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Susan Smith is a 26-year-old female diagnosed with Borderline Personality Disorder and is on a Disab

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Susan Smith is a 26-year-old female diagnosed with Borderline Personality Disorder and is on a Disability Support Pension, who has presented to the emergency department with burn marks all down the left side of his chest as she has used hot wax on her skin to self-harm and has sustained first degree burns in this area. The patient has also made multiple lacerations to both of her thighs, and she has burnt her arms in places with a lighter.  She is clear that she is not trying to kill herself and this is self-harming behavior to alleviate her emotional dysregulation and prevent her from engaging in suicide. She has recently broken up from another boyfriend who was with her for 6 weeks and she has a history of multiple relationships and has been a survivor of domestic violence in the past.  Patient has a history of sexual abuse as a child and is estranged from her parents, brother and two sisters. Susan says that the Ministry of Housing wishes to evict her due to hoarding and her flat has been condemned as a fire risk as she has accumulated so much in her flat and when she has been intoxicated with alcohol previously, she has had physical fights with some of the neighbours due to playing her music loudly in the early hours of the morning.  Susan has consumed 2-4 bottles of wine a day for the past 12 months and smokes “a lot of cannabis.” She has attempted suicide previously by overdosing on tablets and 6 months ago was in the Intensive Care Unit, however on this occasion she has come to the emergency department seeking a psychiatric admission for containment of her risky behaviour. She has a poor appetite as she mainly spends her money on alcohol and cannabis, and she appears very underweight.  This person presents as malodourous, unkempt and reports her ex-boyfriend has assaulted her physically and stolen a number of her valuable possessions like her jewelry.  Reports she fears males due to her abusive childhood and her previous relationships.  She has no psychotic symptoms; however, her mood is depressed, and she is struggling with suicidal thoughts and wants to take an overdose of tablets.  Her short- and long-term memory: and attention and concentration appear to have some impairment – she is finding it difficult to recall information and finds it hard to concentrate and respond to questions asked of her.  You are the mental health nurse who is admitting this patient to the psychiatric ward, you will complete the recovery focused care plan with 5 clear areas of nursing care identified and what interventions you will put in place for short term and long-term care and support of this patient?”

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