April 3, 2012

Just when I feel like a Competent nurse, I encounter something that brings me back to Beginner

Or at least back to Advanced Beginner.

It was in dealing with a patient with histrionic personality disorder. And while I know about it, I haven't actually encountered a patient with it. Lots of experience with the borderline, antisocial and obsessive-compulsive personality disorders, but this patient was a first for me.

And try as I might, I was on the losing end of this battle...fortunately the team rescued me.

I admit, I feel like I let everyone down since I wasn't able to deal with her. But I'm trying not to be too hard on myself--after all, as a per-diem, I don't always get to stick around long enough to really form good relationships with patients. And it's not often that one gets to see personality disorders that aren't borderline...even with all the time working inpatient, I can't recall working with a patient with histrionic personality disorder. Borderline, antisocial, OC, dependent, avoidant, paranoid, schizoid (really!)...and of course, lots of NOS, which usually ended up having more of borderline flavor than anything. Now I can add histrionic to the list.

Since we haven't really had any of these patients before and I wasn't the only staff member that was feeling off-balance with her, the staff ended up having an impromptu in-service on the care and feeding of the histrionic.

And I plan to do a little more reading up on it...a coworker recommended an excellent treatment planning book that had practical advice and interventions, instead of just the basic theory and the neatly wrapped up ivory-tower case study of my psych nursing textbook.

Oh well. It's a reminder that even though I've learned a lot, I still have a lot to learn.

3 comments:

Anonymous said...

Hi,

I just wanted to thank you for keeping your blog, Meriwhen the RN. I am thinking seriously of going to nursing school as a second career after being a chemist for 23 years in the Pharma industry and (still )raising a couple of kids). Did well in all the prereqs, but it's scary scary scary.

You have documented openly so many aspects of student and career life without being "clinical" or leaving out all the different aspects.

Thank you

Meriwhen said...

Thank you for reading and for the kind words :)

Best of luck with whatever you decide to do about school!

Kolohe said...

In the interest of presenting both sides of the coin, Anonymous, I'll give you a link to another nurses blog. Her experience has sadly been about the opposite of Meriwhen's. Here it is:

http://quarterlifecrisis2.blogspot.com/2012/01/emancipation-proclamation.html?spref=fb

Things went awry for her from immediately after nursing school; and it never got better. :(