Family is a term that can be defined differently by every person. In health care, family does not always mean individuals related by blood; instead, a family is seen as a support system to an individual that is in a state of compromised health (Friedman, Bowden, & Jones 2003). The family’s role in a healthcare setting can vary depending on the client’s condition. In the intensive care unit, the family plays a big role, especially for the patients who lose their abilities to provide self-care and make decisions. On the contrary, the family’s role is different in a step-down unit, in which clients are in a more stable condition. As a healthcare worker, it is important to understand the role of family concept, family system, and the application of an appropriate family nursing theory.
Concept of Family in Health Promotion:
Families come in many different sizes and dynamics. Family is more than individuals living under the same roof. It is a support system for all aspects of health. A healthy family can play a big role in a family member’s health recovery by coming together as one support system to promote healing and help the individual achieve health goals, since one key function of the family system in healthcare includes health promotion and prevention (Friedman, Bowden, & Jones 2003). However, families react and manage issues connected to healthcare based on values and culture. According to Friedman, Bowden, and Jones (2003), “health behaviors, attitudes, and values are learned in the family” (P. 49).
In addition, according to Ross, Mirowsky, and Goldsteen (1990), “a family is an economic unit bound together by emotional tie, and health is described as a state of emotional and physical well-being” (P. 159). Therefore, the family system is a well-balanced unit, and the relations found in a family system are so complicatedly tied together that a little change in any one part surely results in changes in the whole family system (Friedman, Bowden, & Jones 2003).
Concept Used in Area of Nursing Practice:
The concept of family most used in a hospital setting is family as context. Depending on the family dynamics and the support from family members, family can be viewed as a resource to the patient, and in some cases family can be viewed as a stressor. However, in most cases, family plays an important role in the environment and care of a patient. Working in the Oncology/ Intensive care unit (ICU) Step-Down Unit, I have learned that the family support is very important for the patient and staff as well. In my unit, the nursing staff considers the clients and their families as one unit, and they care for them as a unit. Most of the clients have either chronic diseases or terminal illnesses, and they bounce back into the hospital quickly. Families are constantly being educated because most of the time, there is the question of compliance with the treatment regimen.
For example, if a congestive heart failure (CHF) patient takes their medication, such as diuretics, on time, follows a low-salt diet, and keeps up with their physician appointment on a regular schedule, then they will not have to be in the hospital all the time with a fluid overload and shortness of breath problems. Families are education along with patients through lectures and reading material. Therefore, everyone is aware of the benefits and risks of health promotion. Sometimes, we also discharge patients home on ventilators from my unit.
Ventilators require a large amount of education from the nursing staff to make sure the families are ready with all the necessary information and education needed to provide quality care of their loved ones at home. Family members are included in the plan of care and patient care from the day of hospitalization. Therefore, when it is time for discharge, family members and patients are ready.
Theory Conducive to Area of Nursing Practice:
Florence Nightingale’s environmental theory is very helpful in my area of nursing practice. She stresses the important of environmental factors in illness and health (Selanders, 2010). This theory is best because in the ICU Step-Down Unit, the environment is very important. Most of the patients are on ventilators that breath for them or have trouble breathing. Therefore, the environment around them must be as normal as possible. The rooms must be kept organized, clean, and odorless from scents such as bleach, perfume, or cologne. These patients are connected with many lines, wires, and cords.
All lines, cords, and wires must be arranged to keep the patients free from injury, and they must also be plugged into emergency outlets only in case there is ever a power failure. During discharge planning, especially for patients who are on ventilators, it is important that the nursing staff and discharge planner assesses the home environment and patient’s safety at home. The home environment must be checked for an adequate power supply to maintain the ventilator machine.
Whenever an individual is hospitalized, no matter how sick he or she is, the emotional stress on the patient and the family can be very overwhelming. In nursing, we care for clients and their families. The family system plays an important role in promoting, preventing, and recovering a family member’s health. We, as healthcare providers, must involve the family into nursing care. Also, practicing nursing care based on theories such as those of Florence Nightingale can help healthcare providers to make sure that they have done everything for the positive outcome of the patient’s health and safety.
Friedman, M.M., Bowden, V.R., & Jones, E.G. (2003). Family nursing: Research, Theory, &
Practice (5th ed.). Upper Saddle River, NJ: Prentice – Hall. Ross, C., Mirowsky, J., & Goldesteen, K. (1990, November). The Impact of Family on Health:
The Decade in Review. Journal of Marriage and the Family, 52(), 1058-1060. Selanders, L.C. (2010, March). The Power of Environmental adaptation: Florence Nightingale’s Original Theory for Nursing Practice. Journal of Holistic Nursing, 28(1), 81-88.
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