Self-mutilation in people with borderline personality disorder: nursing approach in an acute unit

Abstract

Borderline personality disorder (BPD) is the most prevalent personality disorder (around 2% of the population) and is characterized by instability in relationships and identity, high impulsivity, self-harm, chronic suicidal ideation and emotional dysregulation, which makes its management a challenge for nursing in hospitalization units. We present the case of a 28-year-old woman with BPD who is admitted for the fourth time to an acute unit after a medication overdose in the context of a romantic breakup, and who during admission has a crisis with self-harm (frontal contusion and scratches) and suicidal threats. After assessment according to Virginia Henderson’s needs model, the diagnoses of self-mutilation, risk of suicide and anxiety were formulated, with their NOC outcomes and NIC interventions (self-injurious behaviour management, violence prevention and anxiety reduction). Nursing accompaniment during the crisis, listening to the distress and facilitating emotional expression allowed the patient to recognize the trigger and verbalize the desire to learn to manage crises without self-harming.