Discussion week 3

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Group Discussion in D2L – Week 3
Read Green (2012) and fill out the family construct grid in relation to Green (2012) located in Module 2. Please note, the grid is only to guide your
thinking and discussion posts. Please post your grid and any relevant commentary about which family nursing concepts seem most pertinent.
The focus for this week is the Fault in Our Stars book discussion by John Green. I am providing the following list of questions to jump start the book
discussion. You don’t need to answer all of the questions. This is meant to be a free-flowing conversation, and I expect each of you will add your
questions throughout the discussion.
Each of you can tell us how you experienced the book and pick one of the questions below to answer if these help focus your thoughts.
1. John Green uses the voice of a teenage girl to tell this story. Why do you think he choose to do this? Was it effective? How would it have
been different if he had told the story from a different voice? How does voice relate to family nursing practice?
2. What does the title, Fault in Our Stars, mean?
3. How would you describe the two main characters, Hazel and Gus?
4. How do Hazel and Gus relate to their cancer?
5. At one point in the book, Hazel states, “Cancer books suck.” What is she really meaning?
6. How do Hazel and Gus change, in spirit, over the course of the novel?
7. Why is “An Imperial Affliction” written by Peter Van Houten Hazel’s favorite book?
8. How many of you looked to see if, “An Imperial Affliction” was an actual book?
9. What do you think about the author Peter Van Houten?
10. Why it was so important for Hazel and Gus to learn what happens after the heroine dies in the An Imperial Affliction?

NURS 362 Summer 2022

Week

Family Topic

Assigned Content/Readings

Thought/Discussion Topic

Written Assignments/

Meetings

Module 1

Week 1

May 16

Introduction

Background Understandings of Family and Societal Care

George Maverick audio

Watch the three video clips in order:

Video 1: Brief with Family Focus

Video 2: Simulation with Family Focus

Video 3: Simulation without Familiy Focus

Kaakinen*, Coehlo, Steele, & Robinson (2018) Ch. 1

Denham*, Eggenberger, Young, & Krumwiede (2015) Ch. 1 & 12

Bell (2011)

*Reading list will just use first author name

Individual, Family and Societal Care

Foundations for Thinking Family

Look for posted orientation video on D2L explaining basics of course syllabus, calendar, and assignments. Please ask if further questions after listening and reading documents thoroughly. Thanks!

Free Write #1 regarding healthy families due

May 22nd

Group Discussion in D2L – Week 1

For each week, your initial posting is due by 11:59 p.m. on Wednesday and 2 responses to your peers by 11:59 p.m. on Sunday. Remember to include citations and references to support your comments.

1. Introduction Thread – Help your classmates to get to know you as a person, nurse, and family member. Share aspects of yourself in a posting–For example, Tell us about your family of origin. Tell us about your current family (remember that if you do not have biologic members present in your life, friends as family may apply to you. Pictures of you and your family? What is the work of family? What are your future family goals? What piques your interest in this course and family focused nursing care?

2. Reflect on an illness experience in your own family or a family you know. Describe the struggles the family experienced with the illness. Consider the biological, social, psychological, or spiritual factors that influenced the management and coping of the family. Based on your experience pose a nursing approach that may have been helpful to the family. Use your readings to support your analysis and response.

3. What is your definition of family and family health?

4. Describe your family health experience utilizing the 3 family health domains (contextual, functional, and structural).

5. Describe your family’s health routines. Identify some barriers or challenges for families not developing or maintaining health routines

6. To introduce family nursing practice and give you a background on how to care for the family unit, please watch video clips of our former nursing students caring for George Maverick in our simulation suite on the Mankato campus. Observe the similarities/differences seen between the individual focus (video 1) vs. family focused care (video 2).

7. Thinking Family – Address the health inequities or health disparities: Does the basic premise of family focused nursing care hold true: When the health of one family is improved, the health of society has also been improved.

Week 2

May 23

Background & Understandings of Family Nursing

Theoretical Foundations for Family Nursing

Family Structure, Function, Process

Aspects of Health

Kaakinen (2018) Ch. 2, 3 & 6

Denham (2015) Ch. 2, 3 & 7

Khalili (2007)

Duhamel, Dupuis, & Wright (2009)

Foundation for ‘Thinking Family’

Family as Unit of Care or Context?

Family Nursing Theory

Denham’s Core Processes

Health Routines

Free Write #2 regarding

family during acute care experience due May 29th

Group Discussion in D2L – Week 2

1. What are the barriers/challenges described in your readings that you also face in your environments as you attempt to provide family focused nursing? (e.g. family as client, family as context, family as barrier, family as caring process, family as resource)

2. Review the power point: “Family Nursing Background and Understandings.” Reflect on nursing practice that views family as the unit of care and nursing practice that views family as contextual to the individual patient. Do you believe that current nursing practice most often views family as the unit of care or family as a context to the situation? How do these two views differ?

3. Develop 5 questions focusing on one of Denham’s Core Processes. Interview a client in your workplace or within your community and describe their answers to your questions. Identify family routines and factors related to family health routines.

4. From the Khalili article, what were the most significant aspects of the illness transition for the family? What resources did the family need/want? What were the barriers and facilitators to obtaining the needed resources or supports? What may have changed in the care situation for the family if the family would have been viewed as the unit of care?

5. Using one of the family theories/frameworks described in the literature reflect on an illness experience in a family. (You can reflect on a family you have cared for in your nursing practice.) Consider how family structure, function, and process influenced the family health experience and outcomes. Analyze the experience from a family theory/framework perspective.

6. Use your reading on a One Question Question by Duhamel et al. (2009) to practice this questioning strategy with a family. Share your reflections and outcomes.

Module 2

Week 3

May 30

Family Construct

Share examples from the book to describe Denham’s Core Processes

Fault in Our Stars (Green, 2012)

Read The book and complete the Family Constructs Grid

Post & Discuss

Fault in Our Stars Book Discussion

Free write # 3 regarding family in crisis or trauma experience due

June 5th

Complete First Family Visit

Family Assessment-this is just a guideline to keep you on track-it is not literally due.

Group Discussion in D2L – Week 3

Read Green (2012) and fill out the family construct grid in relation to Green (2012) located in Module 2. Please note, the grid is only to guide your thinking and discussion posts. Please post your grid and any relevant commentary about which family nursing concepts seem most pertinent.

The focus for this week is the Fault in Our Stars book discussion by John Green. I am providing the following list of questions to jump start the book discussion. You don’t need to answer all of the questions. This is meant to be a free-flowing conversation, and I expect each of you will add your questions throughout the discussion.

Each of you can tell us how you experienced the book and pick one of the questions below to answer if these help focus your thoughts.

1. John Green uses the voice of a teenage girl to tell this story. Why do you think he choose to do this? Was it effective? How would it have been different if he had told the story from a different voice? How does voice relate to family nursing practice?

2. What does the title, Fault in Our Stars, mean?

3. How would you describe the two main characters, Hazel and Gus?

4. How do Hazel and Gus relate to their cancer?

5. At one point in the book, Hazel states, “Cancer books suck.” What is she really meaning?

6. How do Hazel and Gus change, in spirit, over the course of the novel?

7. Why is “An Imperial Affliction” written by Peter Van Houten Hazel’s favorite book?

8. How many of you looked to see if, “An Imperial Affliction” was an actual book?

9. What do you think about the author Peter Van Houten?

10. Why it was so important for Hazel and Gus to learn what happens after the heroine dies in the An Imperial Affliction?

Week 4

June 6

Annotated Bibliography

Read syllabus for assignment instructions. Below are several reputable websites that explain how to prepare an annotated bibliography. https://guides.library.cornell.edu/annotatedbibliography

http://library.ucsc.edu/ref/howto/annotated.html

https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibliographies/index.html

Annotated Bibliography

June 12th

Please upload your Annotated Bibliography. 

Review and provide feedback for two individual’s Annotated Bibliography.

Incorporate the feedback you receive from your peers into your final Annotated Bibliography.

Week 5

June 13

Family Chronic Illness Experience

Family Construct

Share examples from the book to describes Denham’s Core Processes

Genetics & Genomics

Genova (2009) Still Alice

Read the book and complete the Family Constructs Grid

Post and Discuss

Kaakinen (2018) Ch. 10 & 11

Denham (2015) Ch. 8, 9 & 13

Svavarsdottir (2006)

Alzheimer’s disease fact sheet:

http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet

Bennet (2008) This is a very complex and technical article. Read through it for the general ideas presented about the history and uses of genetic mapping.

Family Coping with Chronic Illness

Family Suffering

Still Alice Book Discussion

Free Write # 4 regarding

family during a chronic illness experience

June 19th

Complete Second Family Visit

Family Intervention – this is just a guideline to keep you on track-it is not literally due.

Group Discussion in D2L – Week 5

1. Svavarsdottir conducted an integrative review about Nordic families with children who are chronically ill. Three exemplar family cases were described. How can nurses be empathetically connected to these families? In Figure 1, Svavarsdottir (2006), shows how family daily activities, family relations and family health are interconnected. Describe how the family’s quality of life is affected if one or more of these 3 factors were hindered. What may be some suggestions to help these families boost their quality of life? Feel free to share any experiences in your career where you were empathetically connected to a family and helped boost their quality of life.

2. From your readings and your own experience, identify and discuss five needs of families during a crisis experience.

3. Develop a three generation pedigree to assess your personal family history information using the following website https://phgkb.cdc.gov/FHH/html/index.html The pedigree should represent three generations (student, parents, grandparents). Complete your family history, save it, and view your history grid and genogram. Share your insights into your family health with your group (you do not need to post the pedigree itself).

4. The Bennet article is a helpful resource for pedigree and genogram symbols when you start diagramming genograms in Module 3.

5. Read the genomics case study and Alzheimer’s fact sheet.

Module 3

Week 6

June 20

Family Assessment & Interview

Denham (2015) Ch. 4 & 5

Review Kaakinen (2018) Ch. 5 & 8

Duhamel, Dupuis, & Wright (2009)

Family System Strengths Stressors Inventory pdf on D2L

Family Assessment

and Interview

Family Assessment and Interventions in Practice

Complete Third Family Visit

Family Evaluation -this is just a guideline to keep you on track-it is not literally due.

Group Discussion in D2L – Week 6

1. What is your perspective on key elements of family assessment, based on your text readings? Develop and post the family interview guide you plan on using for the family interview. What underlying framework supports your interview guide (Calgary Family Assessment Model (CFAM), described in Wright and Leahey A Guide to Family Assessment and Intervention, Family System Strengths Stressors Inventory (FS3I)? See PDF attachment on D2L

2. Discuss family assessment in your groups. Discussion may include why family assessment is important or how assessment approaches and structure may differ across settings. Discuss barriers, personal or institutional, to engaging in family assessment.

3. Create and upload the Family Nursing Tools:  Genogram, Ecomap, Circular Conversation, and Attachment Diagram.  {Make sure the name of your family members are changed to protect their identity. 

Module 4

Week 7

June 27

Family Assessment and Interventions in Practice

Family Interventions

Review Kaakinen (2018) Ch. 10 & 11

Denham (2015) Ch. 11, 14 & 15

Wiegand (2008)

Review Video in Module 1: Simulation SEE Model

Video: Debriefing SEE Model with Family Constructs and Family Nursing Actions

Refer to the following chapters to identify nursing interventions:

Kaakinen (2018) Ch. 12-17

Denham (2015) Ch. 10, 11, 12, 13, & 14

Family Level Nursing Approaches

Upload draft Family Nursing Project into discussion thread this week

Please upload your Family Nursing Project.

Review and provide feedback for two individual’s Family Nursing Project.

Incorporate the feedback you receive from your peers into your final Family Nursing Project paper.

Module 4

Week 8

July 4

Family Nursing Policy

Review Denham (2015) Ch. 12

Family nursing interventions and approaches

Family Nursing Project due July 10th

July 10th is the last day to submit graded assignments.

Group Discussion in D2L – Week 8

1.

2. 1. Based upon your readings and your family interview paper experience, what policies (community, institution, statewide, nationwide, global, unit-based, etc.) would you want to put into practice to support the use of the family nursing interventions?

2.

3. 2, Consider your readings and discussions this semester (textbook, personal annotated bibliography, articles, postings, etc.). What family nursing interventions/approaches do you propose to support the family health and illness experience and advance family nursing practice?  Post at least 5 nursing interventions/approaches (include citations and references).

3.

4. 3. Choose a policy at your institution and review it from a family friendly perspective. What did you see? Are there improvements you could suggest?

4.

5. 4. Contact your risk manager or quality and safety nurse to learn whether or not family is used as an indicator within your institution. If yes, find out why and how the institution is measuring the family indicator. If no, propose why the institution needs to focus on family and how a family focused nursing practice could be implemented.

Family Constructs and Family Nursing Actions

Renee Kurth

Family constructs

What do you notice about the construct in the story?

Nursing actions directed toward the family

Family Information Keeper

The information keepers in each family (Hazel and Gus) are their mothers. They are the individuals that hold the knowledge of each person’s health and illness.

Offer additional resources,

Hold meetings to discuss plan of care

Hold family meetings so everyone understands the information presented to them.

Family Vigilance

Hazel continues to go to support group even though she does not initially like it. She complains but her parents are vigilant about her attending support group routinely.

Family needs to reduce the risk of infection for Hazel and ensure she has her oxygen always available.

Monitor for symptoms- use appropriate hand hygiene, reduce the chances of infection,

Advocate for effective management of oxygen.

Family Waiting

Each family waiting for the next step, the next complication, the next positive moment, and waiting for death. The families waited for miracles and different outcomes to each situation presented. The time continues to be uncertain/unknown.

Provide contact numbers for resources

Family Protection

Both families are very protective of Gus and Hazel, what they do, how they are feeling, where they go, and what they experience?

Provide respite for the caregiver to allow a break or time away from their family member

Family Anxiety

Both families experience anxiety about death and anticipation of death for each of their children. They also have an anxiety of the complications of their illness and hospitalizations. They also experience anxiety about each of them being an individual and doing their own things with their illness and independence.

Discuss the plan of care with the family, what symptoms will anticipate a hospital admission, what have they decided about end-of-life cares, and management of the symptoms.

Family Uncertainty

Both families have a sense of uncertainty. What does the future hold? When will death occurs? Will the plan of care continue or what will derail their plan?

Offer additional resources and develop a plan of care.

Family Health Promotion

Hazel wants to live her life as she knows it will be brief. She wants to experience the things that will make her happy.

Help remove the barriers of Hazel doing normal teenage activities. Help find equipment like a portable oxygen tank that is easier to carry, offer a wheelchair if she will be walking long distances to avoid shortness of breath. Encourage her to participate in more activities.

Family Change

Both families (Gus and Hazel’s) did not want to lose their roles as parents when their children were gone.

Suggest parent support groups to assist in the role changing and feelings associated. Involve expert resources for counseling as needed.

Family Stress

Both families experience stress with the illness, complications, and future of their illness.

Discuss stress coping skills, beliefs the family lives by, and actions they take to reduce stress. Assist family with finding the resources needed to reduce the amount of stress by offloading some of the normal everyday routines (hire a cleaning lady, have someone grocery shop, etc.).

Family Crisis

When Isaac’s girlfriend breaks up with him, Gus, and Hazel comfort him and help him understand the right to be angry.

Assist Isaac in returning to a level of functioning prior to his relationship with his girlfriend, provide support, and listen.

Family Beliefs

After experiencing the death of Gus, Hazel is no longer afraid of death as she knows she will be closer to the people she loves.

Gus’s family is religious, but they still struggle to be close to their son.

Offer listening ears to allow Hazel to discuss her feelings and her methods of coping.

Family Communication

Hazel’s parents try to communicate with her routinely, how she is feeling, and what she is thinking but they can be overbearing and hovering. They want her to be a normal teenager and they encourage her to go to her support group to assist in this sense of normalcy.

Encourage routine family meetings and open communication. Encourage daily, weekly, monthly huddles to keep all necessary people involved in current situation, plan of care, and future state.

Family Coordination

The mother is the coordinator of care.

Hazel’s mom attended the trip with them and coordinated some of the experiences they shared.

Offer respite care to provide a break to the mother.

Family Connection

Hazel is so worried about her parents experiencing pain from her illness that she distances herself from them instead of making more time to be with them and create memories.

Encourage routine family meetings to talk about current state and what they can do as a family to create memories. Identify barriers to activities and help breakdown the barriers.

Family Vulnerability

Hazel’s mother is vulnerable because her life revolves around her daughters and her cancer diagnosis, and she will be vulnerable and have difficulty coping when she is gone.

Encourage support groups, open family conversations, and expression of feelings

Family Support

Family is not the only important thing but the support of true friendships. Hazel, Gus, and Isaac can relate to each other and rely on each other as a family. They provide support to each other and lift each other up when they are down.

Help patient with activities of daily living

Provide additional entertainment for her friends to participate in.

Provide additional opportunities for the friends to get together to keep them all safe.

Family Coping

The parents are overprotective of Hazel and Gus, but they also understand why.

Assist the family in decision-making by offering additional resources for support.

Family Caregiving

Gus and Hazel both had families that were very involved in their care and provide care to them when they were the most vulnerable.

Help develop the skills and knowledge for the family to care for the individual.

Family Inquiry

Gus and Hazel have an effective support system and family involvement in their well-being and diagnosis.

Seek additional learning opportunities

Develop knowledge and understanding of different approaches to cancer treatments and options.

Family Structure

Family is their support for both Hazel and Gus. They want to be independent but continue to rely heavily on their parents for support as needed.

Establish boundaries

Family Fear

Hazel and Gus’s family have a fear of them dying. Hazel’s mom had a fear of not being a mom anymore.

Gus had a fear of not being remembered after death. Hazel and Gus had a fear of time as they knew how precious their days were.

Allow an opportunity for the family to discuss their fears with each other—provide resources to the family-like support groups, clergy, prayer, or other spiritual/religious rituals.

Family Suffering

Hazel was devastated by Gus’s death, but it also allowed her to realize the importance of living in the moment and it is ok that love does not last forever.

Invite Hazel to a meaningful conversation and allow her to express herself, what she has learned, and what goals she has developed

Family Transitions

Gus’s family transitions from one stage to the next as he progressively worsens, and his health deteriorates.

Gus and Hazel transition through life as they learn about love and the experiences of life.

Identify the level of transitions and develop a plan of care for each transition stage. Include the family in the discussion and plan development.

Family Illness Experience

Like everyone, the family is also impacted by the experience and illness.

Assist the family in managing their everyday roles and responsibilities

Family Cultural Influences

Hazel’s family celebrates half birthdays and Gus’s family lives with a cheerful outlook and uses positive sayings throughout their home to encourage hopeful behaviors.

Be aware of their culture, build trust, listen to their individual needs and practices

Family Experience with EOL

Gus and Hazel had an increasing interest in adult experiences when on their trip. They drank liquor and participated in intimate experiences. They had these experiences as they knew their time was limited. Hazel’s mom did not object to some of these experiences and she often encouraged them to enjoy their time.

Both families knew they both were limited of their independence, and they relied on each other’s family to express their emotions.

Understand the patient and family’s goals for care.

Listen to the patient and the family and their wishes

Advocate for the patient’s wishes

Manage symptoms and promote comfort

Communicate the signs/symptoms and care of the patient with the healthcare team

Complete appropriate assessments

Manage the medications and supplies needed

Family Management Styles

Parenting a teenage child with a cancer diagnosis is difficult. They continue to relate to the days when she was healthy. They want her to be a teenager but also cling to her youth by asking her to sleep with her stuffed childhood animal.

Discuss with the family and individual and understand their perspective of Hazel and Gus’s chronic condition.

Family Sharing/Storytelling

Gus, Hazel, and Isaac can relate to each other as they share similar stories of cancer, being young, and so close to death.

Help reduce the number of barriers faced by Gus, Hazel, and Isaac to routinely communicate and be together. Identify transportation needs any technology needs to allow for frequent communication and support.

Reference

Green, J. (2012). The fault in our stars. Dutton Books

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