Family nursing is still seen as a fairly new specialty area in nursing. There has been discussion to define what family nursing is and what role family and nursing play in this matter. The consensus is that all definitions have as core concepts the notion of providing nursing care to families and family members (Braun & Foster, 2011). Nurses have realized what an important role that families can play in promoting positive health outcomes by getting them involved in patient care. With that said families are seen in the context as how the nurse sees them and works with them.There are several definitions and concepts of family and they are believed to contribute to education, research and theory. Family Concepts The first concept seen is family as context. The patients care is individually focused and the family is seen as a resource but also can be seen as a stressor. The patient is seen as the primary focus and the nurse includes the family if she sees it to be of value and beneficial to the patient as a resource. In regards to promoting health with this type of nursing the patients family becomes involved if the nurse sees it as a benefit and if so they can help the family and be a good resource for them.
The second concept that is seen is family as sum. In this type of nursing the whole family is treated and when they have all been treated then care has been provided. Health promotion has been met when care is provided to all family members. The third concept is family subsystems which is the basis for interpersonal family nursing. Examples of this type of nursing would be marital relationships and care giver issues. The fourth concept is family as the client. The patient is the whole family and that is what the focus is about. Family dynamics and relationships are examined along with the outer environment.
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The last concept is family as a component of society. The family is seen as one subsystem within a larger one such as a community or society similar to an educational or religious institution (Friedman, Bowden, & Jones, 2003). Family can also be seen and described in other non-traditional manners. The term family takes on new meaning and is no longer considered the traditional mother and father roles. The new family unit may consist of single parents, divorced, gay, two female or two male parents but regardless of the mixture it is still a family unit that nursing has to learn to work with.
The organizational changes put demands on professionals, such as nurses, but also demand an active participation by the family. Thus, nurses have to find new perspectives for their role and to create new ways for collaborating with their patients/families (Braun & Foster, 2011). The nurse’s challenge will be to learn what is necessary and meet the needs of this non-traditional family. The educational needs and resources are focused in a different direction but the family still has the same needs of a traditional family. Family in and Around Home
Family in this area is considered family as context where the patient is the main focus. If the nurse sees that the patient’s family is needed as a resource then they are contacted. Sometimes if the family is seen as a road block then the nurse may opt to leave them out of the picture. There is evidence of families playing a role in the recovery of the patient (Sjoblom, Pejlert, & Asplund, 2004). In mental health most of the patients need someone to help them and often there are many patients out there who do not have a guardian or health care power of attorney.
The patients are left to make their own decisions and when they are suffering from an acute exacerbation of their illness, this can make it difficult for them to safely make decisions. It is important that they have a guardian, family or friends to help them. Sometimes the closest thing to family is their case manager or an employer. There has been a move away from regarding the family as a burden to looking at the burden families are carrying. The interviews reveal that this new view has not been completely integrated in practice (Sjoblom, Pejlert, & Asplund, 2004).
The family as context is the best method for the patient since they should be the focus of the problem. Theory Florence Nightingale discussed in her notes on nursing several issues that involved the family. She knows of their importance in getting the family involved in caring for the sick. She mentioned in her notes, tips on caring for the ill and it also involved the family. Her theory may have been basic and discussed environmental issues which could be considered a weakness but it also discussed some strengths which were the importance of family involvement and its relevance to healing themselves.
The families of people with a severe mental illness often carry a heavy burden. Research has shown that they feel that they are to blame for the disease; they experience sadness, worry, shame and guilt. The lack of participation reinforces the feeling of being excluded. (Sjoblom, Pejlert, & Asplund, 2004). Nursing can only continue to assess the need for family involvement and encourage the families to stay committed with the patients which will help promote healing and increase their support systems.
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