Do nurses also propagate the stigma attached to mental health disorders? Student nurse Lindsay had heard about the difficult behaviours of people with personality disorders. But her wary attitude changed when she realised that listening to hearsay and her preconceptions had prevented her from guaging her patient’s needs.
As a second year mental health student nurse, I was really looking forward to my first placement in my field of practice, in an acute female inpatient unit.
As my university course had not covered personality disorders by that point, I had limited knowledge of this client group before starting placement. I had heard many comments from ward-weary mental health nurses about ‘attention seeking’ and ‘game playing’ behaviour from people with personality disorders. So, I was a bit wary about the prospect of working in such an environment. It was definitely a fear of the unknown.
My first day was a real eye opener. I witnessed first-hand the reality of working with patients with EUPD, and I have to admit, I was a little bit terrified. There were many challenging behaviours present, none of which I had come across before.
The ward psychologist invited me to sit in on some of his sessions with patients. After one particular session, he asked me why I thought the patient had asked to see him. I wasn’t entirely sure, as it didn’t seem to me that she would use the skills she had just been taught, or that she was even particularly interested. At one point, it did appear that the patient was just enjoying having us there. ‘For attention?’ I asked. Instantly I regretted my answer. To be honest, I’m not even sure where it came from. I had subconsciously fallen into the culture of stigmatising people with EUPD. With a smile, the psychologist corrected me, ‘for a connection’ he said. The patient was seeking a connection. This was her way of seeking contact with staff without having to make herself vulnerable by saying ‘I just want to spend time with someone’. The content of the session was irrelevant, it was having the company that mattered. She just didn’t feel comfortable enough to say so.
There are often days on the ward when I experience behaviour that challenges, and some days there are high levels of distress. But I have realised that behaviour that is referred to as ‘attention seeking’ or ‘game playing’ is actually a way of communicating. It is just a matter of figuring out what is being communicated. I was lucky enough to be working alongside a psychologist to help me with this. But I do hope that in time this will be a skill I can develop.
Certain words are used on the wards without much consideration of their negative connotations. However, I have made the decision to subtly change the way I use my words in future, to describe more empathetically the actions of a person with EUPD. You never know, this might just help us to see things a little differently.
Lindsay Hill is in her second year studying mental health nursing at University of York