January 20, 2012


I have a BPD patient that for the life of me I am unable to establish any rapport with. I usually don't have a lot of problems interacting with the borderlines--I can often establish a good relationship with them...at the least, I can get them to interact. But most of the BPD patients I've worked with have been in detox or depressive units, not in eating disorders.

I've tried a few different approaches with this patient and she shuts down every time. I'm also not the only staff experiencing difficulty with connecting with her. Instead she gets very superficial and cagey, and I'm not sure exactly how to proceed...especially as she seems to be telling everyone a different story. We reviewed her history and saw the same patterns of behavior in the past that we're seeing now.

So I talked to the doctor and said that I was having a hard time establishing any connection with this patient, and that I wasn't sure if it was because of the patient's superficiality towards treatment, or if it's me not having a whole lot of eating disorder experience...or both. The doctor felt that it was probably both (I take no offense). Unfortunately for me, I can't force the patient to get invested in her treatment, and my limited eating disorders experience doesn't help me. And only time and work will give me experience.

I should keep brushing up my knowledge and just keep trying to connect. I can't force that either...but I can keep trying and see if she eventually responds.

I actually felt like a green nurse after talking to this patient. Well, I am a fairly young (career-wise) nurse who--while having learned a lot--still has a lot of learn. Fair to say that after a couple of years, I've moved from green to lime...but man, I really felt like a newbie after this patient.

Live and learn. Learn and live.

1 comment:

Medic2RN said...

Don't feel bad, even with more years under your belt, there will be one patient who throws you for a loop and makes you feel greener than grass clippings. I admire your tenacity with this patient.