Class 7 - Communication with Clients and Families about Loss and Grieving Flashcards
How can I as a nurse help orient the family?
Nurse-client relationship - reciprocal relationship between nurses & family (equal partners & sources of information.
Nurses offer information to family as soon as client is admitted.
Show the families around the unit, cafeteria, restrooms, parking options, nearby lodging, access to physicians etc., routines, processes.
Initial encounter sets the tone for the relationship.
Begin with formal introductions.
Explain the purpose of gathering assessment data.
Listen carefully for family expectations & general anxiety that may be revealed more through behaviour than through words.
What kind of questions could you ask to help gather assessment data on a pt?
Inquire about the relationship the family has with client.
Ex, “I would like to understand more about the effect of your husband’s heart attack on the family.”
Inquire about: the Family’s cultural identity
Rituals, Values, Level of family involvement, Decision making
Traditional behaviours, related to health care of client
What are some questions the you could ask to gather assessment data?
How does the family view the current health crisis?
What is each family member’s most immediate concern?
Has anyone else in the family experienced a similar problem?
What do family members believe would be most helpful to the client at this time?
How does the family explain the reasons for the illness or injury?
Is there anything else I should know about your family & this experience?
How has the family handled the problem to date?
What types of questions could you ask in the planning stages
Therapeutic questioning
Circular questions: focus on family interrelationships and the impact a serious health alteration has on individual family members and the family system.
What are some nursing actions that could help to promote positive change in family functioning?
Encouraging story telling of the illness
Commending family & individual strengths
Offering information & opinions
Validating or normalizing emotional responses
Encouraging family support
Supporting family members as caregivers
Encouraging respite
What kind of informational support can be provided to families?
Helping a family become aware of information from the environment & how to access it empowers families.
Providing information related to talking with extended family, children, & others about the client’s illness.
You can help family members prepare questions for meeting with physicians.
Engage families in discussions about the cultural, ethical, & physical implications of using or discontinuing life support systems
What are three benefits to family involvement when a client is ill?
Involvement with patient care
Increased family communication
Decreased number of complaints
What are some ways that nurses can involve the family in the care of their loved one?
Range-of motion exercises
Holding client’s hand
Positioning pillows
Providing mouth care or ice chips
Talking with client, even if client is unresponsive
Also need encouragement to take time for self, regroup, recharge. (respite)
You are a role model for communication, using caring words, touch, etc.
If a pt is unresponsive families have a fundamental need for more informatio. What can the nurse do to help with this?
Provide updated information as clinical situation changes is critical.
Expect to repeat information, because of anxiety that may limit processing of complex or emotionally difficult information.
Use simple & understandable terms
Answer questions honestlyThe family needs to feel some hope & that staff genuinely care about what is happening with the client & family.
Having one family member as the primary contact helps ensure continuity between staff & family.
Phone call to update status when family can not be present reduces family stress
Families need ongoing info on client’s progress, modifications in care, any changes in expected outcomes.
Allow opportunity to ask questions and clarify information
What can the nurse do to provide caregiver support?
Provide emotional support
Remain aware of one’s own values, staying calm and thoughtful can be helpful to a family in crisis.
Your words can either strengthen or weaken a family’s confidence in their ability to care for an ill family member.
Families can experience conflicting emotions (compassion, protectiveness, and caring mingled with feelings of helplessness & being trapped or even guilt.)
Geographic proximity may put pressure on some family members.
Criticism or advice from less involved family members can create rifts.
Some begin mourning for their loved one wishing it would all end & then feel guilty about those thoughts.
Listening to family feelings & struggles without judgement can be the most healing intervention you can provide.
Nurses can normalize negative feelings by offering insights about common feelings associated with chronic illness.
