Borderline personality disorder is characterized by a pattern of emotional, impulsive, and temperamental behaviors. Patients with borderline personality disorder have difficulty maintaining stable relationships and reaching goals, and often blame failures and disappointments on others. The nurse must maintain an assertive approach in communicating with the patient, creating an agreement with the patient about appropriate behaviors and treatment goals. Although limits on patient behavior are necessary, a serious environment is not required. Repression of negative emotions is not appropriate. Patients with borderline personality disorder are often manipulative; the patient will need guidance in directing the treatment course.