Nursing case studies

Family Nursing Care – Reed’s Case Study

A family can be described as the basic unit of the society and forms the community’s critical framework. In the field of nursing, it is considered as primeval and therefore subject to various nursing activities (Friedman et al. 2003). This, in the end, has led to the development and ultimate success of the society. It entails a relationship between a male and a female working as one entity to develop and uphold a favorable atmosphere for all the family members. I was assigned Reed’s family case study. Reed is a grandmother who takes care of her grandchildren after Tyron killed Opal. Her finances are barely enough, but she supplements from gardening of family consumables and some money from her daughter. Jamala, one of her granddaughter, feels guilty for her mother’s death and has resulted in using of pot and alcohol since it helps her feel less guilty.; Daymond in puberty and therefore easily upset. LaQuita spends most of her time busy reading, but Morganna seeks attention and throws tantrums if she doesn’t get any. In this case, I had to make a comparison with experiences I had with other families in the healthcare setting. It provides both negative and positive experiences, factors and various model of family relation on daily situations.

Family Functions

In Reed’s family, there is the problem of the effectiveness of family meetings. I am of the opinion the only family meeting is held on Sunday and comprises of the extended family. This means the family is bound to experience problems due to lack of effective communication (Thomason ; Havice 2009). The meetings are usually on Sunday after church and not constructive in nature. One of the factors to consider for bringing the family together is the emotional aspect which has been almost completely ignored in Reed’s family. The Sunday meeting at Reed’s house has no apparent purpose apart from having supper together as a family. There is no enough quality time since Reed’s daughters have busy schedules with their families and she worries what might happen to her grandchildren should something happen to her. There is an issue of balancing the busy work schedule, school time for the kids and family time. This leads to the emergence of the issue of quality family socialization (Janice 2016). According to my perception having a family supper on Sunday is not enough for quality family socialization. The case study of Reed’s family does not mention any socialization time and the grandmother spends most of her time trying to feed her grandchildren and worrying who will take care of them should something happen to her. She feels she can deal with the girls but feels out of element in parenting her grandson. Azalia should quit worrying so much about tomorrow and focus on spending quality time with her family which would help in dealing with issues affecting the grandchildren.

The Reed’s family economic status is in not in a good situation. This is because she is relying on pension and security funds to take care of her family. These are barely enough, and her daughter supplements her. She continuously fears that her funds might not support them for long. The case study points out that Reed’s income is barely enough to cover her expenses and she has to depend on her daughters to provide clothes and toys for the children. It can be noted how Jamala is not happy with their state of poverty and keeps asking her grandmother to let her work. We can see that Azalia is growing old and the economic state of the family will move to worst if there is no intervention. On a personal level, I have a belief of better things to come with a better economic state ensuring less stress in the daily operations. Reed lives from day to day through her faith.

Regarding the health aspect, it is clear that Azalia has been active and of good health. She has osteoarthritis, and despite her many chores, she does not complain. Jamala is a teenager who needs help since she thinks she is to blame for her mother’s death. She has turned to drug abuse since it makes her feel good and forget about her mother’s death. Daymond, on the other hand, is a teenager who is becoming aggressive since he thinks he should be in charge being the only male in the family. Reed has however tried to channel his energy into something physical. Despite Azalia being old and busy, she needs to make time for her children. One good thing is that Reed ensures the family is well fed. Reed should try to find counseling services for the children since Jamala is disturbed. Such services would help in motivating the children in the right direction.

Family Developmental Stage

The family theory outlines the interactions in a family which consist of how certain events are interpreted and how to deal with the outcomes. It also entails the process utilized by persons to deal with things they encounter in the family context (Friedman et al. 2003). There are various development stages in a family. The family developmental stage of Azalia’s family is a family with school children and teenagers. It also has an aging family member, and this means there might be potential confusion such as adjusting to retirement. The development tasks especially for LaQuita and Morganna is the enhancement of educational achievement and being able to fit in the community. For Jamala and Daymond, the development task entails gaining a sense of independence. Currently, Reed is old and has experience in bringing up girls. This means that she has the ability and experience to guide the three girls. The grandchildren require guidance for them to feel loved and develop accordingly.

Family stressors

Stress can affect how a family function and has the potential of impacting on the welfare of the family members (Friedman et al, 2003). There are various sources of stress in a family. The long-term stress is the lack of adequate finances. Azalia’s family does not have enough funds. Despite Azalia having a garden where she grows family produces, she is worried that her funds are not last long. Her fixed income with small retirement and social security is not enough in covering all the family expenses. Jamala keeps asking her grandmother to allow her to work since she is discontent with the family poverty. The short-term stress includes family conflicts (Thomason ; Havice 2009). Another stressor in the family is aggressiveness with Daymond who is a teenager now and feels he should boss them which causes arguments and discord in the family.

Family strengths

A family can enhance its strengths to reduce the implications of the stressful situations (Stanhope ; Lancaster 2004). On its financial stress, Azalia receives help from her daughters in the form of clothes and toys for the children. She also grows family produce, and this complements the family income. Azalia despite the stressful situations can cope through hope from her deep faith.

Functional and dysfunctional coping strategies

Functional coping strategies are those things a person does to deal with a problem (Janice 2016). To deal with Daymond’s aggressiveness, Azalia has tried to gently re-direct his aggressiveness into physical activity. To cope with the financial stress, she gardens the family food to supplement the income she receives. Jamala has contacted the local marijuana dealer so that she can start distributing pot to her friends. Daymond in coping with stress fights, punches and tears things up. LaQuita spends most of her time reading, but Morganna throws tantrums whenever she feels she is not the center of attention. The Dysfunctional coping strategies entail mostly how an individual is mentally or emotionally deals with stress and less on dealing with the problem itself (Thomason & Havice 2009). Azalia mostly lives each day at a time, and her deep faith keeps her strong. Jamala in dealing with her stress she is drinking and using pot because it makes her feel good about herself.

Nursing Diagnosis

The nursing diagnosis is ineffectively coping with stresses (Thomason & Havice 2009). My intervention for the entire family would be to provide an environment they can talk about their issues, fears, and expectations (Janice 2016). They should face problems as a family by setting achievable goals and then motivate each other. I will provide them with a hotline for self-help groups. There is also the chances of using community nurses. They can access family resources such as counseling, church, educational classes and anger management classes. According to Watson theory, the nurse will be providing basic human needs (Stanhope & Lancaster 2012). It is essential for the nurse to foster a good caring relationship with their clients since it enhances family growth and development.

Conclusion

The case study has discussed how the family is meeting the various functions such as socialization, reproductive, economic and health. There has been the identification of the immediate stage of the family as guided by the family development theory. According to the family stress theory, it has been possible to identify the short-term and long-term stressors in the family and the coping strategies utilized by the family members. After a critical evaluation of the family, it has been possible to provide an appropriate nursing diagnosis.

References

Friedman, M., Bowden, R., & Jones G. (2003). Family Nursing: Research, theory and practice. (5th edition). New Jersey: US. Pearson Education.

Stanhope, M. & Lancaster, J. (2012). Public health nursing: Population-centered health care in the community (8th edition.). Maryland heights, MO: Mosby Elsevier.

Stanhope, M. & Lancaster, J. (2004). Community and public health nursing (6th edition). Retrieved on March 1, 2017 from http://evolve.elsevier.com/Stanhope

Janice, M (2016). Journal of Family Nursing. Sage publications vol. 22. ISSN: 10748407

Thomason, D. & Havice, P. (2009). From family stress to family strengths. Retrieved on March 4, 2017 from http://www.clemson.edu/fyd/Assets/Adobe_Acrobat_files/tcct_from_family_stress_to_family_strengths.pdf