Borderline personality disorder (BPD) is a complex presentation that can have a significant impact upon the individual and on his or her quality of life. BPD has often been associated with negative connotations (e.g. 'manipulative', 'attention seeking'). The aim of the current study was to gain a fuller understanding of how community psychiatric nurses (CPNs) make sense of the diagnosis of BPD and how their constructs of BPD impact their approach to this client group. Four CPNs, three women and one man, were interviewed using a semi-structured interview schedule. The data were analysed using interpretative phenomenological analysis, to reveal over-arching and sub-themes. The results indicated that participants attempted to ascribe meaning to the client's presentation 'in the moment'. When they had a framework to explain behaviour, participants were more likely to express positive attitudes. When they did not have such a framework, participants could view clients in more pejorative terms. As participants were deriving meaning 'in the moment', there could be fluidity with regards to participants' attitudes, ranging from 'dread' to a 'desire to help'. This could lead to participants shifting between 'connected' and 'disconnected' interactions with clients. The limitations and implications for clinical practise will also be considered.

The staff of the Children's Service of the Langley Porter Neuropsychiatric Institute have evolved from their experience certain concepts concerning the nature of the nursing skill needed in providing a therapeutic living environment for hospitalized psychotic children, as well as a number of hypotheses pertaining to the methods by which such skill can be attained by the professionally trained nurse. This paper discusses these concepts and hypotheses and their background. It also indicates the nature of work in the first year of a three‐year project supported by a National Institute of Mental Health project grant which was designed to provide a clinical test of the hypotheses.