How do nurses experience working with adolescents with a diagnosis of 'personality disorder' or 'emerging personality disorder'?

Accessible summary What is known on the subject Nurses are less sympathetic to patients with a diagnosis of 'Personality Disorder' ('PD') and there is disagreement about whether the diagnosis can be applied to children and young people. What this paper adds to existing knowledge., We examined the experiences of nurses working with adolescents with a diagnosis of 'PD'. Six nurses were interviewed and we analysed the data using an approach that focussed on experiences. We found two themes. One concerned the emotional impact of working with these young people and the other the ways in which this affected the dynamics of the clinical team. Many of the experiences and wishes of the participants, such as anger, feeling unskilled and wanting training, are similar to those of nurses working with adults with 'PD'. Others appear to be more pronounced in this setting, particularly lack of certainty surrounding diagnosis, the dilemmas this raises in providing a service and the difficult interpersonal dynamics in the nurse-patient relationship., What are the implications for practice Nurses working with these young people need space in supervision to discuss the challenges they face. This has been found to alter staff attitudes in adult services., Nurses would benefit from training in relation to this diagnosis, particularly with an emphasis on the role of early trauma, and in approaches to working therapeutically with this population, such as cognitive analytic therapy., Abstract Nurses experience adults with a diagnosis of 'personality disorder' (' PD') as challenging, but nothing is known of their experiences working with young people with a diagnosis of ' PD' or 'emerging PD'. This study aimed to explore the experiences of nurses with this group. Six nurses were interviewed individually and the transcripts analysed employing interpretative phenomenological analysis. Two themes were identified: emotional impact, and conflict and need for support. Participants described powerful emotional responses and heavy time demands as particular challenges. They also reflected on tensions that arose in the wider team and service context. The importance of reflective space, training and the need for specialist approaches, such as therapeutic input, was emphasized by all participants. The study's findings suggest that while there are some similarities to adult services, there are also issues specific to nursing adolescents with ' PD', which merit further attention, including the implications of the lack of diagnostic clarity for treatment approaches and the difficult interpersonal dynamics of the condition. Recommendations for practice include additional training in relation to the theoretical understanding of diagnosis itself and in working therapeutically with young people with the diagnosis, employing approaches that have been found to be useful in adult services. [ABSTRACT FROM AUTHOR]