Hypothetical Family Health Promotion Assessment - Essay Example

? ASSESSMENT Hypothetical Family Health Promotional Assessment Word Count: 2500 (10 pgs Friedman, Bowden & Jones (2003) outline six (6) assessment categories, and data to be collected within each, in Appendix A (long version) and Appendix B (short version). After reading about the Morrison family in the novel Crow Lake, select the two (2) assessment categories you perceive as most relevant for promoting their health. Provide the rationale for your selection. (900 words) The notion of what family consists of has definitely changed over the years. While some families may consist of the standard two-parent home, there are a numerous amount of ways in which families are organized and in which social groups they exist. The modern nurse must be sensitive to these unusual circumstances and adjust one’s attitude accordingly, being careful not to place judgment upon clients who need nursing services. According to Bomar (2004), “During the past two decades, the evolution of family nursing assessment in nursing theory, practice, education, and research has been observed and documented in the nursing literature” (pp. 275). Nurses must be sensitive also to the fact that various ages, races, ethnicities, and other demographics of people may not fit perceived stereotypes, or that their lives’ paths vary significantly from what is considered socially appropriate or aesthetically pleasant. Some people live in abject poverty while other patients may be quite rich—and it is important for the nurse to understand that she must treat all of her patients with the same amount of dignity and care as she would anyone else. This is especially true of the Morrison family as evidenced in Mary Lawson’s book Crow Lake. Katie is definitely not the typical caregiver, as she is an young adult herself and learning how to take care of a young sister who is less than five years old. Katie is one of the focal points of the book, a scientist who struggles with the issues that surround being impoverished, but, at the same time juggling responsibilities while aspiring to a better life. The FFAM is, according to Stanhope and Lancaster (2006), “[o]ne family assessment model and approach developed by a nurse…” (pp. 335). The FFAM is able to assess various family issues that are of concern to the nurse in his or her chosen profession. Obviously, in any family there are immediate telltale signs of problems. The most obvious sign of some problem is physical abuse, although, the problems to be discussed here are more internal, invisible, intangible problems which can have effects on patients. Although one can’t see a bruise, indeed, the individual is injured, albeit in his or her psyche. It is the emotional pain that can also scar a patient irrevocably for life, and this is what the nurse seeks to diagnose in order so that he or she can assuage the patient’s fears and continue to pursue a plan that will plot a course of treatment appropriate for the patient. Affective Involvement is the first aspect that I would think would be very key in assessing the Morrison family’s situation. The family’s young ones are taught not to express themselves overtly in a strong manner. Says Lawson (2003), “Understatement was the rule in our house. Emotions, even positive ones, were kept firmly under control” (pp. 9). Most relevant for promoting the Morrison family’s health in this category comes under the concern of the young people basically not being cared for in the ways they need to develop. For example, one very important concern is Katie’s younger sister Bo, who is a toddler. Toddlers need lots of love and affection from parents in order to develop properly, and without that kind of support, Bo will rely almost entirely upon her older sister as a mother figure, and upon her brothers Matt and Luke as father figures. However, since Luke at one point might go away to college, and Matt establishes his own family—only Luke remains once he decides that he is going to get a job to support the family instead, even though he acquires a scholarship. Control and lack of control—basically, control issues—run through the current of Crow Lake. Usually people with control issues have little to no control over their own lives. They can’t control the fact that bills are rolling in the door and they won’t be paid on time or at all. They can’t control their upbringing, or others’ reactions to them. However, the one trick that people with control issues need to remember is that they can control how they react to situations and that their situations in life are not static or in a vacuum. Not only is there room for upward mobility, but there is help available to people with control issues in the ways of communal support and chat groups as well as other options being available. Control, therefore, is a major issue that summarily needs to be addressed with all kinds of due diligence. It would not be fair to allow the Morrison family to wallow in a state of effusive despair because of their lack of self-control as well. Lawson (2003) also states, “…fighting itself didn’t seem to be against the rules” (pp. 12). In that sense, even though there was a restraint on emotions, there wasn’t enough restraint on anger, and that anger could build up to a point where it would eventually implode—which it did occasionally. These are the challenges that the Morrison family faces. * Using the short version of the FFAM as an organizational guide, identify the data from the novel that a nurse could use to complete the two selected assessment categories. (850 words) In a nutshell, the affective involvement and control issues of the Morrison family are compounded by the difficulty in the family situation of the children having been left orphans. Katie relates in Crow Lake (2003), “I had my work, and I had Daniel, and between them they took up a lot of time and energy. It’s true that things hadn’t been going too well in either department for a while, but I didn’t think to connect that with ‘the past’ [which I preferred to forget]” (pp. 20). Affective involvement included her relationship with Daniel, an academic whom she loves and with whom she wants to eventually someday marry and start a family. Daniel is an academician from a well-respected family, and Katie has difficulty showing her feelings as a result of her repressed orphaned upbringing—having had to basically struggle most of her life in order to get what she had—while Daniel grew up having the easy life, having had many things given to him in his upbringing. Affective involvement means giving of oneself, and with Daniel, Katie didn’t really have a lot of affection left to give for awhile being stressed out with things she had to worry about. Her inability to control her work life also causes her much stress as is indicated from that quote. Her inability to regulate her affective involvement at a beneficial level—as well as manage the control of her own life—overshadow any success she may have had or might have in the future, if she cannot harness her powers of execution. Katie is part of her own family which dictates that she must interact socially with them. As stated by Crane and Marshall (2005), “The family and its parts as well as the family and society are in dynamic interaction” (pp. 258). In order to complete the two selected assessment categories, the nurse will have to ask a number of possibly tough, but seemingly harmless questions to the person being serviced, which will help the nurse in her assessment of the patient’s situation (in this particular instance, it would be Kate being assessed most likely): How are you feeling? Questions like these help the nurse get into the head space of the person being questioned, and definitely provide a non-invasive form of introduction in order so that the nurse can have a way into the patient’s psychological state—to gain some perspective, one might say. This question is quite standard, and most people—no matter how angry—would probably not oppose to answering such a seemingly harmless question. Really, what the nurse is really asking is “How are you?”, but in a less direct way. What do you feel about your situation? This can allow for the patient to recollect and reminisce about feelings the patient has about what is going on in her life right now. Sometimes an empathetic ear is all someone needs in order for one’s mental state to improve. In Katie’s case, she is probably not in the best psychological state right now, having had to deal with her future husband as well as take care of her work situation. What are your plans? Helping the patient to think leaps and bounds beyond the current situation can be very helpful in terms of giving her more perspective. She needs to know that her current situation is not permanent, that she is going to have success in life if she pursues her goals and reaches them, and that her current situation can and will indeed improve. She needs this type of encouragement from the nurse, as well as an assessment of whether she is having any psychological throwbacks pursuant to her current stressors. This includes ensuring that the patient can take care of herself and others around her, as well as ensure the overall mental, emotional, physical, and spiritual components of the patient are securely stable and fixed. These are just a few ideas of assessment questions that the nurse can ask in order to delve more deeply within the life of the patient. Since Katie most likely suffers from problems stemming from affective involvement and control or lack thereof, the nurse should be diligent in being sensitive about this encounter for assessment purposes. It is important that the nurse continually be aware of the patient’s mental state as she goes through various phases of her current living situation. The nurse should ensure that the psychosocial, emotional, and socioeconomical situation of the patient is tended to with the greatest care and patience. It is hoped that through this type of assessment, an intervention can be made in the patient’s life, as well as the lives of her family members—through simply accessing the trust of one family member, Kate. At that point, perhaps other family members could come forward and their personal issues could be divested of themselves in order to evaluate their particular situations. * Once the assessment data are presented, identify at least two and at most three priority family health promotion nursing diagnoses for the Morrison family that rise out of the assessment process. Provide the rationale for their selection as priorities. (750 words) The family assessment overall is important. Edelman and Mandle (2005) think “…an important consideration in the appraisal of health promotion and disease prevention is the family assessment” (pp. 6). However, one needs to realize that the diagnoses that stem from these assessments would best be described as: a wellness condition, derived from the assessment of affective involvement; and a health threat, derived from the assessment of control. The wellness condition is more or less concern for the young girl, Bo. The trash cannot be taken care of at the house, and the work that needs to be done around the farm cannot be handled by Kate alone. When Matt gets injured after having married one of the Pye girls, one realizes that the wellness of Matt’s father-in-law is negative, and could affect Matt’s family in a dire situation. As it stands, Matt is already impoverished, and he and his wife (the Pye girl) bring a youngster into the world themselves, thus continuing the cycle of poverty. Wellness of young children is evidently something that captures one’s imagination as a horrible example of what it is really like for young people to live in abject poverty. Without access to affordable medical care or adequate food sources, a young person’s development could be significantly hampered by the economic circumstances of their parents and/or guardians. It has come to a point where something must be done. The rationale for this priority of a wellness condition for the young children arises out of the fact that these young children are required by law to receive an adequate amount of care, or else it could warrant charges of child abuse as would be defined in Canadian federal law, without question. Life events obviously contributed to the danger of a health threat. The Morrison family parental figures both died, thus leaving the children orphans to fend for themselves. This was a major life change. As stated according to Orshan (2007), “Friedman, Bowden, and Jones (2003) labeled the life events that signify a change as family stage markers (p. 108)” (pp. 247). Basically, there are several problems which could have—and which one did—develop as resultants of the parents dying. First of all, Matt got injured due to being in a work-related accident on the farm. Luke is constantly in danger of getting sick due to having a job that does not provide benefits, nor is it a good enough job that it can lift the family out of poverty. Bo would probably need immunizations on a yearly basis or perhaps every few years. This would become a health hazard if certain immunizations could not be paid for. Bo could suffer from mumps, measles, rubella, chicken pox, polio, or a number of other common diseases that one can be stricken with in childhood—but which could be prevented with a simple immunization. Katie, due to the stress of having managed the whole family pretty much up until this point, is probably burnt out and at the breaking point. She is, in addition, not only having difficulty expressing herself—as are the rest of her family members, with regard to emotions—but she also expresses control issues as she faces having to deal with Daniel while trying to main some semblance of normalcy within her own life when everything is falling down around here. She is struggling to survive. The rationale for a health threat seems most likely due to the inevitable amount of trash that would pile up. Since there is no trash removal from such an impoverished family, they would most likely live in filth and have little access to proper care. This may be a frustrating fact for the nurse to face, but nevertheless, it must be entertained. A health threat is a diagnosis that affects the whole family, not just the young children—similar to the problems with the wellness condition. The point of these diagnoses are not to humiliate people or make them feel badly. The point of the FFAM to diagnose patients is in order so that they might be aided in terms of having their life situations improved upon through access to medical care—at the hands of a patient nurse who is willing to assess the patient(s)/family. REFERENCES Bomar P (2004). Promoting health in families. USA: Elsevier Health Sciences. Crane DR and Marshall ES (2005). Handbook of families and health: interdisciplinary perspectives. USA: SAGE. Edelman CL and Mandle CL (2005). Health promotion throughout the life span. USA: Elsevier Health Sciences. Lawson, M (2003). Crow lake. USA: Random House, Inc. Orshan, SA (2007). Maternity, newborn, and women’s health nursing. USA: Wolters Kluwer Health. Stanhope M and Lancaster J (2006). Foundations of nursing in the community. USA: Elsevier Health Sciences. Read More