Maria is a 23-year-old female on disability pension. She left school since she was 12 years old and currently staying with her grandmother in Dromana. She has a long history of Borderline Personality Disorder with a self-harming behaviour and been experiencing chronic suicidal thoughts which often occur spontaneously with clearly definable triggers. These thoughts can be managed effectively well by the use of distraction/relaxation techniques, however, her level of distress can quickly escalate to an acute crisis situation whereby Maria becomes overwhelmed by the desire to end her life and emotional pain. Maria will then attempt to self-lacerate to reduce her distress or overdose on over the counter or prescribed medication.
One of the crisis plans that would prevent her from inflicting harm to self is by encouraging her to call a clinician or duty worker during business hours or call the Triage after business hours for phone coaching to de-escalate her current acute emotional state. As Maria is learning to move from her emotional mind to a ‘wise’ mind, we are encouraging her to try to balance these better. Maria understands that her emotional mind and wise mind are often unbalanced, which usually makes her emotions take hold which then often escalate, leading to self-harm behaviour.
[Source: Out-Patient Record, Peninsula Community Health Service (2010)]
Patient teaching plans are tools developed by nurses in facilitating a systematic and evaluative way used in communicating to their patients regarding a particular treatment or practice. According to Bastable (2008, p.407), a teaching plan is a “blueprint for action to achieve the goal and the objectives that have been agreed upon by the educator and the learner.” In this context, the nurse is the educator while the patient is the learner where a teaching and learning activity will occur for a specific treatment of therapy will occur.
Bastable (2008) further explained that
References: Bastable, S.B. (2008). Nurse as Educator: Principles of Teaching and Learning for Nursing Practice (3rd ed.) MA: Jones and Bartlett Publishers. Binks, C., Fenton, M., McCarthy, L., Lee, T., Adams, C.E., & Duggan, C. (2009). Psychological Therapies for People with Borderline Personality Disorder (Review). The Cochrane Collaboration, John Wiley & Sons, Ltd. Falvo, D. (2010). Effective Patient Education: A Guide to Increased Adherence (4th ed.). MA: Jones and Bartlett Publishers. Head, R. (2010). Another Pathway for Generating Compassion Toward BPD Patients. Journal of Journal of the Academy of American Physicians Assistants, Febuary 2000. Mountain, J. (2008). Bipolar Disorder: Insights for Recovery. Colorado, USA: Chapter One Press. Neacsiu, A.D., Rizvi, S.L. & Linehan, M.L. (2010). Dialectical Behaviour Therapy Skills Use as a Mediator and Outcome of Treatment of Borderline Personality Disorder. Journal of Behaviour Research and Therapy, vol. 48, pp. 832-839. Redman, B.K. (2007). The Practice of Patient Education: A Case Study Approach. USA: Elsevier Health Sciences. Saarmann, L., Daugherty, J.A., & Riegel, B. (2000). Patient Teaching to Promote Behavioural Change. Nursing Outlook, vol. 48, no.6, November – December. Shand, A. (2010). Outpatient Record, Peninsula Community Mental Health Service, 15-17 Davey Street, Frankston, Victoria, Australia (Unpublished Case Study) Ziegler, S.M |advising. | |Demonstration |2 | | | (Source: Bastable 2008).