Triumvirate nursing for personality disordered patients: crossing the boundaries safely

As the issue of the treatment and effective management of personality disordered patients comes under close scrutiny in the wake of the Fallon Inquiry, we offer a brief overview of the nature of the challenges involved in nursing this difficult group of patients. Traditional methods of setting limits and defining boundaries are no longer convincing amidst the allegations of multidisciplinary staff being culpable, at one level or another, for their contribution in this tragic inquiry. In this paper we offer a strategic mechanism of constructing nursing care for this difficult group of patients and provide a framework for crossing boundaries safely through a multidisciplinary framework. We term this triumvirate nursing. Nursing management of those patients considered to have personality disorders is traditionally very difficult. This difficulty, in part, stems from the inability of nurses to strategically develop therapeutic relationships in a safe manner. Crossing boundaries is a necessary part of therapeutic exploration and relationship building; triumvirate nursing offers a safe mechanism for undertaking this. Creative thinking is a necessary part of the future development of the nursing management of these disorders.