Cluster A: Paranoid Characteristics (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 If you have a patient who has a paranoid personality disorder.

    00:07 Understand that it comes with certain characteristics.

    00:11 For example, they do not trust you.

    00:14 This excessive and pervasive mistrust is in every thing that they do.

    00:20 It's not just about you.

    00:22 It's really important for us, as nurses to remove ourselves as being an important part of that person's life.

    00:30 And instead, see the person for who they are and understand that their mistrust is not something that they have control over.

    00:39 This feeling of suspiciousness is not purposeful towards us.

    00:46 It is actually part of their thought composition.

    00:50 They also may suspect other people.

    00:53 They might tell you, "Oh, my roommate really wants to hurt me.

    00:57 I'm having a hard time sleeping at night because I know that my roommate, as soon as I go to sleep is going to do something to me, that's really bad." There doesn't need to be any evidence of this.

    01:10 Again, I want for you, as a nurse to really find in your heart and in your soul.

    01:16 And imagine how difficult it must be to see the world through the eyes of someone who cannot trust.

    01:25 Also, when we are thinking about the person who has paranoia, they might have jealousness.

    01:33 There's a jealousy that comes in where they want to then control the people around them.

    01:38 They might be looking at you and thinking, "Well, this person seems to like me, but then I see, I see that person talking to Mr. X.

    01:49 And she seems to be just as nice to Mr. X.

    01:52 I think I want to make sure she doesn't talk to Mr. X, again." Again, remember, they don't have control over these kinds of thoughts.

    02:02 We want to make sure that we are helping them to very slowly understand that it's not only about them.

    02:12 Their preoccupation with everyone around them, with worrying that someone has more than them, or someone's out to get them.

    02:20 Or it just seems like in the world, no matter where they land, their boss doesn't likes them.

    02:27 This is part of their thought composition.

    02:30 It's what their story is.

    02:32 It's how they walk out of their house.

    02:35 They might be very reluctant to even talk to you about anything.

    02:39 They're suspicious of you.

    02:41 They want to keep all of their information to themselves, because information is power.

    02:47 And that would be sharing their power with you.

    02:51 And finally, they can be very, very sensitive to criticism.

    02:56 Even something that you don't think is criticism.

    02:59 They might take it and really hold a grudge against you for something you said, something that you don't even understand.

    03:07 So let's just take one little step back and wonder how this can develop in a person.

    03:13 And if you can imagine a child, a child who is not safe.

    03:17 A baby who is not safe in their own house.

    03:21 And how everything that is done or said is made to them to be the reason why mom doesn't ever have anything fun in our life.

    03:31 Or the reason why, dad is drinking, Or why don't you just shut up as a baby whose still trying to learn how to speak.

    03:40 And realizing that the only way to save yourself at the age of two would be to worry about everyone else because everyone is a threat to you.

    03:52 And that gets cemented in as a pattern of thinking in your own mind.

    03:58 So let's think about a patient who might have a paranoid personality disorder.

    04:03 So when told that he was scheduled that to interview a patient with a paranoid personality disorder, the student nurse anticipated finding, what? What could the student nurse think would be what he sees or she would see? A charming, dramatic, seductive, and admiring seeking person? A person who had a preoccupation with suspicion, magical thinking, and distrust.

    04:33 Perhaps a person who had a difficult time being alone, who is submissive, indecisive.

    04:41 Or perhaps somebody who had grandiosity.

    04:44 Somebody who felt that they were entitled to everything.

    04:47 We just talked about this paranoid personality disorder.

    04:52 And if you said it would be B, you are 100% right.

    04:56 This is the person who has suspicions and who has distrustful of just about everyone, and who believes that magical thinking is the answer.

    About the Lecture

    The lecture Cluster A: Paranoid Characteristics (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Personality Disorders (Nursing).

    Included Quiz Questions

    1. Suspiciousness
    2. Jealousy
    3. Sensitivity to criticism
    4. Easily trusting
    5. Hypomania
    1. The client who was repeatedly blamed for their mother's substance use disorder as a child.
    2. The client who was adopted as a baby and has a good relationship with their adoptive parents.
    3. The client who has a family history of bipolar disorder.
    4. The client who has experienced auditory hallucinations since adolescence.

    Author of lecture Cluster A: Paranoid Characteristics (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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