Research suggests that nurses have negative perceptions and subsequently negative interactions with patients diagnosed as having Borderline Personality Disorder (BPD). However, this research is mainly quantitative in nature and does not allow nurses to speak freely about their experiences of working with this client group. The purpose of this study was to explore nurses' relationships with BPD patients from their own perspective. Semi-structured interviews were used to elicit the participants' experiences of BPD patients and thematic analysis was used to raise themes from the data. One core theme and four major themes were identified. The core theme was: 'Destructive Whirlwind', which refers to the nurses perceiving these patients as a powerful, dangerous, unrelenting force that leaves a trail of destruction in its wake. The major themes were: care giving; idealized and demonized; manipulation and threatening. The study concludes that nurses experience BPD patients in a negative manner. This can be attributed to the unpleasant interactions they can have with them and feeling that they lack the necessary skills in working with this group. The results also indicate that nurses want to improve their relationships with BPD patients.

Therapeutic engagement involves healthcare professionals spending quality time with patients and aims to empower the patient to actively participate in their care. This project was commissioned by the National Institute for Mental Health in England (NIMHE) Acute Care Programme in order to gain a greater understanding of how this process is successfully achieved and maintained on psychiatric wards. The NIMHE acute care lead in each regional development centre was asked to nominate wards that they thought were accomplishing a high level of therapeutic engagement. From this selection, a steering group identified seven 'positive practice units' that were suitable for inclusion in the study.Representatives of the multidisciplinary teams (MDT) who worked on the positive practice units took part in focus groups, which discussed the practices employed on the units to engage patients. Thematic analysis was used to code the data and raise themes. The themes that emerged from this analysis were: Respecting and empowering patients; Staff being 'available'; Engagement-focused observation; Good MDT working; Therapeutic work; Services for discharged patients; Embracing change. The study concluded that the positive practice on the units was the result of having a dynamic ward culture which was grounded in having empathy for patients and supporting staff.

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Kate Woollaston looks at infant sleep problems and addresses some common concerns that parents have to enable practice nurses to support parents through this process