Client B: 18 y/o Male Location: Inpatient

Client B: 18 y/o Male Location: Inpatient acute behavioral health ward Situation: Client B has been informally admitted to an acute mental health ward. This is client B’s first admission. Client B was being treated for depression by his GP, until he attempted suicide by cutting his wrists. While discussing the situation leading up to the suicide attempt client, B became increasingly agitated, tearful, and distressed; and verbally demanded to see a doctor. Upon being told that the doctor would be there in about 10 minutes, client B became angrier and demanded medication to calm himself down. He ran to the ward’s doors shouting that he wanted to go home. At that moment, the doctor arrived, and client B immediately calmed down. As the assessment progressed, client B admitted that reacting angrily when he does not get his way is normal for him. He went on to say that he always feels remorseful after an angry outburst. He describes himself as a “terrible person who was out of control,” and he “just wants to die.” Currently, client B has been admitted informally to the ward. Due to his impulse control difficulties, this could change? On this basis, what does the nurse need to know when managing client B’s legal status? Client A is diagnosed with “borderline personality disorder” What other types of personality disorders are there, and what clusters are they classified under? What are some personality traits an individual diagnosed with a personality disorder might exhibit? What specific psychological interventions would the nurse put into the plan of care for client B? Client B has now been on the ward for over six months. Each time discharge has been arranged, client B self-harms or threatens suicide. Client B has now agreed to go to a therapeutic community, a place has been secured, and client B is now engaging in pre-therapy work. What other treatments besides a therapeutic community are recommended for clients diagnosed with borderline personality disorder? While working with client B, the nurse found the relationship, at times, to be very stressful. What would be the signs of stress? What strategies could the nurse use to manage their stress? SCIENCE HEALTH SCIENCE NURSING NUR 251

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