[Nursing care for a patient with borderline personality disorder]

Personality traits reveal characteristics and patterns of an individuals environmental observations, thinking processes, and coping strategies. They exert long-term effects on adaptation and personal identity. The author presents a case study of a patient with Borderline Personality Disorder (BPD) who suffered from suicidal ideation, intense mood swings, all-good/all-bad thinking patterns, and poor job performance. An assessment is offered of the patient's physical, emotional, cognitive, social, and spiritual characteristics based on his subjective reports, interview records, and behavioral observations. Three primary nursing diagnoses were identified: a) potential for self-directed violence, b) ineffective coping mechanisms, and c) personal identity disturbance. A stable therapeutic relationship was formed over an 18-month period, including the establishment of coping skills, a support system, and crisis intervention training for both the patient and his family. The treatment was successful in reducing the patient's self-mutilating behavior, increasing his stress management skills at his workplace, and developing appropriate social behaviors leading to a more stable personal identity.