Topic 12 Flashcards
Family durability
System of support and structure within a family that extends beyond the walls of the household
family resiliency
ability to cope with expected and unexpected stressors
family diversity
Uniqueness of each family unit
what is the goal of family centered nursing
to address the comprehensive health care needs of the family as a unit; and to advocate, promote, support, and provide for the well-being and health of the patient and individual family members.
what is the defintion of a family?
-The family can be defined biologically, legally, or as a social network with personally constructed ties and ideologies.
-No two families are alike; each has its own strengths, weaknesses, resources, and challenges.
what are 5 trends that are threats/concerns for families
o (1) changing economic status
o (2) homelessness
o (3) domestic violence
o (4) the presence of acute or chronic illnesses or trauma
o (5) end-of-life care.
what are factiors that influence family forms
-family caregivers
-poverty
-homelesness
-domestic violence
the structure of a family is based on…
the ongoing membership of the family and the pattern of relationships
rigid family sturctures
specifically dictate who accomplishes different tasks and also limit the number of people outside the immediate family allowed to assume these tasks.
extremely flexible family structures
There is sometimes an absence of stability that would otherwise lead to automatic action during a crisis or rapid change.
family nursing is based on the assumption that…
all people, regardless of age, are members of some type of family.
A nurse can view the family in three ways: as _____, as _____, or as ______.
as context, as the patient, or as a system
Family as context
primary focus is on the health and development of an individual member existing within a specific environment
-Although the focus is on the individual’s health status, assess how much the family provides the individual’s basic and psychological needs.
family as patient
the family processes and relationships are the primary focuses of nursing care.
-Focus your nursing assessment on family patterns rather than the characteristics of the individual members.
family as system
Remember that looking at the family as a system requires that you look at the family as context and as patient. These two perspectives are not mutually exclusive. You may use them simultaneously.
-Both family members and family unit
family forms
patterns of people considered by family members to be included in the family
nuclear family
Consists of husband and wife (and perhaps one or more children). living as one unit
extended family
includes relatives (aunts, uncles, grandparents, and cousins), in addition to the nuclear family.
single-parent family
a family in which only one parent is present to care for the children
-Is formed when one parent leaves the nuclear family because of death, divorce, or desertion, or when a single person decides to have or adopt a child.
blended family
Is formed when parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation.
-consists of a biological parent, a stepparent, and the children of one or both parents
alternative family
Relationships include multi-adult households, “skip-generation” families (grandparents caring for grandchildren), communal groups with children, “nonfamilies” (adults living alone), and cohabitating partners.
family heath system (FHS)
a holistic model that guides the assessment and care for families. It includes five realms/processes of family life: interactive, developmental, coping, integrity, and health.
Genetic factors reflect a family’s…
heredity or genetic susceptibility to diseases that may or may not result in actual development of a disease.
how can acute/chronic illness influence a family?
economically, emotionally, socially, and functionally and affects the family’s decision making and coping resources.
what is essential to provide individualized patient/family-centered care?
Incorporating the patient’s and family’s cultural beliefs, values, and communication patterns
trauma
sudden, unplanned, and sometimes life threatening event
end of life care
the support and care given during the time surrounding death
The five areas of family life to include in an assessment are…
interactive, developmental, coping, integrity, and health processes of the family
If a patient has been hospitalized or is in a rehabilitation setting discharge planning begins…
with the initiation of care and includes the family
Calgary Family Assessment Model
Focuses on interactions among the individuals in the family
-famuly assessment questions include: family structure, developmental assessment, and family functioning
Family caregiving
o The routine provision of services and personal care activities for a family member by spouses, siblings, friends, or parents
Family caregiving activities include…
include finding resources, providing personal care, monitoring for complications or side effects, providing instrumental activities of daily living and ongoing emotional support and decision making
the nurse as an educator
Your focus as an educator may be on the family caregiver, to prepare that person to manage the skills and processes needed to manage the patient’s needs within the home.
caregiver burden
stress responses experienced during prolonged periods of home care by family caregivers
restorative and continuing care: family
-Maintain patients’ functional abilities within the context of the family.
-Make sure home environment will accommodate a patient’s strengths and limitations.
-Show how to perform aspects of physical care.
autonomy
Refers to the commitment to include patients in decisions about all aspects of care as a way of acknowledging and PROTECTING A PATIENTS INDEPENCENCE. Involving patients in decisions about their care is now standard practice.
what are providers legally obligated to inform patietns about?
risks and benefits of treatment plans and then to enste that they indtertans and agree with their plan
beneficence
doing good, Implies that the best interests of the patient remain more important than self-interest, taking positive actions to help others
nonmalefiecence
Avoidance of harm or hurt.
-(not only the will to do good, but an equal commitment to do no harm)
justice
refers to fairness
fidelity
As a nurse, you keep promises by following through on your actions and interventions.
-also refers to the unwillingness to abandon patientsregardless of the circumstances, even when personal beliefs differ
just culture
refers to the promotion of open discussion without fear of recrimination whenever mistakes, especially those involving adverse events, occur or nearly occur.
Code of nursing ethics
o A set of guiding principles that all members of a profession accept
o Helps professional groups settle questions about practice or behavior
o Includes advocacy, responsibility, accountability, and confidentiality
social networking and nursing
-risk to patient privacy is great
Advocacy
refers to the support of a particular cause. As a nurse you advocate for the health, safety, and rights of patients, including their right to privacy and their right to refuse treatment.
Responsibility
refers to willingness to respect obligations and to follow through on promises.
Accountability
refers to the ability to answer for one’s own actions.
Standards are set by The Joint Commission and the ANA
Health care facilities have compliance officers who are responsible for making sure that the institution remains in compliance with standards and regulations.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
mandates protection of the patient’s personal health information.
value
a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior.
Ethical dilemmas almost always occur in the presence of…
conflicting values
Clarifying values
is an important and effective part of ethical discourse. In the process of values clarification, you learn to tolerate differences in a way that often (although not always) becomes the key to the resolution of ethical dilemmas
Deontology
Defines actions as right or wrong based on their “right-making characteristics,” such as fidelity to promises, truthfulness, and justice.
Utilitarianism
ethics proposes that the value of something is determined by its usefulness. The greatest good for the greatest number of people is the guiding principle for determining right action in this system.
-because its main emphasis is on the outcome or consequence of an action
feminist ethics
focuses on the inequality between people
ethics of care
Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives
Casuistry, or case-based reasoning
Turns away from conventional principles of ethics as a way to determine best actions and focuses instead on an “intimate understanding of particular situations.” This approach to ethical discourse depends on finding consensus more than an appeal to philosophical principle.
what are teh 7 steps that will guide you thorugh an ethical dilemma
Step 1: Ask if this is an ethical dilemma.
Step 2: Gather all relevant information.
Step 3: Clarify values.
Step 4: Verbalize the problem.
Step 5: Identify possible courses of action.
Step 6: Negotiate the outcome.
Step 7: Evaluate the action.
Nursing colleagues
listen to the problem, offer alternative actions, and help you articulate the issue. Giving and receiving support from other nurses promotes a positive work environment
Nurse leaders
may include a preceptor, charge nurse, manager, educator or advanced practice RN. They may have faces and manages similar situations and so have guidance to offer, They can also access other resources withing the hospital.
Members of the interprofessional team
includes physicians, social workers, therapists pharmacists, and chaplains. All may be interacting with the patient or aware of the situation that you are facing. Hearing their perspectives can help you to identify the problem and consider solutions.
Consultation services
may include ethics committees and palliative care specialists
Professional organizations
often set standards for nursing practice and have web-based resources to help you develop knowledge and skills in ethical analysis
Boards of Nursing
can help address questions about scope of practice and competency
Ethics committees
-present in majority of hospitals and home health agencies usually multidisciplinary and serve several purposes: education, policy recommendation, and case consultation.
