Borderline Personality Disorder on the Behavioral Unit - page 2

Folks with Borderline Personality Disorder or BPD can often be a challenge on a behavioral health unit. When dealing with BPD, here are some cognitive-behavioral tips: 1. Focus on the here and... Read More

  1. by   Hygiene Queen
    Also, when it comes to this "manipulation", BPD patients are very POOR manipulators. You KNOW whatthey are trying to do. They aren't smooth Ted Bundy-like manipulators that cause you to "fall into the trap" before you realize it.
    You DO realize it.
    They aren't savvy... because they aren't, necessarily, consciously doing it.
    If they want to talk about the past trauma, it's actually better to say, "That was a terrible experience, but we need to stay focused on how we are going correct your RESULTING issues as they they affect you TODAY. Yesterday is done, what can we focus on to help you with your problems NOW?"

    Typically, they don't want to hear that.
    It takes away their "victim" status, which they feed off of.
  2. by   GoSteelers
    great info! BPD patients ran me out of my job as a home health psych nurse. I got so tired of dealing with them.
  3. by   MauraRN
    Great info on this thread. I am new at psych HH and I know the BPD's are trying to manipulate me. I have been reading up on splitting. I have to find a way to be more patient with these people, one woman in particular. I just want to say "snap out of it" Not very therapeutic, I admit.
  4. by   nscurn
    Hi--I found this thread while searching for a discussion of RNs who have BPD, not those who work in that field. But as one recently diagnosed, I found the original post very helpful.

    I know there is a mental health in nursing thread but I wanted to specifically talk to you all who have experience with BPD.

    I'm trying to decide if I can continue in my field (NICU). I had a breakdown almost a year ago and have been in and out of inpatient units since. I am on my second atttempt to return to work; the first resulted in a psychotic break.

    I know I was a good NICU nurse before I was diagnosed--I didn't make errors, I was thorough, got along with coworkers, got good evaluations--but in looking back I can see there were times during shifts when I was barely holding it together. I took shortcuts sometimes, or I'd call off sick because I would wake up and HATE my job and know there was no way I could go in.

    Last week I was caring for preemie twins. The mom had been through fertility stuff and had waited a long time for these babies. She was nervous about everything. She and her husband had hired a nanny for home and had called ten references for her.

    And I thought to myself, what would they think if they knew about me? If they knew about my suicide attempts in the past year and my break with reality? They would be horrified, is what.

    I don't know if I belong in nursing anymore.
  5. by   chevyv
    This is great information! The borderline personalities on my unit try almost everyones patience. I've been looking for some new ways in dealing with a few of my pts. I usually do pretty well, but there are times when I feel like yanking my hair out. This post is going with me to work tomorrow.
  6. by   EMcGrady
    Fantastic information!
  7. by   chericoe
    Thanks for the great description and thoughts on how to deal with
    BPD Thunderwolf! I have dealt with patients with this disorder for numerous years now and it only takes one on a unit to destroy the whole milieu! The staff splitting that goes on is usually horrendous if not caught early and the communication between shifts is not adequate. Also, if there is not good support from management, then there is usually trouble. Thanks again!
  8. by   HeatherPsychRN
    OMG! Thank you for this! I am a nurse very new to the psych field, and I have had a BPD pt that has focused in on me... I now understand why, where I am letting this pt down, and what I have done that has been helpful! More importantly, I know what to do to help and structure 1:1 time for the future with this patient. Thank you so much!
  9. by   Mish56
    Great article Thunderwolf! I am one of the nurses on my unit that actually enjoys working with people with BPD. The lack of understanding/education about this particular disorder never ceases to amaze me. Knowledge is power, both for the nurse and the patient. Thanks for your words of wisdom!
  10. by   GalRN
    Realized I hadn't ever thanked you for this info! Thank you! I've worked on a lot of units as a psych traveler, and a lot of them didn't know how to deal with patients who had severe borderline personality disorder. Travelers can't just tell them how they do it other places or that they have a better way, but once they had stretched there resources to the point where they needed some direction, I sent them to this link. The ones who followed the basic guidelines had less aggravation overall, and there were times when all of the staff were able to be cohesive enough that a patient got a little better overall and a lot better during that hospital stay.
    Great guide, and the info about what the pt's are trying to accomplish is extremely helpful too.
  11. by   albymangel
    Admission of those Dx of borderline PD should be avoided or brief as it can be counterproductive according to NICE and Project Air Guidelines

    Sent from my iPad using allnurses