Home » Mental Health Conditions » Borderline Personality Disorder » Nursing Interventions For BPD: Best Practices And Techniques

Nursing Interventions For BPD: Best Practices And Techniques

Doctors and nurses encounter difficult situations with patients quite often. There are times when people refuse to take treatment and become hard to manage and that is when it is time for a Nursing Intervention for BPD patients.

Given the chaotic and even toxic symptoms associated with borderline personality disorder, people suffering from it need extra care. It is imperative for nurses and caregivers to know about the best practices and techniques for nursing interventions for BPD patients to ensure their safety and security.

Dive right in to learn about the best techniques and practices to offer treatment and care to people with borderline personality disorder.

All You Need To Know About Borderline Personality Disorder

All You Need To Know About Borderline Personality Disorder

Personality disorders include a range of mental health issues. They induce symptoms like erratic behavior patterns and strong emotions that impair occupational, social, and almost every other area of functioning.

Borderline personality disorder is one of these severe disorders that cause unstable and impulsive behavior, moods, and relationships. People who suffer from BPD also have a severe fear of abandonment and can also find it difficult to regulate their emotions, specifically anger.

BPD falls under an inclusive group of conditions known as Cluster B personality disorders. People with BPD might not even realize that they have it and that there is a better way to behave toward others.

Ways To Carry Out Assessment Of Borderline Personality Disorder

Ways To Carry Out Assessment Of Borderline Personality Disorder

When it comes to borderline personality disorders, it becomes imperative for nurses to diagnose them to offer better treatment. Here are a few tests that they can do to assess the situation of a patient with BPD:

1. Check Toxicology

A common sign of severe personality disorders like borderline is substance abuse. Intoxication by alcohol or other drugs can often lead people with BPD to display the symptoms.

2. CT Scan

CT Scan

CT scan, scientifically called Computed Tomography scanning, along with the right blood work, can help assess the situation better even if you suspect the organic etiology.

3. Radiography

Radiography could highlight injuries caused by motor vehicle accidents, violent fights, and even self-mutilation.

4. HIV Screening

There is a high chance of people with borderline personality disorders exhibiting impulse control. They might act without considering the risk associated with their toxic behavior, and this can often lead to infections, including sexually transmitted diseases.

What Does The Assessment Of Borderline Personality Disorder Indicate?

What Does The Assessment Of Borderline Personality Disorder Indicate

Assessment of people with BPD can involve an interview of the patient, carefully observing their verbal as well as nonverbal behaviors, conducting a thorough examination of their mental status examination, and conducting a psychosocial assessment.

Assessment findings shared by nurses for people diagnosed with BPD could include the following symptoms:

  • Feeling empty
  • Self-harm
  • Self-mutilation
  • Extreme shifts in mood occurring within a span of hours or days
  • Suicidal tendencies evident in their gestures, behaviors, or threats
  • Impulsive behavior like unsafe sex, substance abuse, reckless driving, overspending, gambling, or binge eating
  • Intense fear of abandonment
  • Leaning toward sarcasm, anger, and bitterness
  • Unstable relationships
  • Unstable career paths and plans
  • Unstable self-image and self-criticism
  • Unstable or even conflicted relationships with neediness and mistrust

How Do You Treat BPD?

Borderline Personality Disorder (BPD) is a complex mental health condition often involving multiple strategies, approaches, and interventions to treat properly.

Role of Nursing Interventions Nurses play a crucial role in the management of BPD. Nursing interventions can include regular monitoring of the patient’s mental status, providing emotional support, and ensuring adherence to treatment plans. These interventions are critical in creating a safe and supportive environment for patients with BPD.

Medication While there is no specific medication for BPD, certain medications like mood stabilizers and antidepressants can help manage specific symptoms. Nurses are responsible for administering these medications, monitoring for side effects, and evaluating their effectiveness in collaboration with psychiatrists.

Crisis Intervention Patients with BPD may experience acute episodes or crises. Nurses must be adept at crisis intervention techniques, including safety planning, de-escalation strategies, and providing immediate support. This intervention is vital to prevent harm and stabilize the patient.

Supportive Care Supportive care involves offering emotional support and validation to patients. Nurses can help build a therapeutic relationship with patients, fostering trust and a sense of security, which is essential in managing BPD.

Lifestyle Modifications and Coping Strategies Encouraging patients to adopt healthy lifestyle choices and teaching coping strategies are important nursing interventions. These include stress management techniques, regular exercise, and healthy eating habits, which can significantly improve the overall well-being of patients with BPD.

Collaboration with Multidisciplinary Teams Effective treatment of BPD often requires a coordinated effort from a multidisciplinary team, including psychiatrists, psychologists, and social workers. Nurses play a pivotal role in coordinating this care, ensuring comprehensive and consistent treatment for BPD patients.

Types of Therapy

Therapy is a cornerstone in the treatment of Borderline Personality Disorder, with several specialized approaches proving effective in managing its symptoms.

Dialectical Behavior Therapy (DBT) DBT is a critical therapeutic approach for BPD. It focuses on teaching patients skills in mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. DBT helps individuals cope with intense emotions and improve their relationships.

Cognitive Behavioral Therapy (CBT) CBT is used to address negative thought patterns and behaviors associated with BPD. Through CBT, patients learn to identify and change destructive thoughts, which can lead to more positive behaviors and mood stability.

Schema Therapy Schema therapy is designed to identify and address deep-rooted patterns in patients with BPD. It helps in understanding and changing long-standing life patterns, thereby improving emotional regulation and interpersonal relationships.

Mentalization-Based Treatment (MBT) MBT focuses on improving a patient’s ability to mentalize, which involves understanding the mental states of oneself and others. This is particularly beneficial in BPD for enhancing interpersonal relationships and emotional understanding.

Psychodynamic Therapy This therapy explores unconscious processes and past experiences that may contribute to BPD symptoms. It helps patients understand and resolve deep-seated emotional issues, leading to greater self-awareness and emotional stability.

Group Therapy Group therapy provides a platform for patients with BPD to interact with peers, learn social skills, and receive support. It’s an effective way to address issues related to interpersonal relationships and social functioning.

Family Therapy Involving family members in therapy can be beneficial for both the patient and the family. Family therapy aims to improve communication, resolve conflicts, and foster a supportive home environment, which is crucial for the management of BPD.

Through these varied therapeutic approaches and nursing interventions, individuals with BPD can achieve better control over their symptoms and improve their quality of life.

Nursing Interventions For Borderline Personality Disorders

All About The Nursing Management For Borderline Personality Disorders

People with borderline personality disorder can be violent and can show erratic behavior, which is harmful to them and others around them. There is a need for proper care and management to keep everyone safe.

Here are a few essential things to keep in mind during the management of such people:

1. Nursing Assessment 

There is a need to carry out a thorough assessment of the client, which includes the following:

History

Many people with BPD have disturbed early relationships with parents that can begin as early as 18-30 months of age. Some of these clients can also have experienced childhood sexual abuse, and a few could have experienced both physical as well as verbal abuse and even parental alcoholism.

Mood And Affect

Mood And Affect

The nurses and professional caregivers must take into account the mood of the patient and how it affects their behavior. People with BPD tend to have a dysphoric mood that involves unhappiness and restlessness.

They may also feel severe boredom, loneliness, frustration, and empty feeling.

Thought Process

The thought process of people suffering from BPD includes polarized and extreme thoughts about themselves as well as others. People often refer to it as splitting.

The ones with BPD can adore or even idealize some people after a brief meeting but quickly devalue the same people if they don’t meet their expectations.

Sensorium Or Intellectual Process

Borderline personality disorder can also affect the senses and intellectual processes. If the intellectual capacities of the person are intact, they are oriented to reality.

2. Diagnosis

Diagnosis

The nursing diagnosis of people who have borderline personality disorder can include the following:

  • Risk of suicidal tendencies due to the low tolerance for frustration.
  • An increased chance of self-mutilation due to impulsive behavior.
  • Risk for violence due to the lack of feelings.
  • Inability to cope with failure to change behavior.
  • Urge to isolate socially due to disruptive relationships.

3. Care Planning And Goals

The nursing planning and goals for borderline personality disorder patients include:

  • Ensuring safety and prevention of injuries.
  • The patient doesn’t cause harm to people or property.
  • Increasing their control of impulsive behavior.
  • They take the necessary measures to meet their needs.
  • Start demonstrating problem-solving skills.
  • Have more satisfaction in relationships.

Best Techniques For Nursing Interventions For Borderline Personality Disorder

Best Techniques For Nursing Interventions For Borderline Personality Disorder

People who have borderline personality disorder often need long-term psychotherapy and care to address the issues they face. Here are some practices for nursing intervention to help such people:

1. Promoting Safety

The first thing a nurse must focus on is suicidal ideation. They must make a plan, have easy access to the means for implementing the plan, identify self-harm behaviors, and also use appropriate interventions.

2. Promote Therapeutic Relationships

Irrespective of the clinical treatment, the nurse or professional caregiver should adopt a structure and set limits for the therapeutic relationship. In a clinical setting, the person with BPD must have scheduled appointments of predetermined lengths and not ask for them whenever they need the nurse’s attention.

3. Establishing Strict Boundaries 

Establishing Strict Boundaries

It is imperative to establish rigid boundaries and also clearly communicate them to ensure that neither the person suffering from BPD nor the nurse feels that their boundaries are being violated.

4. Teaching Communication Skills

The nurse must teach basic communication skills to the patient. It can include maintaining eye contact, being an active listener, waiting for the turn to talk, trying to understand the meaning of the other person’s communication, and lastly, using “I” statements.

5. Controlling Emotions

The nurse must also help their clients identify feelings and how to tolerate these emotions without giving exaggerated responses or causing destruction or self-harm. Urging people to keep a journal can help them gain awareness of their feelings.

6. Reshape Thinking Patterns

Reshape Thinking Patterns

They can use cognitive restructuring, a technique for changing thinking patterns by helping people recognize negative thoughts they have and replacing them with positive ones. This technique can help alter negative as well as self-critical thought patterns.

7. Structure Their Day

Making a daily schedule to minimize unstructured time can help people with BPD manage their alone time. They can plan and write a schedule including doctor appointments, meals, shopping, walks, and even reading time to utilize their day.

Final Thoughts

Borderline personality disorder can significantly impact every aspect of a person’s life. It can lead to severe symptoms, strain their relationships, and even affect people close to them.

People need a proper diagnosis to be able to better understand their situation and its symptoms and how they can deal with them in a better way. The nursing intervention techniques discussed above can help nurses protect people suffering from BPD and help them lead a healthier and happier life!

Leave a Comment