This study explored registered psychiatric nurses' (RPNs') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the “staff-patient interaction response scale” (SPIRS). Four themes emerged following data analysis: “challenging and difficult,” “manipulative, destructive and threatening behaviour,” “preying on the vulnerable resulting in splitting staff and other service users,” and “boundaries and structure.” Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Immunocompromised patients account for about 3% of the US population. Complications arising from infection are common in these patients and can present diagnostic and therapeutic challenges. This article describes the pathophysiology of immunosuppression in five common immunocompromised states—asplenia, HIV infection, solid organ transplant, biologic use, and cancer—as well as specific infectious risks and considerations for affected patients and how to manage them.
Health advocacy is a key physician skill to address social determinants of health and promote health and health equity. 1 We noted a lack of medical school curricula that both address skills necessary to develop partnerships with advocacy stakeholders and students' desires to self-determine advocacy topic areas. A novel learning project was therefore designed to address these goals. Outcomes were followed for 3 years. We aim to describe student and community health partner outcomes and key lessons learned through the delivery of this project.
Approach:The health advocacy project ("HAP") was incorporated as part of a required ambulatory clinical course at the University of Wisconsin School of Medicine and Public Health (UW-SMPH). The HAP allowed medical students to identify a topic and community partner and required students to arrange meetings with the partner to identify shared goals and a mutually agreed-upon project. Students dedicated approximately 8 hours of work over the 10-to 12-week course to this effort. Projects were focused on community partner goals. At the end of the course, students delivered their project, wrote a summary paper, and completed a selfevaluation on changes in attitudes and practice. Community partners submitted qualitative feedback.
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