary support measures are put into place.

In this context, it is important to properly assess the emotional state before considering other interventions like adjusting medication or making referrals. While consulting a psychiatrist, increasing medication, or involving a palliative care team may eventually be appropriate, the initial step is to understand the patient's mental health status comprehensively. This approach ensures a holistic understanding of the patient's experience and provides targeted interventions based on their needs.