Nurses are the people most consistently and intensely involved in the care of people who present to emergency departments because of self-harm, yet most have received no training or support to provide strategic care. This paper will explore unique features of the emergency context for care and provide practical instruction on how nurses working in the area can respond effectively. As this paper argues there is much that the emergency nurse can provide for the client who self-harms and it describes important steps toward recovery - a respectful human encounter, understanding, support for the person's efforts in coping, optimism and hope that pain will lessen and recovery will take place.