Borderline personality disorder - an overview for emergency clinicians

Koehne, Kristy and Sands, Natisha 2008, Borderline personality disorder - an overview for emergency clinicians, Australasian emergency nursing journal, vol. 11, no. 4, pp. 173-177, doi: 10.1016/j.aenj.2008.07.003.

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Title Borderline personality disorder - an overview for emergency clinicians
Author(s) Koehne, Kristy
Sands, Natisha
Journal name Australasian emergency nursing journal
Volume number 11
Issue number 4
Start page 173
End page 177
Total pages 5
Publisher Elsevier Ltd.
Place of publication Oxford, England
Publication date 2008-11
ISSN 1574-6267
Keyword(s) borderline personality disorder
emergency nursing
crisis intervention
Summary The diagnosis of borderline personality disorder frequently underlies self-harm and suicidal presentations to the emergency department. Borderline pathology combined with high levels of comorbidity, stigma, and treatment uncertainty, increase the challenges of caring for someone with this diagnosis in an emergency setting. Attributes such as black-and-white thinking and splitting may compromise an already precarious situation. The maintenance of safety requires prioritisation and necessitates a practical and respectful approach, which avoids notions of attention-seeking behaviour. Clinical assessment should distinguish between self-harm and suicide attempts where possible and take into account acute on chronic risk. The emergency clinician will need to consider the degree of containment required in the emergency department and is encouraged to maintain transparency and honesty with the client regarding treatment decisions. If hospitalisation needs to be considered, clinicians should take into account immediate therapeutic benefit versus the counter-therapeutic risk of dependency and regression. Overall, it is reasonable for clinicians to aim for clients to return to their pre-crisis level of functioning, and beneficial for clinicians to approach this client group with therapeutic optimism.
Language eng
DOI 10.1016/j.aenj.2008.07.003
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2008, Elsevier
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Document type: Journal Article
Collection: School of Nursing and Midwifery
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