Psi

everyone doesn't have a personality disorder. there are a number of criteria that need to be met to get this diagnosis. overeating does not qualify on its own. neither does dsh, although it is a strong indicator, particularly when it is habitual. the issue is not that pds are likely to kill patients. the issue is that to meet the criteria of pd an individual has to have an inability to cope with life and patterns of extreme behaviour. a nurse, particularly in mental health has to have a number of attributes to their personality in order to be able to function safely and effectively. the existence of a pd indicates that one or more of these attributes are not present.

everyone doesn't have a personality disorder. there are a number of criteria that need to be met to get this diagnosis. overeating does not qualify on its own. neither does dsh, although it is a strong indicator, particularly when it is habitual. the issue is not that pds are likely to kill patients. the issue is that to meet the criteria of pd an individual has to have an inability to cope with life and patterns of extreme behaviour. a nurse, particularly in mental health has to have a number of attributes to their personality in order to be able to function safely and effectively. the existence of a pd indicates that one or more of these attributes are not present.

What is an OP?

What is an OP?

How exactly does saying that PDs (not people who have suffered from mental illness) should not work as nurses deter people with mental illness from seeking help? You appear to be unable to distuinguish between someone having a flawed personality and someone who is ill.

How exactly does saying that PDs (not people who have suffered from mental illness) should not work as nurses deter people with mental illness from seeking help? You appear to be unable to distuinguish between someone having a flawed personality and someone who is ill.

If you check back through the thread you will see that I did give practical advice on the situation. However, the particular post that I was replying to had broadened the scope of the discussion and implied that it was OK for PDs to be nurses, which I think is a very dangerous and naieve notion.

If you check back through the thread you will see that I did give practical advice on the situation. However, the particular post that I was replying to had broadened the scope of the discussion and implied that it was OK for PDs to be nurses, which I think is a very dangerous and naieve notion.

I would say without hesitation that suffering from a PD does very much make someone unsuitable to work as a nurse.

I would say without hesitation that suffering from a PD does very much make someone unsuitable to work as a nurse.

"crazy" does exist it is a lay colloquialism that covers psychosis and mania. Self harming on the other hand isn't necessarily an illness and is more often and indication of personality disorder, it appears that it is you who is guilty of jumping to conclusions. There have been a number of cases in the UK (e.g. Beverly Allit) were nurses have murdered or harmed patients for their own gratification. Reports on these incidents have consistently shown that signs of severe PD were ignored. If it has been six years since previous episodes then it is quite likely that it was just a short term crisis, but those facts can be quickly established. Not everyone who cuts has a PD, however, it is not an issue that is to be taken lightly and in the balance between the interests of the patient and the interests of the nurse it is important that these issues are looked into when indicated and a collection of scars from previous self harm does indicate that this is worth further scrutiny. As for disability discrimination, it is perfectly justifiable for an employer not wanting to employ someone who is currently self harming or at significant risk. Patients need nurses who can cope with life and aren't competing with them in not being able to cope.

"crazy" does exist it is a lay colloquialism that covers psychosis and mania. Self harming on the other hand isn't necessarily an illness and is more often and indication of personality disorder, it appears that it is you who is guilty of jumping to conclusions. There have been a number of cases in the UK (e.g. Beverly Allit) were nurses have murdered or harmed patients for their own gratification. Reports on these incidents have consistently shown that signs of severe PD were ignored. If it has been six years since previous episodes then it is quite likely that it was just a short term crisis, but those facts can be quickly established. Not everyone who cuts has a PD, however, it is not an issue that is to be taken lightly and in the balance between the interests of the patient and the interests of the nurse it is important that these issues are looked into when indicated and a collection of scars from previous self harm does indicate that this is worth further scrutiny. As for disability discrimination, it is perfectly justifiable for an employer not wanting to employ someone who is currently self harming or at significant risk. Patients need nurses who can cope with life and aren't competing with them in not being able to cope.

posted in error

posted in error

No you aren't over-reacting. The unit is heading for a disaster, you've made them aware of the problems. You need to get out of there as quickly as you can so that they don't take you down with them.

You can't talk somebody out of psychosis. Time after time tree huggers have tried and failed to introduce models of care that don't involve medication. You can however provide a low stimulus and non-threatening environment, and ensure that patients are listened to in a supportive way, and that firm boundaries are in place so that the patients know exactly were they stand. This will go a long way to reducing incidents of violence, but not eliminate it completely. In terms of your request for research take a look at this http://www.staff.city.ac.uk/~ra917/citynurse/projplan.htm As for the punchbag thing, its just not true, there's plenty of research to indicate that agressive behaviour leads to a measurable increase in testosterone levels in males, which will increase the likelihood of violence.

Whatever problems you have, unless they are affecting your ability to work safely as a nurse are nothing to with your employer. It looks to me like you have a good case to bring a grievance against the person who reported you. If you were currently self harming it would probably be a different matter, but six years is a very long time and it is difficult to see how anyone could use that to justify dismissal. It is your colleague who has put her job in danger by lying and making defamatory comments.

Whatever problems you have, unless they are affecting your ability to work safely as a nurse are nothing to with your employer. It looks to me like you have a good case to bring a grievance against the person who reported you. If you were currently self harming it would probably be a different matter, but six years is a very long time and it is difficult to see how anyone could use that to justify dismissal. It is your colleague who has put her job in danger by lying and making defamatory comments.

Well in the UK we tend to see quite a few nurses, particularly in psychiatry, who have mild/severe personality disorders. Its one of the few professions that meets their need for regular high drama. They tend to gravitate toward talking therapy services and substance misuse services when they are dealing with a higher proportion of patients with personality disorders.

That sounds like a nightmare. In the UK we often complain about the governing body the Nursing and Midwifery Council (NMC) but after reading this I'm quite grateful for one set of national standards.

You may be absolutely right. I just don't think that is the issue for this family. Wth all due respect. :-) It does seem to be the issue. Daughter had a problem, then she went into hospital and the problem got worse. It seems likely that the problem got worse because she went into hospital. It seems basic good nursing practice to question any intervention that makes a patient's presenting problem worse. I think this is the core of the issue. There may well be issues around splitting. But not buying into splitting does not mean that this girls father has lost the right to question the treatment she is given, particularly when it is causing a deterioration. In my view the nursing approach of constant observation and relieving the patient of all responsibility for her behaviour is bad practice.

I disagree. Borderline Personality Disorder has specific criteria in the DSM- IV and this is absolutely a mental illness/ psychiatric disorder, or whatever name it can be given. Either way, the issue is that this family is in distress and is asking for help. That's my ! The priority of the healthcare staff involved should be to do no harm to the situation. There is no evidence that mental health services can do anything to alleviate personality disorder. There is plenty of evidence that providing support can be a damaging process. It doesn't matter that BPD is mentioned in the DSM or the ICD-10, it is still just a description of a list of personality problems. It doesn't have the characteristics or more importantly the treatablity of serious mental illness. The fewer therapuetic interventions this girl is subjected to the better.

It doesn't sound like your daugher has a mental illness. I agree that it does look like Borderline Personality Disorder. The best thing the staff can do is to lift all the restrictions and play each event of self harm down. In reality the fact that she is getting such intense input is probably making the situation worse. In the UK she would probably not be admitted to hospital, she would be patched up with a minimum fuss in A&E and given an opportunity to talk with someone briefly.