Free Write Example
Posted May 14, 2022 12:01 AM
For patients and their families, acute illness or the exacerbation of chronic illness requiring hospitalization may be unexpected. These experiences often bring out the best or the worst in people and serve as a proving ground for the functionality of the family. Roles are suddenly shifted or reversed (Kaakinen et al., 2018, p. 23). Uncertainty regarding prognosis, timing, and circumstances of recovery creates stress for family members. Those with a host of their own health problems may have difficulty coping with the additional significant emotional and financial burden of their loved one’s illness.
In my own experience caring for acutely ill patients on an intensive care unit, significant acute illness, such as cardiac arrest, creates an environment in which family members with unresolved relational conflicts are forced to interact around important decisions for a common loved one. Sometimes family members and patient significant others battle for decision-making control. At times, they may attempt to manipulate health care providers to take sides. But acute illness may also strengthen families and provide a platform for long-delayed reconciliation. One member’s acute illness may also result in positive health behavior changes for others.
Each person’s need for the support of a family is displayed in the context of acute illness. Some people have very little relational support and can function adequately in their daily life, but during acute illness and recovery have very few resources for even basic support. I’ve taken care of numerous patients who were recovering from open-heart surgery and had no one who could stay at home with them for a few days after hospital discharge. Many people have a wealth of family resources and these families serve to spur the patient on toward the best outcomes. Families encourage patients to eat, mobilize, and ask unanswered questions. Families may voice patient concerns or advocate for comfort or pain control.
It’s important to recognize that most patients live within the context of a family prior to their illness and will eventually return to that context. Considering this, it makes sense that nurses would involve family in most aspects of patient care and teaching as they will continue care during recovery at home. Family members may know the patient well, providing relevant insight on medical and personal history that can help providers with the etiology of the illness and other factors that will provide a more comprehensive and accurate picture of the patient’s presentation.
When considering the family as the client one might anticipate that families will be struggling with knowledge deficit, anxiety, grief, dysfunctional coping, financial concerns, caregiver burnout, and role strain, among other issues. Some of the ways nursing can assist with these issues are the provision of education, empathetic listening, and recruitment of resources, such as chaplaincy staff and social work/case management for post-hospital care. Simply providing information and answering questions can help families cope (Eggenberger & Nelms, 2007, p. 1623). A shift in nurses’ thinking may need to occur to see family not as a hindrance to nursing care, but as an ally in care and to acknowledge and affirm the significance of the family as context for support and healthy behaviors. The family plays an important role in the patient’s life and the patient plays an important role in the family.
References
Eggenberger, S. K., & Nelms, T. P. (2007). Being family: The family experience when an adult member is hospitalized with a critical illness. Journal of Clinical Nursing, 16, 1618–1628. doi: 10.1111/j.1365-2702.2006.01659.x
Kaakinen, J. R., Coehlo, D. P., Steele, R. & Robinson, M. (2018). Family Health Care Nursing: Theory, Practice, and Research (6th Ed.) [EPUB Version]. Available from https://bookshelf.vitalsource.com
