CNA is a cutter

Specialties Psychiatric

Published

I work in LTC, and recently discovered that one of the CNAs is a self injurer. I'm very concerned about her and spoke to the DON about it. He is already aware of it, and told me that her wounds are always properly dressed before she starts her shift. She does excellent work, and is wonderful with the residents, and the other CNAs see her as a leader. Is she safe to work with the residents? I don't know what to think.

yep thats all u can do. let her know ur there for her. i know people who are both nurses and cutters. if her problems arent interfering with her work now id say its unlikely they would interfre with her nursing, her supervisors are aware of her problem and are likely unobtrusively keeping a close eye on her. if her work starts to be affected they will be onto her straight away.

i can feel ur frustration n anxiety about it though, it is hard to know someone is struggling and stand back n do nothing.

In answer to your first question, there is probably no reason to worry about the patients she works with. It sounds like she is highly skilled, insightful and professional.

As for the secondary question about whether she's BPD, I would say she probably is based on the fact that she influenced you to have an entire nationally based forum discussing her! I'm not being facetious. I've worked with BPD in hospital settings for many years and I've found one of the surest indicators for BPD is when there is very intense disagreement among the staff about the dx!

In answer to your first question, there is probably no reason to worry about the patients she works with. It sounds like she is highly skilled, insightful and professional.

As for the secondary question about whether she's BPD, I would say she probably is based on the fact that she influenced you to have an entire nationally based forum discussing her! I'm not being facetious. I've worked with BPD in hospital settings for many years and I've found one of the surest indicators for BPD is when there is very intense disagreement among the staff about the dx!

I'm no psych nurse..but wouldn't she fall into the 'danger to self' category? aren't we responsible to report these things to the proper authorities? just curious :/

I'm no psych nurse..but wouldn't she fall into the 'danger to self' category? aren't we responsible to report these things to the proper authorities? just curious :/

Someone that self- inflicted a wound requiring 23 stitches is indeed a danger to themself.

Tho not a bad person, and not necessarily BPD. Not knowing all the details of this person' s lifestyle, I'll venture a guess drugs and alcohol are involved somewhere

Specializes in LTC, home health, critical care, pulmonary nursing.

She passed her drug test. She's very competant. The thing about it is, yes, she's a danger to herself, but not to anyone else I don't think. I wasn't too sure about it when I started this thread, but I am now. If I hadn't seen her in the ER that night, I never would have known.

Someone that self- inflicted a wound requiring 23 stitches is indeed a danger to themself.

Tho not a bad person, and not necessarily BPD. Not knowing all the details of this person' s lifestyle, I'll venture a guess drugs and alcohol are involved somewhere

y wud drugs and alcohol be involved? just curious, and yes she is a danger to herself but it is necessary t weigh up how much of a danger, yes that is a lot of stitches to nedd but she did go to er n seek the attention she needed....thats a good sign. and self injury does not indicate a risk of suicide, it merely indicates a maladaptive way of coping with things.

If I hadn't seen her in the ER that night, I never would have known.

that al u need to remember, if u hadnt seen her u wudnt have known.

she is competent and clearly stable at work, if u notice her competency or work slipping then approach her or her supervisor but otherwise respect her privacy, her confidentiality and her trust. im glad u can see that she isnt a danger to others just cs she is a cutter. and may i say thank you for being openminded enuff to come here and ask about a situation u were uncomfortable with and keeping an open mind :)

Specializes in Med-Surg, Geriatric, Behavioral Health.

Lovingtheunloved, I am glad others have provided you feedback. As you learn more about others who cut themselves or have or possibly do not have BPD, you will come to a place within yourself in how best to be supportive to your friend. Again, folks with BPD and level of cutting/coping is as varied as the rainbow. I personally provided outpt therapy several years ago with a woman who was highly competent, intelligent, , articulate, well liked, in college (law), but could not resist her impulses to poke needles and knitting needles THRU her breasts. She almost lost one breast via gangrene. I only knew this because I was part of her tx team. On the outside to others, she showed no outward scars or wounds to be observed by the casual observor because where she did this. However, she was BPD, but a very highly functioning one. I recommend that you look up BPD on the internet or read about it in the DSM (the psychiatrist's bible of dxs) in order to answer the question for yourself. There is also a book that has been out there on the shelves for years called "I love you, I hate you" which focuses on the disorder. You have had various feedback. We, the readers, do not have much info to go by other than what you have told us about her personally, and it isn't much. This may account for the mixed feedback from us. Learn more about BPD and criteria, evaluate your friend with an objective mind, compare the two, let us know then what conclusions you come up with then. We'll probably be able to provide better feedback for you then. I wish you well.

Specializes in LTC, home health, critical care, pulmonary nursing.

Thunderwolf, thank you so much for your knowledge and insight. I have been doing some reading on BPD, and unfortunately, I don't know her well enough to come to any sort of conclusion as to whether she has it or not. I'm just going to try to be there for her. When I started this thread, my main concern was that she wasn't safe to work with the residents, but she has by far proven that she is. She's obviously in a lot of pain, and I just hope she can find it within herself to seek the help she needs. Thank you all for your feedback.

+ Add a Comment