Nurse's Pocket Guide

interrupted FAMILY PROCESSES
Answers to these questions help identify specific problems
needing to be addressed.
• Ascertain role expectations of family members. Who is the ill
member (e.g., nurturer, provider)? How does the illness affect
the roles of others?
• Identify “family rules.” For example, how adult concerns
(finances, illness, etc.) are kept from the children.
• Determine effectiveness of parenting skills and parents’
expectations.
• Note energy direction. Are efforts at resolution/problem solving
purposeful or scattered?
• Listen for expressions of despair/helplessness (e.g., “I don’t
know what to do”) to note degree of distress and inability to
handle what is happening.
• Note cultural and/or religious factors that may affect perceptions/expectations
of family members.
• Assess availability/use of support systems outside of the family.
NURSING PRIORITY NO. 2.To assist family to deal with situation/
crisis:
• Deal with family members in warm, caring, respectful way.
• Acknowledge difficulties and realities of the situation. Reinforces
that some degree of conflict is to be expected and can
be used to promote growth.
• Encourage expressions of anger. Avoid taking comments personally
as the client is usually only angry at the situation over
which he or she has little or no control. Maintains boundaries
between nurse and family.
• Stress importance of continuous, open dialogue between
family members to facilitate ongoing problem solving.
• Provide information, as necessary, in verbal and written formats.
Reinforce, as necessary.
• Assist family to identify and encourage their use of previously
successful coping behaviors.
• Recommend contact by family members on a regular, frequent
basis.
• Arrange for/encourage family participation in multidisciplinary
team conference/group therapy, as appropriate.
• Involve family in social support and community activities of
their interest and choice.
NURSING PRIORITY NO. 3. To promote wellness (Teaching/
Discharge Considerations):
• Encourage use of stress-management techniques (e.g., appropriate
expression of feelings, relaxation exercises).
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
302 Cultural Collaborative Community/Home Care