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Introduction - Family Nursing Assessment
Family is related to primary care that is provided to patients of any age. This assessment is about family nursing where it will critically analyse therapeutic nurse-client conversations and based on that it will develop a care plan, which will translate by strength-based perspectives. It will also discuss strengths of the clients and family.
Criteria 1- Therapeutic nurse-client conversation
In this assessment, I am going to analyse a nurse-client conversation by considering primary health care principles and strength-based approach. Their conversation indicated that Amy is a 14-year old girl who lived with her mother Jay-Anne and her mother's partner Patricia who also has two children from her past relationship named Anthony and David. Amy had navel piercing and she did not inform her mother about her piercing even when she was close to her. Now, Amy is suffering from pain and redness in the piercing area. Amy has seen a nurse who works at her school and that nurse told her to bring a family regarding family meetings.
During that meeting, nurse asked some basic questions about Amy and her family members and how much she is closed to her family. I will use PHC principles to critique the information of this nurse-client conversation. PHC is basic healthcare, which is available to every individual at the first level of healthcare (Behzadifar et al. 2017). Additionally, Du et al. (2019) stated that PHC has five major principles such as social equity, self-reliance, intersectoral coordination, nation-wide coverage, and people's involvement. However, in this case, I am considering people's involvement because case study shows that there is a communication gap between Amy and her mother and that is why she did not tell her mother about her navel piercing. Thus, people's involvement, in terms of family involvement, can be proven beneficial for them.
Moreover, a strength-based approach is work-practice theory that pays attention to individuals’ strength and self-determination (Fukada, 2018). This theory defines that every individual has uniqueness, which helps to move his or her journey. Based on the interview, I can mention that a few things went well, for example, Amy brought her mother to nurse, which means she still has faith in their relationship, or maybe she believed that her mother would understand her passion. Additionally, when the nurse asked questions, Amy answered them without any hesitation, which was a good thing because it helped to understand Amy’s relationship with her new family and there are several things, which need to be improved.
I believed that although Amy is close to her mother, still there is a communication gap between them or she might feel fear as she thought she might hurt her mother’s feelings or get any negative replies from her mother because the interview also indicated that Jay-Anne was not happy with navel piercing. Thus, they try to improve their relationship so that Amy can share anything with her mother without having fear. In the future, while I conduct any nurse-client family strength conversation I will try to value families’ expertise, for example, if the patient is suffering from any health issue I will direct the families to take care and engage with each other.
Criteria 2- Strengths of family and client
In this section, I am going to analyse strengths of client and family with help of strength-based nursing and foundational pillars. Four foundational pillars are empowerment, innate capacities, relational and person-centred. Additionally, core values of strength-based nursing are Holism & Embodiment, Uniqueness, Health & Healing, Self-Determination, Person-Environment, Learning, Timing & Readiness, Collaborative Partnership, and Subjective Reality. In Amy’s case, I consider person-centred foundational pillar because the family meeting indicated that Amy knew that her mother will not accept her navel piercing thing and that is why she hide it from her, which mean even when she has a good relationship with her mother she hides things and that maybe because of teenage age. Research also found that teenagers hide things from their partners because they think parents can make negative comments or get angry over them (Lachance, 2020).
Additionally, she said that she wants to explore new things and do adventurous things; however, at her age that is dangerous and her mother will not allow her. However, since she has a good connection with her mother she may not hide things from her and the nurse told her exploring is good; however, at this age doing dangerous activities can harm her she understood. Thus, it can be considered as the strength of Amy because she understands that this type of behaviour can make stress her mother. Additionally, regarding core values, I consider collaborative partnership because since Amy is living with her new family she needs time to be normal with them and accept them. However, she said that she has no problem with Patricia and her brothers; however, she also stated that she does not spend sufficient time with them. Since Amy has any issue with her new family and relations with her stepbrothers are good, it can be considered as the strength of the family because when she needs their help they will support her.
Criteria 3- Development of care plan
Now I am going to develop a plan by considering Dream and Design/Co-construct cycles of Appreciative Inquiry (Appreciativeinquiry.champlain.edu, 2017). I will develop this plan with five stages and these are stated below.
Family meeting shows that Amy has a communication issue with her mother, as she did not tell her about navel piercing and consequences of that. Since she started to live with a new family, she might experience some issues while communicating with them that she cannot even tell her mother.
For mitigating these issues, some care approaches have been mentioned below.
- Person-centred therapy
- Family therapy
- Take her into proactive and extracurricular activities
- Encourage her to invite her friends to her house
This approach will help her to build strong communication with her family as well as she can develop new skills by doing extracellular activities, which will be beneficial for her mental health.
These approaches should help her to make an effective connection with new family members, where she can share her problems with help without hesitations.
A nurse will deliver these approaches after a few family meetings, where the nurse can understand the issues and recommend these approaches.
This assessment aimed to analyse therapeutic nurse-client conversations and recommend a care plan. From this discussion, it can be concluded that family meetings help to share their thoughts and issues, which again help healthcare practitioners to offer care plans for the patient.
Behzadifar, M., Mirghaed, M.T. and Aryankhesal, A., 2017. Primary health care: an important approach for health sector, missed in Iran’s health system evolution plan. Iranian journal of public health, 46(9), p.1307.
Du, S., Cao, Y., Zhou, T., Setiawan, A., Thandar, M., Koy, V., Nurumal, M.S.B., Anh, H., Kunaviktikul, W. and Hu, Y., 2019. The knowledge, ability, and skills of primary health care providers in SEANERN countries: a multi-national cross-sectional study. BMC health services research, 19(1), pp.1-8.
Fukada, M., 2018. Nursing competency: Definition, structure and development. Yonago acta medica, 61(1), pp.001-007.
Lachance, J., 2020. Parental surveillance of teens in the digital era: the “ritual of confession” to the “ritual of repentance”. International Journal of Adolescence and Youth, 25(1), pp.355-363.
Appreciativeinquiry.champlain.edu, (2017). 5-D Cycle of Appreciative Inquiry. Viewed on: 1/12/2021<https://appreciativeinquiry.champlain.edu/learn/appreciative-inquiry-introduction/5-d-cycle-appreciative-inquiry/>