I have been a psychiatric nurse for a short while and find my most challenging patients to be those with diagnosed 1>Borderline Personality Disorder & 2> Intermittent Explosive Disorder.
It is especially difficult when the pt. has both diagnoses....If you add a polysubstance dependence diagnosis to the mix, then we are talking huge difficulties in providing therapeutic communication & milieu to these patients.
Any tips from your experiences for dealing with these two categories of patients that have these diagnoses?
I have found 1:1 to be one of the only tools that really works, but it is not always realistic in all situations to have that staffing available.