LEC 2: Family Nursing Flashcards

1
Q

Family Nursing

A

The process of providing for the healthcare needs of families that are within the scope of nursing practice. This nursing care can be aimed towards the family as context, the family as whole, the family as a component of society.

  • Hanson, 2005
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2
Q

What is family nursing?

A
  • Is a specialty area that cuts across the various other specialty areas of nursing
  • Highly contextual
  • Relational practice
  • Skills-based practice in which nurses face complex clinical situations
    • With these situations, nurses need to simultaneously attend to the needs of multiple family memebrs and complex environments, as well as the family unit.
      • RNAO, 2006
  • Familly assessment and intervention in partnerships and collaborations
  • The nurse needs to meet the family where they are at; are improving the quality not trying to fix things.
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3
Q

What is the goal of family nursing?

A

The goal is to help the family and its individual memebers achieve and maintain optimal health throughout the illness and beyond.

  • West and Jajubec, 2014
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4
Q

Family nursing has roots in what?

A
  • Community nursing
  • Maternal-child nursing
  • Nurse midwifery
  • Public health nursing
  • Psychiatric or mental health nursing
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5
Q

Is family health nursing synonymous with community health or mental health nursing?

A
  • Family health nursing builds on theories and research from deciplines such as family science and health promotion.
  • Bomar (2004) defines family health nursing as nursing actions directed towards improving the quality of family existence by strengthening and collaborating with families.
    • ​The comments on the assumed characteristic of the relationship between nurse and family which is collaborative.
    • This comments on the objective or focus of family health nursing which is positive and strength based and primary prevention based.
    • This comments on the assumed characteristics of the relationship between nurse and family which is collaborative.
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6
Q

What dose contextual factors include?

A
  • Personal elements such as gender and abilities
  • Sociopolitical aspects such as economic, cultural, historical, and geographical
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7
Q

What is rational practice?

A

Rational nursing practice is an understaniding of patient’s healthcare needs within complex context, in which patient experience healthcare and nurses deliver nursing care.

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8
Q

What is family health?

A
  • Health is a dynamic changing state of well-being
  • It includes biological, spiritual, sociological, and cultural factors
  • It affects individual members and whole family systems
  • Definitions are often realted to:
    • Family structure and functioning
    • Family physical and mental wellness
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9
Q

What do nurses need to think about when it comes to family health?

A
  • How families are organized
  • How the family functions or what they do
  • How the family manage over time
  • How the family rate, cope, change, and grow
  • Need to think about interaction, development, coping, structure, historical narrative, and style of family life
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10
Q

How do families affect eachothers health?

A
  • Establish health promotion behaviors
  • Define illness
  • Confirm validity of illness experience
  • Initate treatment
  • Influence outcomes
  • Foster resolution and/or adaptation
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11
Q

What are the assumptions that are made in family nursing?

A
  • Family is a basic unit of our society
  • Family is an efficient way to deliver care to people
  • Individuals are best understood in their social context which is their family
  • Identification of actual or potential needs for one member will lead to detection of needs in other memebrs (reciprocity in effect)
  • Clarity with one affect clarity for whole
  • Health promotion for one member increases the health of others
  • A families’ decision about healthcare is influenced by many variables
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12
Q

What is the reciprocity effect?

A
  • What happens with on happens to all
    • Identification of actual or potential needs for one member will lead to detection of needs in other memebers
    • Nurses examine individual diversity and how family diversity influences the individual and vice versa
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13
Q

What is the role of the family in family nursing?

A
  • Decisions are made independently of the nurse
  • Transformation happens when family has authority
  • Families will engage in health behaviours that are relevant and pertinent to their family life and context
  • All families have the capacity to transform their quality of life and family health
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14
Q

What is the nurses role in family nursing?

A
  • To lisen, facilitate change, and empower the family
  • Peopel continually and actively reauthor their lives and stories. Our commitment to families is to show curiosity, delight, interest, and appreciation for their strengths, resources, and resiliency
    • Wright and Leahey, 2013
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15
Q

What is family diversity about in family health?

A
  • It is about recognizing and embracing the uniqueness of each family that we encounter in our nursing practice.
  • They key is to understand that within one family there is internal diversity.
  • Each family we work with is different than the one before.
    • Internal: within the family form, nor one family is the same as another.
    • Between: between family form, no two nuclear families are the same.
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16
Q

What are the four appraoches to family nursing practice?

A
  1. Family as context
  2. Family as client/patient
  3. Family systems nursing
  4. Family groups in society
  • Each appraoch has its roots in different specialities within the nrusing profession
  • Apprach used is determined by many factors, including healthcare setting, family circumstances, and nurse resources.
17
Q

Family Nursing Practice: Family as Context

A
  • The focus is on assessment and nursing care of an individual and the family as context of the individual.
    • Family can be viewed as a stressor or a resource
    • Family involvment vaires
  • It takes a patient focused perspective
    • Nursing care focuses on the individual as the client
    • Traditionally this person is our main focus and the family comes second
  • Most nursing specialties vew families in this way: family is the social environment for an individual or a resource for the individual client
18
Q

Family Nursing Practice: Family Unit as Client/Patient

A
  • Focus is on entire family; it is the assessment of all family memebrs
  • Family is seen as the sum of its memebrs
  • Memebers: separate rather than interacting units- all are assessed
  • This appraoch sees the family as the sum of the parts
    • Focus is on strengthening the family unit
    • RN assess the whole
    • Family is seen as the sum of all individuals
    • Everyone is equally important
  • Mainly used by general practitioners/primary care settings
    • Care is provided to all family members over time)
19
Q

Family Nursing Practice: Family Systems Nursing

A
  • Family is the client, viewed as an interactional system, reciprocity, impact
  • Recognizes the system is more than the sum of its parts because the interactions happen in and to, from external froces
  • It recognizes the family system is more dynamic becuase of the impact and reciprocal nature of the interactions from the external forces
  • There is focus on the family as a whole system and the individual members as parts of the system which also shape the system
  • The family memebrs interact, so the nurse can anticipate that when something happens to one member the other members in the family will be affected and the whole is affected/changed
    • Interaction and reciprocity are key ideas
    • Family is the client
    • Interactions between family memebrs is the target for nursing interventions
    • RN assesses interactions, relationships, and reciprocity
    • Need for interventions arises when conflict of change in family system arises
20
Q

Family Nursing Practice: Family Groups in Society

A
  • Families are a subsystem of larger systems in the community, society, common issues, and trends
  • Family is seen as a basic component of society
  • The family unit is the background and the aggregate issues are in the foreground
  • Family inteacts with other units to receive, exchange, and give communication and services
  • RN focuses on linking family with community supports and agencies
21
Q

What are the 3 levels of nursing practice with families?

A
  1. Generalist (Baccalaureate): Family as context, family-centered care
  2. Specialist (Masters): Family as unit, family systems nursing
  3. Doctoral level: Family research
22
Q

Approaches/ Levels of Nursing Practice with Families

A
  • Education for family nursing begins during undergraduate nursing education and may continue through post doctoral training
  • In the area of generalist vs. specialist, the nurs who views the family in context could be a generalist in family nursing and a specialist in another filed of nursing
  • A nurse who practices family nursing are specialist in family care and generalist in other areas of nursing
23
Q

Levels of Nursing Practice with Families: Generalist (Baccalaureate)

A
  • Family as context, family-centered care
  • At the baccalaurate level, students should receive preparation for working with family as context and the family as a component of society
  • This is consistent with the generalist orientation of undergraduate nursing education
24
Q

Levels of Nursing Practice with Families: Specialist (Masters)

A
  • Master’s level preparation is required for specialty practice in family nursing such as working with the family as a client or the family as a system.
  • This preparation consists of courses pertaining to family theory, nursing interventions with families, advanced practice, and clinical supervision
  • Master’s preparation has a clinical specialty focus
25
Q

Levels of Nursing Practice with Families: Family Research (Doctoral Level)

A

Doctoral and post-doctoral education in nursin is usually on family theory development and research and family nursing.

26
Q

What are the roles found in family nursing?

A
  • Health educator
  • Care provider
  • Family advocate
  • Case finder and epidemiologist
  • Researcher
  • Manager and coordinator
  • Counselor
  • Consultant
  • Environment modifier
27
Q

What is the nurse’s role as a health educator?

A

Teaching families formally or informally about health and illness and acting as the main provider of health information.

28
Q

What is the nurse’s role as a care provider and supervisor?

A

Providing direct care and supervising care given by others, including family members and nursing assistants.

29
Q

What is the nurse’s role as a family advocate?

A

Working to support families and speaking up on issues such as safety and access to services.

30
Q

What is the nurse’s role as a case finder and epidemiologist?

A

Tracking disease and playing a key role in disease surveillance and control.

31
Q

What is the nurse’s role as a researcher?

A

Identifying practice problems and seeking answers and solutions through scientific investigation alone or in collaboration.

32
Q

What is the nurse’s role as a manager and coordinator?

A

Managing, collaborating, and liaising with family members, health and social services, and others to improve access to care.

33
Q

What is the nurse’s role as a counselor?

A

Playing a therapeutic role in helping to cope with problems and to identify resources.

34
Q

What is the nurse’s role as a consultant?

A

Serving as consultant to families and agencies to identify and facilitate access to resources.

35
Q

What is the nurse’s role as a environmental modifier?

A

Working to modify, for example, the home environment so that the disabled can improve mobility and engage in self-care.

36
Q

What are the obstacles to family nursing as a specialty?

A
  • Lack of literature
  • Lack of comprehensive family assessment models
  • It’s just “common sense”
  • Historical ties with medical model
  • Traditional charting systems
  • Diagnosis system
  • Healthcare service hours