NRS 429 TOPIC 2 DQ 1: What is a definition of family that encompasses the different family structures prevalent today?

NRS 429 TOPIC 2 DQ 1: What is a definition of family that encompasses the different family structures prevalent today?

What is a definition of family that encompasses the different family structures prevalent today? Discuss the importance of acknowledging nontraditional family structures. Explain how family systems theory can be used to better understand the interactions of a modern family (traditional or nontraditional).  

This is a favorite “life verse” of mine. I actually had it read at my Graduation from Nursing School in 1993. It is a very inspirational scripture because we know that we can do anything with the help of Jesus Christ. He certainly gives us strength in the difficult moments. I am very grateful for this verse.  

I think that Romans 8:28 is one of my most inspirational Scriptures to share. “For we know that all things work together for good, to them who love God, to them who are the called, according to His purpose.” (The Holy Bible, KJV.) 

This verse speaks to things working out, so it has a positive outlook. It also lets us know that things are still working out, even when they seem to be failing. This is where real Faith comes in. Knowing that God is going to work anything out and that we should never give up, because we are THE CALLED. We are the people that He has called to do His good works.  

Reference:  

The Holy Bible, KJV.  

my motto for this stage in my life is to simple take it one day at a time and be quick to let go of things that make me mad and I can’t do much about them and try to be honest with my self as much as possible. I can do all things through Christ that strengthens me Philippians 4:13 

The Serenity Prayer 

God, grant me the Serenity 

To accept the things I cannot change… 

Courage to change the things I can, 

And Wisdom to know the difference. 

Living one day at a time, 

Enjoying one moment at a time, 

Accepting hardship as the pathway to peace. 

Taking, as He did, this sinful world as it is, 

Not as I would have it. 

Trusting that He will make all things right 

if I surrender to His will. 

That I may be reasonably happy in this life, 

And supremely happy with Him forever in the next. 

Amen.         

Even though I walk through the valley of the shadow of death, I will fear no evil for thou art with me. 

I have two: 

“Faith is being sure of what we hope for, and certain of what we do not see.”  

Hebrews 11:1 

“Life isn’t about waiting for the storm to pass…It’s about learning to dance in the rain.”  

The family certainly has an important role in facilities treatment of patients, since it can provide effective psychological and emotional support to patients undergoing treatment within any given facility. Additionally, the role of family and friends is not only important for adults but also for the younger generations. Consequently, the facilities staff needs to maintain continuous communication with parents and relatives of patients, and provide them with the appropriate information concerning the condition and progress of their loved one and how they are progressing throughout the therapeutic regime. This method will help provide more effective and holistic care support for the patient.  

How have you seen a holistic approach to incorporating family into the care process work in your own situations?  

It is true that the staff of a given facility will need to maintain continuous communication with the parents and relatives of patients concerning the progress ad and condition of the patient. However, with HIPPA nurses or staff of the facility can only provide information to relatives of the patient if the patient chooses for that information to be shared with them otherwise it will be a breach of the HIPPA law. Nurses can only share patients’ health information/condition if the patient gives permission for such information to be given to members of their family. For patients who give permission to nurses or providers to share their health information to their loved ones, it always brings about positive health outcomes when members of the family are familiar with what is going on with their loved one and are actively involved in the care of their family member.

Currently, my mother has Kaiser Permanente insurance, she lives with my older brother who is not a nurse, my brother and I are listed as her emergency contacts and care providers. She speaks very limited English and she is not health literate and she relies on me to decide and make suggestions when it comes to her health. Anytime anyone of us call to schedule her appointments, the Kaiser Rep will verify our identity and will request to put our mom on the phone as well. One of us will have to take her for her appointments and because we are involved in her care, she feels very confident and comfortable and she is satisfied with the medical care that she is receiving.  

Communication between the patient treatment facility and the family is a major source of emotional support for the family. In our NICU, parents are provided with the opportunity to watch their babies via zoom. They call whenever they want, to see their baby and they communicate with nurses about their child’s progress. They are encouraged to call for their babies around feeding times or bath times and be part of it. The parents love doing that and it gives other members of the family the opportunity to see their baby. 

That is a great response. I work in the OR and I definitely know how it is to have great communication with the patient and family. I give the family an update about the patient every hour when we start the procedure. Having communication with the family give them comfort about their family member. Had there been a time where you didn’t have a chance to communicate with the family? 

NICU is different in arrangement. Babies are in isolettes and are under observation around the clock. There are nurses at all times to attend to any need from the parents. If parents call when their baby’s nurse is not there, the charge nurse will always assist them after proper identification of course. 

Great, the family is the key to healthcare wellness for the patient, the family represents advocacy in the healthcare community, a patient who does not have family in the facility the improvement or stay in the facility is different for those who have family in the facility. As Nurses and professional providers In order to provide equity of care, we must recognize that each individual we serve has unique and diverse beliefs, cultural experiences, and needs. In addition, we must also recognize that our colleagues culturally and others we work with having culturally diverse beliefs. The most significant problem in the facility is the barriers to the delivery of culturally diverse sensitive care language barriers, one of the members of the family should be there for interpretation. Being culturally competent requires compassion and a more profound and ardent commitment to our patients, their families, and our communities. 

Family is the functional unit where life begins. Every individuals comes from a family and the love from the family cannot be compared with anyone else. As much as nurses tries to give psychological supports to patients,share information about their care, the support gotten from the family surpasses every other one. As a child, can you relate the joy you had when your parents comes to cheer you up in school during an award giving day?

The bond from the family is very strong same goes to the patient. I have nursed several patients who had a better outcome as a result of family involvement.I once nursed an 80 years old diabetic patient who kept refusing nursing care and medications despite all client educations and hence was not getting better. Surprisingly when the children got involved in the care, the patient started accepting her medications and blood sugar became controlled.I later discovered that the patient was kind of paranoid and doesn’t accept foods or drinks from strangers as she believed that her husband died from food poison given to him by his best friend. If the family was not involved in the care of the patient, she would have developed some complications  

I strive to always incorporate a patient’s family members into their care in the Emergency Department. We often encounter situations in the ED which are not true emergencies. There is often a knowledge deficit about where the patient should actually be, along the continuum of care. My role as a Case Manager is to educate the patient and family member on the level of care that they actually need, and how to obtain follow-up in the right location.  

A Holistic approach to care in the ED involves allowing family members to visit and stay with the patients. Family members can often be helpful in Advocating for the patients and assisting with basic care. This can be a wonderful opportunity to assess the skills of a family Caregiver, and to teach them new or improved skills for caring for their loved one.  

currently on the floor I work on we have a patient of a very young age that was in a trouble MVA need back surgery and is a mother to a 5yr with disabilities and 2-3 yr. topically we don’t let people under the age of 16 visit but has had the ability to see her babies while hospitalized and it gave her strength to want to therapies and her family is very supportive of her and helping with the babies , even had a family meeting ( without health care personal) about her return home and how they are going to accommodate and assist in her transition. it was really beautiful to see that everyone was trying to help instead of one family member doing it all or having to beg others to help  

Communication is so important when communicating to family members about how a certain procedure is going. I have personally used holistic techniques when I was in nursing school. In nursing care I have assisted patients in incorporating aromatherapy for holistic care. Different smells of oils takes the edge off of anxiety while getting ready to prep them for surgery.  

Incorporating touch is one holistic approach I use for my patients and their families. I encourage the partner of my patient to massage their partners back during labor, rub their feet and wipe their brow as needed. This physical touch often relaxes the patient while also comforting them, knowing someone is right by their side while they are in pain and often feel they are not in control. I also use touch when the baby is born, teaching the patient, her partner and the family that their new baby needs comfort and immediate touch, to bond and feel comforted. We do skin to skin immediately after delivery, this shows the impact of touch as it regulates the babies heart rate, temperature, respiratory rate and and overall feeling of comfort. We also encourage the patients partner to do skin to skin with their baby.  

The meaning of family has a wide variety of definitions in society. Family is the place where you can be heard and seen and feel welcome. Family is the place that you feel like you are at Home. The family is a coordinated unit which functions to influence the well-being and personal development of each member. (Sharma, 2013.) 

It is important to have a good understanding of family structures. It is important to understand the presence of non-traditional family structures, in order to assist a patient’s loved ones and provide information and support systems. It is a goal of the Registered Nurse to be non-judgmental and to point patients and families in the right direction. (Resnicow, 2012.) 

Family systems theory can be utilized to aid in the nurse’s understanding of family structures. The nurse can develop insight into the every-day functionality of families. The nurse can also identify dysfunction and interruptions in family functioning due to illness or traumatic events. The nurse can assess for adverse childhood experiences or grief issues within the family system. This leads to an increased awareness of the impact that some events may have on the entire family structure and functioning. 

Sharma, Rahul. The Family and Family Structure Classification Redefined for the Current Times. Journal of Family Medicine and Primary Care: Oct–Dec 2013 – Volume 2 – Issue 4 – p 306-310 doi: 10.4103/2249-4863.123774  

Resnicow K, McMaster F. Motivational Interviewing: moving from why to how with autonomy support. Int J Behav Nutr Phys Act. 2012 Mar 2;9:19. doi: 10.1186/1479-5868-9-19. PMID: 22385702; PMCID: PMC3330017. 

The term family has a different meaning today than in the past. Barnard (2022) defines family as “a group of persons united by the ties of marriage, blood, or adoption, constituting a single household and interacting with each other in their respective social positions, usually those of spouses, parents, children, and siblings.” Spouses and parents can be woman-and-woman, man-and-man, or they do not go by gender. Family can include others who are not blood relatives or adopted. Some consider their closest friends as family. Overall, the family is supposed to influence other family members to enhance their well-being and develop close relationships. Nurses utilize the family systems theory to understand family structures better. Nurses need to understand traditional and nontraditional family structures to provide the appropriate resources and interventions for a specific family or patient. Addressing these concerns adequately can strengthen the family dynamic and improve a patient’s outcomes.  

Reference 

Barnard, A. (2022 August 16). family. Britannica. https://www.britannica.com/topic/family-kinship  

Michelle Ball Your concept of family is really great. The family is a basic unit of study in many medical and social science disciplines. Definitions of family have varied from country to country and also within a country. Because of this and the changing realities of current times, there is a felt need for redefining the family and the common family structure types, for the purpose of study of the family as a factor in health and other variables of interest. 

Yes, the assessment by the nurse is a very integral part of understanding family structure. Not every individual, and family is the same. That is where judgment and assessment come into play. “Through assessment, we can identify the quality of family functioning, know the strength and weaknesses of the family unit and we will have a general view of the health status of family members” (nursinganswers.net, 2020, p.1)  

Reference: 

Role of nurse in family health assessments. NursingAnswers.net. (2020, October 14). Retrieved October 9, 2022, from https://nursinganswers.net/essays/role-of-nurse-in-family-health-assessment-nursing-essay.php#citethis  

Read the abstract for the article found here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5213594/  

Write anything that stuck out to you concerning the challenging interactions related to dealing with families for one minute and post it here.  

The key word that come out strongly is, “knowing the family”, this refers to our ability as nurses to assess family relationships, how each family member interacts with each other in times of support. Recognizing and interpreting nonverbal communication is key aspect during the assessment period, it helps us learn the family more. Handling oncology patients is very demanding in all aspects, especially at a family level, physically, emotionally, mentally, and financially, attending to family concerns helps them cope with the situations, especially as nurses, we are always near the patients, and act as advocates between family and providers. For a successful partnership for families to healthcare promotions, interviewing them is key. ( McLeod et al., 2010) 

Barriers to engagement of families is the topic that I found to have the greatest impact. It is important for the nurse to identify barriers that exist within the family Caregiving structure, such as poor-functioning skills or issues with family dynamics. I also think that it is important for the nurse to anticipate specific barriers that may come up for patients and families. Identified barriers may include educational level, stress level, coping skills, concern for other family members, resources, communication, and team work. The nurse can assist a family with forming an “early alliance” and assist them with working in a functional way, together. (Zaider, et al, 2016.) 

Zaider TI, Banerjee SC, Manna R, Coyle N, Pehrson C, Hammonds S, Krueger CA, Bylund CL. Responding to challenging interactions with families: A training module for inpatient oncology nurses. Fam Syst Health. 2016 Sep;34(3):204-12. doi: 10.1037/fsh0000159. PMID: 27632541; PMCID: PMC5213594. 

When I read the abstract from the link posted was came to my mind is how nurses deal with patients and their families in hospice care setting. Imagine how nurses will have to deal with patients who have received the bad news on the prognosis of their ailment and have to be put on hospice care; and their family members. In most cases, if the patient is the bread-winner of the family, the situations get even muddier.

Nurses will have to deal with the patient going through the stages of grief as well as their family members. The stages of grief as advanced by Kubler-Ross denial, anger, bargaining, depression and acceptance and at each stage, the patients and their family members will exhibit behaviors that the nurses will have to deal with. As nurses how can we deal with grieving family members? How can I tell a young patient’s wife that everything is ok when we know that everything is not ok.  

What stuck out to me was labeling the patient’s family as “difficult” without considering the family dynamics and the situation surrounding the patient’s hospitalization. The most for me is the escalation challenge when a nurse is experiencing difficulty performing a procedure on the patient even though she has explained the procedure to the patient and their family and is being placed under undue pressure by the impatience of the family members of the patient as they want the best care for their member.

This further puts the nurse on edge and causes him/her to be defensive and thus label the patient’s family member difficult. To the nurse, the patient’s family members are just waiting for her failure and are looking for any opportunity to explode on her, whereas it could be that they are scared for their family. The nurse needs to have an understanding of the patient as well as the family dynamics and emotions to offer the most appropriate care for both patient and the family members. 

During the time that I spent reading the abstract, the concept of assessing the “emotional temperature” kept popping into my head as the most important term. This helps to raise awareness among nurses about the need to maintain emotional vigilance whenever they are interacting with a patient’s family. In order for nurses to effectively react to stressful situations, the goal of this method is to give them the ability to take a moment for themselves and focus on how they are coping with their own stress. Appreciative listening is a skill that nurses are strongly urged to develop, and they should try to resist the natural urge to find solutions to problems. 

“I took care of someone whose parents were on two different ends of the spectrum. The mom wanted to keep fighting and kept thinking that the patient was coming around and making improvements even though he was terminal, and the dad was grasping the reality of the situation.” this quote stuck out to me because its a good reminder to take an extra five minutes to debrief from a rude patient or family member’s comments and investigate their true frustrations. It really help in gaining trust an makes the rest of their hospitalization smoother.  

This article is actually very relatable as I work in a mixed oncology unit and as of late I have been getting the change to take care of patients who are unfortunately approaching the last stage of their treatment and/or have a poor prognosis. I always struggle to make that connection with the family it is always a tough time for anyone seeing their loved ones in a state of such poor health and there are so many care team members coming in like palliative, the oncology team and many more so you get lost in the midst of it. For me I try to create talk with the family and participate in active listening when I can but also working the nightshift there are less resouces to call upon, for example during the day there is chaplain and religious services that you can call upon and help put the family at somewhat ease during a troublesome time.  

What struck out to me most is acknowledging the emotions of the family. Most times we have patients and families who tends to be very difficult especially when there is a poor outcome. We should see these emotions as a grieving process and try to acknowledge them as normal rather than seeing the family as been difficult. We try to build trust and empathy as well as having good interpersonal relationship with the family. Explain care and procedures to family and involve them in the car of the patient