How to Do a 15-Minute

Question 1

Reason nurses offer for not routinely involving families in their practice

Answer 1

–I don’t have time to do family interviews”
–time is of the essence in nursing practice
–nothing meaningful can be accomplished in one meeting with a client.

Question 2

Facilitating beliefs

Answer 2

Illness is a family affair

Conversations with patients and families about illness experience can contribute to healing, diminish suffering

Nurses can involve and assist families in care

Question 3

when nurses do not include family members in their practice, some very constraining beliefs usually exist

Answer 3

• If I talk to family members, I will not have time to complete my other nursing responsibilities.”
• “If I talk to family members, I may open up a can of worms, and I will have no time to deal with it.”
• “It is not my job to talk with families; that is for social workers and psychologists.”
• “I cannot possibly help families in the brief time I will be caring for them.”
  If the family becomes angry, what would I do?”
• “What if they ask me a question and I do not have the answer? What would I do? It is better not to start a conversation.”

Question 4

5 Key Ingredients

Answer 4

Therapeutic conversations
Manners
Family genogram
Therapeutic Questions
Commending Strengths

Question 5

Therapeutic conversations

Answer 5

• is purposeful and time-limited
• can be as short as one sentence or as long as time allows
• potential for healing through the very act of bringing the family together

Question 6

Manners

Answer 6

are simple acts of courtesy, politeness, respect, and kindness

Question 7

absence of manners

Answer 7

• nurses who do not introduce themselves to their patients or patients’ family members
• Not referring to the patient by name
  labeling the patient or family difficult,
• Providing care without encouraging participation by the patient or family,
• not talking or making eye contact

Question 8

Examples of good manners that invite a trusting relationship are:

Answer 8

1. Always call patients and family members by name.
2. Always tell the patient and family members your name.
3. Explain your role for that shift or meeting or any encounter with the patient and/or family.
4. Explain a procedure before coming into the room with the equipment to do it.
5. If you tell the patient or a family member that you will be back at a certain time, attempt to keep to that time or provide an explanation about why it didn’t occur.

Question 9

Therapeutic Questions

Answer 9

We encourage nurses to think of at least three key questions that they will routinely ask all families
Common themes
– sharing of information
– Expectations of hospitalization
– clinic or home-care visits
– challenges
– sufferings,
– most pressing concerns or problems

Question 10

commendations

Answer 10

are observations of behavior that occur across time
Ex. “Your family is showing much courage in living with your wife’s cancer for 5 years.”

• Families who internalize commendations offered by nurses appear more receptive and trusting of the nurse–family relationship
• Strengthen working relationship
• May change family’s view of self, increase moves to solution

Question 11

overall framework for ritualizing a 15-minute

Answer 11

1. Begin a therapeutic conversation with a particular purpose in mind that can be accomplished in 15 minutes or less.
2. Use manners to engage or reengage. Introduce yourself by offering your name and role. Orient family members to the purpose of a brief family interview.
3. Assess key areas of internal and external structure and function— obtain genogram information and key external support data.
4. Ask three key questions of family members.
5. Commend the family on one or two strengths.
6. Evaluate usefulness and conclude.

Question 12

three errors that we believe occur most frequently in relational family nursing practice

Answer 12

1. Failing to create a context for change
2. Taking sides
3. Giving too much advice prematurely

Question 13

before a context for change can be created, ________

Answer 13

all obstacles to change must be removed
Ex. a family member who does not want to be present or attends the session under duress

Question 14

Study: three families who reported negative responses

Answer 14

• Curiosity was absent on the part of the nurse interviewer
• nurse interviewer paid no attention to how the intervention “fit” the family’s functioning
• did not ascertain from the family if the intervention ideas offered were useful.
• clinical nursing team becoming too “married” to a particular way of conceptualizing the family’s problems or dynamics

Question 15

How to Avoid Failing to Create a Context for Change

Answer 15

1. Show interest, concern, and respect for each family member.
   – invite to a family meeting anyone who is involved with or concerned about the problem or illness
2. Obtain a clear understanding of the most pressing concern or greatest suffering.
   Seek each family member’s perspective on the problem/illness
3. Validate and acknowledge each member’s experience.
   no one view is the correct
4. Acknowledge suffering and the sufferer.

Question 16

How to Avoid Taking Sides

Answer 16

1. Maintain curiosity.
   Be intensely interested in hearing each person’s story
2. Remember that the glass can be half full and half empty simultaneously
   There are multiple truths and therefore many ways to view a problem or illness
3. Ask questions that invite an exploration of both sides of a circular, interactional pattern
4. Remember that all family members experience some suffering when there’s a family problem or illness.
5. Give relatively equal “talk time” and interest to each family member.
6. Remember that information is, as Bateson (1972) described it, “news of a difference
   Treat all information as new discoveries
7. Try not to answer phone calls or have “side conversations” involving one family member “telling on” another family member.
   Invite the person to bring the issue to the next family meeting

Question 17

How to Avoid Giving Too Much Advice Prematurely

Answer 17

1. Offer advice, opinions, or recommendations only after a thorough assessment has been done and a full understanding of the family’s health concern or suffering has been gained and acknowledged
   Otherwise, advice and recommendations can appear too simplistic, patronizing
2. Offer advice without believing that the nurse’s ideas are the “best” or “better” ideas or opinions
3. Ask more questions than offering advice during initial conversations with families.
4. Obtain the family’s response and reaction to the advice.

Question 18

what is the near enemy of connection

Answer 18

control (we want to fix things but we need to hear their story , we need to help them decide how to move forward)