The family in this case study is depicted as one of middle income capacity with the man of the house being the main provider of the house and the rest of the family being dependent on the father. The family is composed of children and the grand mother, a sign that they value the unity and living together as a social and communal responsibility to each other. The family also displays several signs of financial and communal pressures from the coping habits that they adopt like the father of the house smoking marijuana and resorting to alcoholism to cope with the pressure that the family needs predispose him to. This is a fairly young family and several needs are evident within the house like the schooling needs and the medical care since David and Charles are young children and suffer conditions that need constant medical checkup and consultation with their doctor hence a lot of money needed. Though both the father and mother of the house have some form of employment, the earnings are not enough to have them live a comfortable life as can be seen from the two bedroom house that they live in as compared against the number that this small house is meant to accommodate, as well as the fact that the couple is unable to seek medical checks regularly, indeed they do not have medical insurance.
Jean Watson theory of Human caring
The revolution of nursing has seen a lot of changes in the way that patients are cared for. The contemporary nurses have a much wider and diverse clientele or patients to handle and there is need to have a comprehensive approach to nursing hence the need for the philosophy that was crafted by Jean Watson. The Watson approach to nursing is considered one of the most influential approaches towards community nursing human caring in general.
There are 10 tenets that define the Watson approach and that ultimately contributes to the influence that the theory has in the public health nursing. These tenets or measures that are used to guide nurses in their care and empathy with the patients are frequently referred to as the carative factors and are as below as outlined by Wagner A.L.(2010):
Humanistic-altruistic system of value-this involves practicing loving kindness towards the patients. The nurse needs to realize the vulnerabilities of the patients and themselves and listen to them, accept them as they are and honor the human dignity.
Installation of Faith-Hope -- the presence of the nurses to the patient should be authentic hence bestow the feeling of hope and having faith in the nurse. This will create connection between the patient and nurse, encourages the others to carry on with life, incorporates their beliefs and faiths into the care plan and predominantly the nurses will view the patients as human beings and not objects.
Cultivation of Sensitivity to self and others-this helps the nurses to go beyond the ego self. This sensitivity will enable the nurse to create a more trusting and helping care relationship with the patients or the people the nurse works with. The nurse will have discernment in evaluating situations rather than being judgmental over the patients. She will also accept herself and others as people who are worth respect and caring that is unique to themselves hence improving the care and the thinking of the nurses.
Development of Helping-trusting, human care relationship-this requires that the nurse establishes a caring relationship with the patient and even the family members. This will help her hold others with unconditional love, practice authentic presence, become aware of their styles of communication and will allow the patients to choose the best time to talk about their concerns.
Acceptance and promotion of the Expressing positive and negative feelings -- the nurse needs to be present for the supporting of the patient in expression of his feelings and show care and oneness with the patient at such times. In this endeavor, the nurse will also be required to see the process of healing as an inner journey, will encourage narratives to be said by the patients, help them see the good aspects in their situations and help the patient deal with their negative feelings.
Use of Creative problem-solving caring process -- the nurses need to use the creative scientific problem solving approaches in order to help the patients in their problems. This approach will also enable the nurse to use the ethical, aesthetic, personal, metaphysical and empirical approaches to care for the patients for full satisfaction with the care and comfort while sick. The nurse will also use self to create a healing environment, encourage the patient to ask questions and help the patients get a new meaning to their suffering that will help in dealing with the health situation.
Promotion of Transpersonal teaching-learning-this approach will promote knowledge, empowerment and growth in the healing process. The nurse will need to keenly listen to the patients tell their experiences in life, speak to them calmly and respectfully, seek to know what the patient knows about their sickness and then shares, coaches and provides information that will help meet the needs of the patient.
Supportive, protective, and/or corrective mental, physical, societal and spiritual environment-this will mean the nurse will be helping create and provide a healing environment at all levels. The nurse will enhance a healing environment for the physical and the spiritual self that respects dignity.
Human needs assistance or the help in gratification of human needs- the nurse should have a genuine intention in helping with the basic needs as they view the patient as a complete whole who has needs like any other person. Will respect the needs of privacy of others and helps them feel less worried despite their conditions.
Allows for the Existential-phenomenological-spiritual forces- this means the nurse will attend to the spiritual/mysterious needs of the patients, she will recognize the inner feelings of the patients and indeed surrenders control and anticipates miracles for the good of the psychological stability of the patient.
3 prioritized family nursing diagnoses
First family diagnosis is on the substance abuse that can be categorized as deficient since their pursuit to have a drug free family has been sabotaged by the content marijuana smoking and alcoholism of the martin due to work related stress. The healthy people 2020 LHI is adults engaging in binge drinking during the past 30 days. The intervention that must be applied to this health problem is a visit to the Kaiser Permanente or Bellflower medical center for guidance on how to quit alcoholism. Martin also needs to join the various groups that were observed jogging on bike trail. He also needs to visit the Little House that is a social service center that offers support to drugs and alcohol addicts within this community.
Second family diagnosis is compromised health service access status of the family which emanates from the health conditions that both children have and the lack of insurance cover for the entire family. The healthy people 2020 LHI for this is people with access to medical insurance and people with a usual primary care provider. These two indicators of a family that has a good health service access are missing within this family. Here, the father and other need to scout for an affordable healthcare insurance that they can pull together finances from their jobs and subscribe to and get the family insured.
The third diagnosis is on the environmental quality and this, for the family can be graded as at the risk of secondhand smoking. This is in light of the fact that the father smokes heavily due to stress from job and they live in a two bedroom house. This could be space that is barely enough for proper ventilation hence exposing the children to the smoke from the father. The healthy people 2020 LHI are children aged 3 to 11 years exposed to secondhand smoking (Healthy people2020). Since the family is substantially large, there is need for a different environment hence the intervention here would be to get in touch with the Little House program within the Bellflower region that will enable them to have a bibber house, albeit transitional, as they put in place measures to have their own bigger house.
There are however some legal and/or ethical considerations that may be observed fro these interventions to be effective. There is need to involve the family in the decision making especially in moving out from their current house to seek the alternative shelter that is provided by the social service organization Little House. This will be seen as an ethical step as compared to overlooking their consent. Smoking of marijuana is illegal in this part of the state and the state as a whole hence continued smoking of the drug may pose legal complications for the father of the house hence the need to have a carefully thought out approach to helping Martin quit smoking it…