LEC 4: 15 Minute Interview

Question 1

What are the considerations to think about when interviewing families?

Answer 1

• Maximize your time-effectivness (listen lots, talk less)
• Strengths and problems focused
• Multiple realities, openness to differences, and diversity
• Skills and competencies need time to be developed (labs, clinical work, writing)

Question 2

When working with families it is important to:

Answer 2

• Listen to the patient’s perspective of the family
• Use different theoretical appraoches for each individual family
• Verbalize how their family functions
• Validate your oservations
• Decide on a plan to help them function better

Question 3

Why use the 15-minute interview?

Answer 3

• Time of essence
• Changes in healthcare delivery
• Buget constraints
• Increased acuity
• Staff shortages
• Need to capitalize on moments to interact with families
  
  • Family nursing knowledge easily and effectively applied in very brief family meetings can be beneficial
  • Puproseful, informative, and restorative
  • Even if short, some involvment is better than no involvment

Question 4

What are the key ingredients to the 15-minute interview?

Answer 4

• Therapeutic conversation
• Manners
• Genograms and ecomaps
• Therapeutic questions
• Commending family strengths

Question 5

Ingredient #1: Therapeutic Conversation

Answer 5

• Purposeful and time-limited
  
  • What might the purpose be?
• Act of listening
  
  • Am I a good listner
  • Do I pick up on all the ques
• Potential for healing as they bring family together
• Potential for healing as they bring family together
• Every minute is a potential opportunity for patient and family members to be acknowledged and affiremd
• Critical distinction between time effective 15 min interview vs. social interaction

Question 6

Ingredient #2: Manners

Answer 6

• Simple acts of courtesy
  
  • Politeness
  • Respct
  • Kidness
• Introductions
  
  • Explain role, procedure, use names, speaking directly to patients/family, eye contact, encourage participation
• Why do we care?
  
  • Contributes to the growth of a trusting relationship
  • Not attending to these things can damage the relationship with a patient/family
• Do what you say you are going to do, when you say you’ll do it

Question 7

Ingredient #3: Genograms and Ecomaps

Answer 7

• Genograms are very important if you are caring for patients for more then on day
• Good starting point
  
  • Engages the family, gives you a starting point, groundwork and familiarity
• Essential information
  
  • Identify individuals, ages
  • Occupations/school grade
  • Religion, ethnic background
  • Current health status of all members/concerns
• Keep in mind what is immediately relevant
  
  • ​Not the time to delve into siblings divorces or grandchildren not necessary unless it immediately relates to the family of the health situation
  • Assists in developing relationship as RN is asking about entire family and communication belief that illness is a “family experience”

Question 8

Ingredient #4: Therapeutic Questions

Answer 8

• Utilize linear, circular, and interventive questions
  
  • Focus on the most pressing concerns
• Think of at least 3 questions you will routinely ask to involve family memebrs
• Basic thems to address:
  
  • Sharing of information
  • Expectation of hosptalization
  • Clinic or home care visits
  • Challenges, suffering
  • Most pressing concerns or problems

Question 9

What are some examples of key therapeutic questions?

Answer 9

• Who do you belive is suffering the most?
• Who is most excited about the future?
• What has been the most and least helpful to you in past hospitalizations?
• What is the greatest challeng facing your family right now?
• What is one question you would like most to have answered during our meeting? I may not be able to answer this question at the moment, but will do my best or will try to find the answer for you.
• Help me understand waht that is like for you?

Question 10

Ingedient #5: Commendations

Answer 10

• Positive statments about family strengths, resources, or competencies
• Internalized by the family- may affect a families engagment

Question 11

What is the difference between a commendation and a compliment?

Answer 11

• Commendation: Observation of behavior across time/patterns of behavior
• Compliment: Observation of a one-time occurence

Question 12

Why is it important to provide commendations?

Answer 12

Internalized by the family; may affect the families engagment, uptake, utilization of resources, also helps the family to view themselves differently.

Question 13

Aesthetic Talent, Relational Skills, and Authenticity

Answer 13

• Be a family strengths detective
• Ensure that there is enough evidence for the commendation
• Offer a commendation (if possible) within the first 10 minutes of your interaction, and at the end of your interaction, before offering opinions- may increase the receptivity of the family

Question 14

Overview of the 15 Minute Interview

Answer 14

• Begin a therapeutic conversation with a purpose
• Use manners to engage and re-engae, introduce purpose of the 15 minutes
• Assess key areas of internal/external structure and function
• Ask 3 questions of family members
• Commend the family on 1-2 strengths
• Evaluate usefulness and conclude

Question 15

What are the 3 most common erros in family interviewing?

Answer 15

1. Failing to create a context for change
2. Taking sides
3. Giving to mich advice prematurley

Question 16

Error #1: Failing to Create a Context for Change

Answer 16

• In creating this context for change, both the nurse and family undergo change
• A context for change is the central foundation of therapeutic process
• All obstacles to change must be removed

Question 17

How do you avoid failling to create context for change?

Answer 17

1. Show interest, concern, and respect for each family member
2. Obtain a clear understanding of the most pressing concern or greatest suffering
3. Validate each member’s experience
4. Acknowledge suffering and the sufferer

Question 18

Error #2: Taking Sides

Answer 18

• Most common error
• Most often done unintentionally
• Results in some family memebers feeling disrespected, disempowered, non-infuential

Question 19

How can you avoid taking sides?

Answer 19

1. Maintain curiosity
   
   • There are multiple truths
2. Remember that the glass can be half full and half empty at the same time
3. Ask questions that invite an exploration on both sides of a circular interactional process
   
   • Explore circularity
4. Remember that all family members experience some suffering when there is a family problem
5. Give equal time and interest to each family member
6. Remember that information is news of a difference
7. Avoid allowing family members to tell on others
   
   • Avoid side conversations

Question 20

Error #3: Giving too Much Advise Prematurley

Answer 20

• Why is this a problem?
  
  • Nurses are in a socially sanctioned position that involves offering advice, information, opinions
  • Families are often keen and receptive to nurse’s knowledge
  • Timing and jugment are critical in deciding when, how, and what type of advice is offered

Question 21

How can you avoid giving premature advice?

Answer 21

1. Offering advice, opinions or recommendations only after a thorough assessment has been done and a full understanding of the family’s health concern or problem has been gained
2. Offering advice without believing that the suggestions are the best ideas or opinions
3. Asking more questions than offering advice during initial conversations
4. Obtaining the family;s response and reaction to the advice