Diagnosing Vulnerability in Nursing: Emotionally Unstable Personality Disorder

Vulnerability

Vulnerability is an exposure to physical or emotional harm. Patient and health care vulnerability is a fundamental issue in nursing care, and its main purpose is to enhance protection of patients and healthcare providers from harm (Angel & Vatne, 2016). Vulnerability can be a risk or subjective issue because it takes into consideration the perception of all health stakeholders involved in nursing care. Attention has to be drawn to the patient and all health stakeholders who are exposed to harm in the treatment and care process. Vulnerability also refers to the lack of a good system that can monitor and control the healthcare environment to prevent hostility or harm for the patient and healthcare providers. The emotionally unstable personality disorder is a mental disease or complication which is characterized by abnormal behaviours, variation in moods and emotions. The disorder is also known as the Borderline Personality Disorder (American Psychiatric Association, 2013).

Patients who have this mental disorder are likely to exhibit intense anger, anxiety and they may also suffer from depression. They also have difficulties in creating and sustaining solid relationships because they often feel empty, cause harm to themselves and they have dangerous behaviours which originate from their fear of rejection (Townsend, 2014). They also lack the sense of stability within themselves. The vulnerability of patients suffering from the emotionally unstable personality disorder is affected by personal and environmental factors, and this can affect the patient personal and professional life. Special monitoring, control, and care should be facilitated to avoid the creation of a window of vulnerability which promotes the progression of the disorder (Stepp et al., 2016).

The Effects of Vulnerability of a Patient Suffering From Emotionally Unstable Personality Disorder

Emotionally unstable personality disorder patients can be exposed to various factors that can promote the progression of the illness and its effects on their lives and the lives of health care providers and other stakeholders (American Psychiatric Association, 2013). The experience of vulnerability for patients can lead to the development of stress or anxiety as well as depression which has huge impacts on the patient physiological and social capabilities. It also affects the psychological functioning of the patient. Vulnerability in these patients also can lead to the development of other mental disorders such as Attention-Deficit/Hyperactivity Disorder and Obsessive Compulsive Disorder among others (Brune, 2016).

Exposure to harm for patients with this mental disorder can also lead to self-harm, suicidal thoughts, broken relationships, loss of jobs, deterioration in mental and physical health and sometimes death. Behaviour patterns and moods of the patient also change (Thorup et al., 2012). The healthcare providers and the support group members of the patient are also affected physically or emotionally. It is therefore essential to ensure that all the factors that enhance the vulnerability of patients suffering from emotionally unstable personality disorder are monitored controlled and managed (Gjengedal et al., 2013).

The Needs of the Patient and How to Meet Them

Patients suffering from emotionally unstable personality disorder have various needs which range from symptom control needs, the treatment and care needs and the quality of life that they live needs (Grambal et al., 2017). These needs have to be addressed for effectiveness in the treatment and management of the disorder. The needs that are associated with the symptoms management and control are emotional, social relations, personal injury, identity and thinking challenges and suicidal thoughts as well as the various barriers towards the treatment process. The needs can be addressed through early diagnosis which promotes early treatment (Brune, 2016).

The treatment needs that a patient has are for health interventions, healthcare environment, community support and treatment and many patients need de-stigmatization. These needs can be addressed through diagnosis and effective primary care and treatment process. There is much quality of life needs that a patient suffering from emotionally unstable personality disorder has, which have to be addressed. These needs range from physical health needs, support and family needs, some patients may require spiritual needs and advocacy related needs. Diagnosis, treatment, and care, as well as support, can address these needs (Van Rijsbergena, 2015).

Role of the Healthcare Professionals in Preventing and Recognizing Vulnerability

Healthcare professionals play the most fundamental role in the management, control, and monitoring of the treatment or care environment. They monitor the progress of the patient as well as recommend the most effective strategies and methods of treating and caring for the patient suffering from an emotionally unstable personality disorder (Wrycraft, 2012). Healthcare professionals interact with the patient, and the patient can notify the nurse of their needs for help. The nurse is, therefore, able to provide supportive measures to the patient to prevent vulnerability. Also, this enables the nurse to monitor the treatment environment effectively and recognize vulnerability promoting effective treatment (Townsend, 2014)

The nurse or healthcare stakeholders identify their vulnerability through the engagement with the patient. If the patient exhibits a change in behaviour, the nurse identifies this change and adopts the most effective treatment measures for the behaviour change. The relationship between healthcare professionals is also enhanced through the treatment and caring process which promotes a collective focus on the treatment process. The healthcare professionals also play the role of ensuring that the physical life needs that patients have been met to avoid the creation of a hostile environment that can promote the progression of the disorder (Angel & Vatne, 2016).

Identification of Any Relevant Physical, Social, Psychological and Environmental Factors

The main cause of the emotionally unstable personality disorder is not very clear although research shows that there are very many factors that contribute to its development and progression (American Psychiatric Association, 2013). There also factors that facilitate vulnerability of patients suffering from this disorder. Genetic factors, the functions of the brain, social-cultural and environmental factors are fundamental in increasing the exposure and risk of this disorder (Gunderson, 2011). Family history can enhance the risks of this disorder. Unstable and subjective relations also promote vulnerability. Abuse, hostile conflicts, and environment also promote vulnerability. Social interactions and settings also may increase vulnerability. Personal thoughts, health, and emotions also promote vulnerability (Stepp et al., 2016).

The Addressing of the Identified Needs in Practice

Healthcare professionals can use different strategies for addressing the emotional unstable personality disorder and patient needs. Psychotherapy can be done on the patient through therapist’s sessions. This can be through dialectical behaviour therapy or cognitive behavioural therapy (Wrycraft, 2012). These help patients to address their physical and treatment needs. Medications can also be used in addressing the patient needs which can lead to vulnerability. Some patients may also require inpatient care or specialized monitoring at a health facility. Caregivers, family, and friends can also offer emotional and psychological support to the patient (Brune, 2016).

Role of the Multi-Disciplinary Team (MDT)

A multidisciplinary team is an association of healthcare professionals or workers who come together from different healthcare disciplines to provide specific health care services to a specific patient (Townsend, 2014). For example, nurses, doctors, psychiatrist and social workers may form a group which will facilitate the treatment of a patient suffering from emotional unstable personality disorder. The team ensures that it delivers effective patient care. According to Van Risbergena (2015), the general health practitioners work jointly with practice and community health nurses as well as health educators in the achievement of the multi-disciplinary team treatment goals. A patient suffering from an emotionally unstable personality disorder is likely to register improved health outcomes and satisfaction through the treatment process of a multidisciplinary team. The treatment resources are also utilized well, and all members strive to achieve positive health outcomes (Grambal et al., 2017).