[A nurse's experience building medical alliances for a repeatedly-hospitalized patient with bipolar disorder]

This article reports on the experience of clinical nurses in treating a patient with bipolar disorder who was re-hospitalized following a relapse attributed to poor medical alliance. During the period of nursing care (February 2 to April 7 2009), observation and interviews employed to assess the patient resulted in the three nursing diagnoses of violence risk, disorganized thinking process, and poor medical alliance. With the goal of enhancing medical alliance, an individualized plan of nursing care designed to better understanding the patient's illness history, illness and treatment attitudes, and feelings of ambivalence towards medicines was implemented in order to foster a closer nurse-patient relationship and enhance patient motivation to accept medical treatment to permit a return to a normal life as soon as possible.