Linda McNee and colleagues describe how helping one patient to overcome difficulties led to the development of a staff training package to improve outcomes

In an acute admissions unit for adults with mental health problems staff were often faced with the challenging presentations of patients diagnosed with borderline personality disorder (BPD). One patient who had a particularly lengthy admission appeared to make little progress, which led to feelings of inadequacy among members of the multidisciplinary team. This prompted the development of an innovative and committed approach to caring for people with BPD. The authors describe how they worked to improve staff awareness and instigate a cultural change in the way patients with this diagnosis are nursed.