Mudfiend

Wow, I was gone for a while and so many responses.... To clarify, this isn't an initial diagnosis to get a pt admitted, admission criteria for our unit is Axis I, if there is no Axis I diagnosis, they do not meet criteria, this is diagnosed primarily by one MD after the initial assessment. I'm glad to find out I'm not the only one feeling this way. On my unit now I'm an in the minority. I do feel that some of our patients do meet criteria. But I also agree rn/writer that a lot of the behaviors that is causing the MD to diagnose borderline is pretty "normal" behavior for teenagers. I also get upset when we have to provide educational material to the patient on borderline disorder and they are given an assignment by the MD to read through the information and write down how they fit with each part of the criteria. I don't know about you but in nursing school after reading the symptoms of something everyone in my class "developed" that disease/disorder. It really upsets me because it seems like a diservice to these kids who may not be borderline because in our area there isn't treatment. And to the people in my area, borderline = "they can't be helped" even though things such as DBT have shown to be helpful. This wouldn't bother me if it were one or two patients once in a while. We have a fairly new MD and of his patients he will diagnose borderline 9 out of 10 times. Our other MD who has been with us 6 years could get those same patients on a next admission and not see the diagnosis. I'm starting to not make sense...but I do want to thank everyone for making me feel a little less alone in how I'm feeling about this.

I am a certified psychiatric nurse on a child/adolescent mental health unit. Recently we have had an increase in borderline personality diagnosis. I did not say an increase in borderline personality disordered patients. Just an increase in the diagnosis. I've done some research on it since this has been happening because in school we were taught that Axis II disorders couldn't be diagnosed until someone was an adult. Regardless, we have been having 12, 13, and 14 year old patients who the doctor is diagnosing borderline personality. Some I read the MD's notes and do not see any reason. Sometimes the reason is only self-injury and problems with parents. The self-injury meaning borderline is a completely different topic that I cannot get into because I'll rant. Anyway I just don't see how 90% of our patients are borderline. Does anyone else experience this? I'm mostly upset because as soon as our staff hear a patient is "borderline" immediately they treat that patient negatively and anything the patient does is "staff splitting" and "manipulative". Maybe I'm borderline for being upset by this.