ABSTRACT
Teaching undergraduate nursing students to think critically and reason clinically is a challenge for nurse educators, yet these skills are essential for the professional nurse. The Outcome-Present State-Test (OPT) Model of Reflective Clinical Reasoning (Pesut & Herman, 1999) provides a framework for teaching clinical reasoning skills to nursing students. This article describes how the model can be used in clinical teaching of undergraduate students in psychiatric and mental health settings and presents some findings from an evaluation of the model. Strategies employed in the model implementation are described, along with the benefits and limitations of this teaching method in a psychiatric clinical setting.
Subject(s)
Clinical Competence , Education, Nursing, Baccalaureate/methods , Models, Educational , Models, Nursing , Psychiatric Nursing/education , Thinking , Adult , Attitude of Health Personnel , Decision Making , Female , Humans , Judgment , Male , Middle Aged , Nursing Diagnosis/organization & administration , Nursing Education Research , Outcome Assessment, Health Care/organization & administration , Patient Care Planning/organization & administration , Program Development , Program Evaluation , Psychiatric Nursing/organization & administration , Students, Nursing/psychologyABSTRACT
TOPIC: This paper reviews the current literature on the nursing care of inpatients with borderline personality disorder (BPD). Information is included about the background and various features of BPD, and recent conceptualizations and predicted outcomes for BPD patients are provided. The effect of caring for patients with BPD on the nursing staff is discussed. CONCLUSIONS: With proper education, support, and clinical supervision, the difficulties of caring for patients with BPD for the nursing staff can be reduced, and beneficial outcomes can be achieved for the staff and patients. NURSING IMPLICATIONS: Patients with BPD can impact the entire multidisciplinary team. Understanding the dynamics of patients with BPD helps the staff to develop strategies to avoid splitting, acting-out behaviors, and negative impact on other patients and staff.
Subject(s)
Borderline Personality Disorder/epidemiology , Borderline Personality Disorder/nursing , Mental Health Services/organization & administration , Nursing Care/organization & administration , Prisoners/psychology , Prisoners/statistics & numerical data , Female , Humans , MaleABSTRACT
Some nurses describe individuals diagnosed with borderline personality disorder (BPD) as among the most challenging and difficult patients encountered in their practice. As a result, the argument has been made for nursing staff to receive clinical supervision to enhance therapeutic effectiveness and treatment outcomes for individuals with BPD. Formal clinical supervision can focus on the stresses of working in a demanding environment within the work place and enable nurses to accept accountability for their own practice and development (Pesut & Herman, 1999). A psychiatric-mental health clinical nurse specialist can provide individual and/or group supervision for the nursing staff, including education about patient dynamics, staff responses, and treatment team decisions. A clinical nurse specialist also can provide emotional support to nursing staff, which enhances job satisfaction, as they struggle to maintain professional therapeutic behavior with these individuals.
Subject(s)
Borderline Personality Disorder , Clinical Competence , Nurse Clinicians/organization & administration , Nursing Staff/psychology , Nursing, Supervisory/organization & administration , Psychiatric Nursing/organization & administration , Attitude of Health Personnel , Borderline Personality Disorder/nursing , Borderline Personality Disorder/psychology , Conflict, Psychological , Emotions , Health Knowledge, Attitudes, Practice , Health Services Needs and Demand , Humans , Interprofessional Relations , Job Satisfaction , Machiavellianism , Models, Educational , Models, Nursing , Models, Psychological , Nurse Clinicians/education , Nurse Clinicians/psychology , Nurse's Role , Nursing Evaluation Research , Nursing Staff/education , Nursing Staff/organization & administration , Psychiatric Nursing/education , Social Support , Transference, PsychologyABSTRACT
This study examined relationships between the ability to recognize facial affect and affective intensity in women with Borderline Personality Disorder. Women hospitalized with borderline personality disorder and community women without psychiatric disorder (n s = 35/group) were recruited via convenience sampling. The Pictures of Facial Affect and the Affect Intensity Measure were administered to consenting women. Hypotheses related to differences in recognizing facial affect were supported, but further exploration indicated that selected negative emotions accounted for the statistical significance. Implications for practice and research are explored.
