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Aim To uncover and understand the core elements of how nurses in psychiatric hospitals make contact with patients experiencing suicidal ideation. Design A qualitative study based on the principles of grounded theory was performed. Methods Nineteen nurses on wards of four psychiatric hospitals were interviewed between May 2017 – February 2018. The Qualitative Analysis Guide of Leuven was used to facilitate the constant comparison of data. Findings Nurses make contact with patients experiencing suicidal ideation by “creating conditions for open and genuine communication” while maintaining a focus on “developing an accurate and meaningful picture of patients”. These interconnected core elements represent nurses’ attention to relational processes like building trust as well as their predominant focus on assessing suicide risk. Nurses put other emphases in their contacts with patients depending on whether their approach is guided more by checking and controlling suicide risk or by acknowledging and connecting (with) the person. Conclusion The study enhances the conceptual understanding of how nurses on psychiatric wards can involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation. These findings can be used to underpin the nurses’ role in and contribution to suicide prevention. Impact The core elements “creating conditions for open and genuine communication” while maintaining a focus on “developing an accurate and meaningful picture of patients” can inform policies for nursing practice and education that aim to preserve and improve the capacity of nurses to involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation.