Nurses should understand that the family has a vital task in the concern of health support for patients. Functions and roles in the family are crucial in helping every member and offering care that is effective to the health of patients and welfare of the entire household (Preston et al., 2016). Family assessment acts as a tool for evaluating not only patients and their opinions on diverse factors of health, but the whole household or even community. Health patterns of a family keep changing and are swayed by environmental relations, cultural, social, developmental, spiritual, and biological aspects (Zhou et al., 2016). It is essential to comprehend every pattern within a family because one or some aspects cannot provide an adequate assessment that may ensure quality nursing endeavors.
This assessment was accomplished after interviewing an African American family. This family consists of a husband called Gerald aged 31 years and a wife named Miriam aged 29 years. Their two daughters are Lucy aged 5 and Mary aged 2 years. Miriam is a homemaker while Gerald is the leader in the family and the primary provider. I first came across Gerald at work where he is a nurse at the intensive care unit.
Gerald works long hours, sometimes on the night shift, and hence does not have time for physical exercise since this would decrease his already insufficient rest and sleep hours. Miriam and the children have no psychological or physical conditions that influence family practices. However, Gerald is obese. He is also undergoing treatment for depression, which he attributes to overload at work and constant handling of patients who need critical care (Nurumal et al., 2017).
The family home is spacious since they have a three-bedroom house, which is well lit and maintained. The external environment is tidy and the grass around neatly trimmed. Since Gerald is well-paid for his work as a critical care nurse, the family’s financial status is good because they have even managed to buy two personal vehicles recently. After completing her school work, Lucy likes helping her mother with domestic chores such as emptying the dustbin and arranging shoes on the rack. Mary likes watching cartoons on the TV and playing with her toys. No family memberās developmental condition presents stress in Geraldās household.
The family is in the developmental stage of school-age children and has excellently accomplished tasks both in this phase and previous ones. There is no genetic predisposition to disease in the family and every member undergoes vital immunization. The family has inadequate time with Gerald. They have a happy family and crises are suitably tackled whenever they occur. They hope to educate their two daughters to the highest level and see them prosper in life. Gerald has an emergency plan to deal with depression and uphold work-life balance so that he gets adequate time to spend with his family (Lee et al., 2017).
Nursing Care Plan
Obesity
Gerald spends most of the time at work and does not engage in physical exercise. He has been gradually adding weight since he started working as a nurse five years ago. His daily diet mainly encompasses oatmeal, muffin, chips, meat, potatoes, and some vegetables.
Assessment
Gerald is 1.7 m tall and weighs 88 kg. His BMI is 30.4 kg/m2. His cholesterol is 230 mg/dL with a HDL of 35 mg/dL and an LDL of 170mg/dL. His BP is 138/90, his fasting blood sugar normal at 102 mg/dL, and his ECG displays healthy sinus rhythm. Gerald reports fatigue and shortness of breath with some heavy tasks. His doctor has recommended daily physical exercise and loss of about 30 pounds.
Diagnoses
- Imbalanced nutrition: Higher intake of energy than body requirements
- Activity intolerance: Associated with lack of an exercise program
- Feeling overpowered and emotionally drained: Attributable to inability to satisfy constant demands at the intensive care unit
Expected Outcomes
- Loss of 1 pound every week
- Walk to work every day
- Establish a behavior modification policy to control overeating
Planning and Implementation
- Evaluate BP and weight twice every week
- Identify ways of decreasing eating cues
- Maintain a food diary to assess and modify eating habits
Evaluation
One week after the change of diet and physical exercise, Gerald has lost 1 pound. He keeps a food diary and has determined nursing burnout as an eating cue.
Depression
Gerald reports overwork and inability to cope with stress and mull over issues clearly. He states that he is in a situation of physical, emotional, and mental fatigue attributable to extreme and prolonged stress.
Assessment
Gerald reports inadequate sleeping hours and insomnia at times. He feels overwhelmed by work and is unable to think clearly or tackle stress. He confesses to having one time attempted suicide but was saved by a colleague. He strongly wants to get out of the situation and lead a normal life.
Nursing Diagnosis
- Ineffective strategies of coping with situational crisis
- Overwhelming stress at work
- Modification of social participation
- Suicidal ideations
Goals
- Increased sense of control
- Work-life balance
- Cope with stress
Nursing Interventions
- Regular assessment of the patient’s stress-coping technique
- Request nurse manager for decreased workload by increasing personnel
- Talk with his wife, who will assist him decrease the current emotional and mental exhaustion
Evaluation
Gerald shares his feelings and fears with his wife who assists him overcome occurring tensions. One week after reporting to the nurse manager, she has agreed to recruit an additional nurse in two weeks to help him reduce the current workload.
References
Lee, Y. W., Dai, Y. T., Chang, M. Y., Chang, Y. C., Yao, K. G., & Liu, M. C. (2017). Quality of work life, nursesā intention to leave the profession, and nurses leaving the profession: A oneāyear prospective survey. Journal of Nursing Scholarship, 49(4), 438-444. Web.
Nurumal, M. S., Makabe, S., Jamaludin, F. I. C., Yusof, H. F. M., Aung, K. T., & Kowitlawakul, Y. (2017). Work-life balance among teaching hospital nurses in Malaysia. Global Journal of Health Science, 9(9), 81-85. Web.
Preston, K. S., Gottfried, A. W., Oliver, P. H., Gottfried, A. E., Delany, D. E., & Ibrahim, S. M. (2016). Positive family relationships: Longitudinal network of relations. Journal of Family Psychology, 30(7), 875-880. Web.
Zhou, Q., Chan, C., Stewart, S. M., Leung, C., Wan, A., & Lam, T. H. (2016). The effectiveness of positive psychology interventions in enhancing positive behaviors and family relationships in Hong Kong: A community-based participatory research project. The Journal of Positive Psychology, 11(1), 70-84. Web.