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 patient teaching plans should have a “purpose, content, methods and tools, timing, and evaluation of instruction.” The purpose, content, methods and tools, timing and evaluation of instruction should be in line with the objectives and goals of a teaching plan. In order to have a more comprehensive and effective teaching plan, there is a need to identify concisely the elements of an ideal education process (Bastable 2008). By using a case study of a patient with a Borderline Personality Disorder, this essay will explain the importance of a patient teaching plan. It will further discuss the underlying principles and practice in the development, implementation and evaluation of a teaching plan based on the case study cited. It will also discuss the underlying processes in the development of the patient teaching and learning plan. It will then discuss the issues that will occur in the implementation of the patient action plan. Finally, it will give an analysis of the impact of the teaching plan to the patient.
Importance of Patient Teaching Plan to Patients with Borderline Personality Disorder
Borderline Personality Disorder (BPD) patients have the tendency of “exercising aggression, self-mutilation, impulsive behavioural dyscontrol, or self-damaging behaviour” (Latalova & Prasko, 2010 p. 239). Thus, there are chances that BPD patients have the behaviour to harm themselves like slashing, being violent to other people and they can also be impulsive. According to a letter written to the editor published in the Journal Academy of American Physicians Assistants (JAAP, 2000) by Roxane Head, the patients that have BPD “may experience simultaneous conflicting thoughts, images and emotions.” Hence, these conflicting thoughts, emotions and images could trigger higher level of suicidal tendencies. Incidence of BPD cases are brought about and associated to Post-Traumatic Stress Disorder (PTSD) which establishes the link that causes mood instability as a result of prior “parental...
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(Source: Bastable 2008).
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