Good looking male borderline patient.

Specialties Psychiatric

Published

So we have this guy on the ward, BPD, he had a horrendous childhood, sexual abuse outside home, parental abuse, bullying at school, .He is also extremely pleasant to talk to, but very clingy. Seems to want to be mothered. This has meant in his adult life he has been exploited sexually amongst other ways. Iam his key nurse.

He is a drug abuser anabolic steriods, and is extremely muscular and tall. powerful with a horrendous temper which meds seems to do little to control , which has caused him in other facilities to get in violent altercations with male members of staff,including choking one out and headbutting another.Patients he distances himself if anything ,zero problems . With female members he is extremely placid and cooperative,they all love him despite his history as he is funny and engaging to talk to ,polite and well spoken.Yet with males very little will cause him to become confrontational ,even his tone of voice changes.

.Zero history of any incidents with female members. His abusers were male when he was a child so maybe it is that.

I can't help be be attracted to him and am having trouble maintaining boundaries.The problem though is the opposite as I feel I have even tighter boundaries perhaps too tight than I would say a female borderline patient and I think it is affecting things,I am giving him less one to one time than I would others for instance . Just wondered how others cope.

Specializes in Psych, Substance Abuse.

I suggest you have your charge nurse assign another nurse to this patient.

elkpark

14,633 Posts

Does your organization/facility have any kind of clinical supervision for staff? This would be a good thing to process with a more experienced colleague.

Specializes in PICU, Sedation/Radiology, PACU.

I agree that you need to disclose the situation to your supervisor and have another nurse take over as his key nurse. You are doing yourself and the patient a disservice by remaining his primary caregiver. Your feelings are understandable, and not something you should be ashamed of, though it might be helpful to talk through it with a professional to get to the root of the attraction and learn ways to cope with similar situations in the future.

guest52816

473 Posts

You need to have yourself reassigned ASAP. First and foremost, this person is a PATIENT, and a psychiatric patient. You must maintain professional boundaries.

Have you ever witnessed a full-blown BPD? There is nothing pleasant or charming about these people when they experience an outburst of rage or are somatic every 30 minutes.

Last night, my unit had a two-hour code with a female BPD experiencing rage that medication wouldn't touch. It was ugly.

For the sake of your job, good patient care and your own sanity, have yourself reassigned and STAY AWAY.

Orca, ADN, ASN, RN

2,066 Posts

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

I have known staff who have hooked up with former patients, and the outcome hasn't been pretty. Aside from being unethical and profoundly unprofessional (perhaps even illegal, depending upon the circumstances), you need to keep his mental health background in mind as you swoon over this "hot" patient. A male nursing colleague hooked up with a former patient, a female with bipolar disorder and borderline personality disorder (a nasty disposition and lots of energy to fuel it, a real winning combination). It was impossible for me to feel any sympathy, because he knew her mental health history going in. Bipolars are also notoriously noncompliant with their medication, so what he saw on the unit wasn't what he saw after she left.

Nothing good can come from getting personally involved with this man. You have already mentioned his history of drug abuse and violent behavior. He is in a controlled environment, so you aren't seeing this now. See him away from work, and I guarantee that you will.

I commend you for acknowledging the problem. Don't act on whatever feelings that you might have for this patient. Get out of the situation now.

Meriwhen, ASN, BSN, MSN, RN

4 Articles; 7,907 Posts

Specializes in Psych ICU, addictions.
I...am having trouble maintaining boundaries.

After reading this, whatever else in your post is inconsequential. If for any reason you're having any problems whatsoever maintaining boundaries, you request not to be assigned to him. And this is for YOUR OWN sake as well as being in the best interests of the patient.

Don't feel bad about it--struggling with boundaries can and does happen to the best of us. But CYA and get this patient off your assignment list ASAP.

GeminiNurse29

130 Posts

The very first day at my job, the head boss (not just DoN but the boss boss) came and met us and told us the first rule: don't fall in love with patients, and don't date them.

Get a new assignment and maybe speak with someone who has experience dealing with this kind of thing to get to the root of your attraction, as another person suggested.

Dont risk youe license, reputation, job, or integrity.

Goldenfox

303 Posts

The moment I read the first part of your topic I knew you are in a bad situation. This man might be very pretty to look at but he is a patient, and a patient with significant mental health issues. You already knew that getting inappropriately more involved with him is not a good idea for many reasons. All of your colleagues here have told you to remove yourself from this situation, and that is good advice. Talk to your supervisor and do it now. If you don't, you're going to regret it very much later.

RNGummy40

43 Posts

So we have this guy on the ward, BPD, he had a horrendous childhood, sexual abuse outside home, parental abuse, bullying at school, .He is also extremely pleasant to talk to, but very clingy. Seems to want to be mothered. This has meant in his adult life he has been exploited sexually amongst other ways. Iam his key nurse.

He is a drug abuser anabolic steriods, and is extremely muscular and tall. powerful with a horrendous temper which meds seems to do little to control , which has caused him in other facilities to get in violent altercations with male members of staff,including choking one out and headbutting another.Patients he distances himself if anything ,zero problems . With female members he is extremely placid and cooperative,they all love him despite his history as he is funny and engaging to talk to ,polite and well spoken.Yet with males very little will cause him to become confrontational ,even his tone of voice changes.

.Zero history of any incidents with female members. His abusers were male when he was a child so maybe it is that.

I can't help be be attracted to him and am having trouble maintaining boundaries.The problem though is the opposite as I feel I have even tighter boundaries perhaps too tight than I would say a female borderline patient and I think it is affecting things,I am giving him less one to one time than I would others for instance . Just wondered how others cope.

From the way you have described this patient I would also recommend you change your assignment. If you take a moment and look at how you have described your patient you wrote, "I am his key nurse. I can't help and be attracted to him." It is clear that you are experiencing counter transference with this patient. Chances are your patient knows already that he can manipulate your actions, whether the manipulation has been small, borderlines generally know how to "leech," on to others to fill their void.

DrCOVID, DNP

461 Posts

Specializes in psych/medical-surgical.

The scales balancing in my head...

Hot and heavy hook up vs possibly throwing away 4 years of schooling a license examination and job secuirty

.......hmmmmmmmmm......

Specializes in PhD in mental health nursing.

It doesn't matter what his diagnosis is or what his history of trauma is or even if he is Richard Gere (watch the movie Mr. Jones). You are in a position of authority and power and you will lose your nurse's licence if you engage in a relationship with this patient.

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