我当了14年的护士。在医学领域，人们普遍认为BPD患者很难相处。我们大多数人会选择一个精神分裂症妄想症患者，而不是照顾一个边缘人。由于这一人群中有较高的吸毒发生率，你可以想象这些患者通常寻求药物的行为水平。对我们来说，与“疯狂”的病人合作并没有什么不同寻常的。我们有精神病、头部受伤和痴呆的患者(我曾被不止一个帕金森患者袭击过)。我宁愿接受一个神志不清，可能有暴力倾向的痴呆病人用自己的粪便涂墙也不愿接受一个刻意寻求关注的边缘性病人。这些病人让人精神疲惫。她们是那些威胁要起诉的人，因为她们没有得到她们想要的毒品，她们是那些被称为天后的人，因为没有什么达到她们的标准。即使他们无家可归，满身疥疮和虱子，他们也会发现自己的房间、食物或护理有问题。 It's the lack of self awareness and inability to take responsibility for themselves that I find incredible, there is always someone to blame for their problems. I've met some really great people with BPD who have put in the time to seek therapy and who have done the work to be able to function as a "normal" person. I do realize that this is a very real diagnosis and that these people are in pain, I have seen the most shocking displays of self mutilation from this patient population. I've read quite a bit of educational material on this diagnosis. However, I have found very little information on how to manage their care and interact with them, setting boundaries seem almost imposible. I've had patients call 911 from their hospital room because the thermostat wasn't right. I'd love some advise on how to interact with the BPD. I want to be able to provide the prescribed care without having to play games, such as "I won't let you take my vital signs until you give me dilaudid."