Family Nursing Process and Culturally Competent Care of the Family, Essay Example

Introduction

Family Nursing aims to provide wholesome care to the patient as well the family in its entirety in order to enable the benefits of therapy to be really effective. Impersonal treatment with drugs or other therapeutic interventions just provide a curative platform but lack the provision of psychological treatment which is absolutely essential for an unhealthy individual. Debilitating ailments do not cause physical distress alone but change the atmosphere in the household towards a negative direction, and the families experience difficulties in regaining a healthy environment within the household. The physician just provides expertise in prescribing the right course of therapy but it is the nursing interventions which facilitate full and wholesome treatment. Modern nursing practice is not just the facilitation of therapy alone but involves the components of research and evidence based practice (Hockenberry-Eaton et al, 1998). Outcome measures have to be predetermined in individual cases depending upon the cultural, ethnic, economic and religious background of the patient and researched thoroughly to develop the strategy for delivering nursing care. Creating congruence with the culture of the patient within an evidence based nursing practice is of utmost importance in order to elicit responsiveness from patients with unique cultural backgrounds (Bridge et al, 2008). It is therefore essential to look into and research all details of a patient as well as the affected family before developing a strategy to appropriately deliver the therapeutic intervention. The effort has to be a consistent one within the available resources until the objectives have been successfully realized.

Scenario Analysis

The presented scenario is a typical example where a wholesome therapeutic intervention is needed, where not only the patient/s but the parents also need psychological counseling and support. Although a sufficient period of twenty years has elapsed since the family migrated from Peru to the United States, the cultural background resulted in the initial fear for the modern medicine system in both parents, Pedro and Maria. This might have led to a less effective treatment for their younger son Marco who has nevertheless been appropriately been treated with insulin therapy after he was diagnosed for diabetes at the tender age of 5 years. Marco naturally needed more attention from his parents due to his diabetic condition and this caused resentment in the elder brother, Jose, who was just two years older. The neglect Jose might have experienced in the early years of his life may have precipitated depression or some other psychological illness in the young boy. The religious affiliation of the family, lack of relatives in the US suggests their isolation from the mainstream society which would have resulted in psychological stress and loneliness in all family members. The mediocre earning of the family and the desire in the parents to educate their children complicate the matter further, especially as Jose is not interested in higher studies.  The diabetic child Marco, on the other hand is a keen student and comes up to the expectations of his parents by endeavoring to be an engineer, at the same time taking good care of himself by taking timely medication in the form of insulin shots. Jose meanwhile develops bad habits due to his temperament and starts using drugs which necessitates more financial resources which he obtains initially stealing money from his parents and later by selling the precious insulin syringes which are provided at a ration to the diabetic Marco by the health insurance company. This jeopardizes the life of both the children as well as the parents. Jose’ bad habits results in him contracting Hepatitis B from the infected syringes and his diabetic brother too contracts the disease through the replaced insulin syringes which he has used inadvertently. There are ample reasons at this stage for the whole family to feel devastated and therefore all of them are in dire need of an appropriate psychological counseling as well the treatment of the medical condition of both children.

Prospective Nursing Care and Medical Interventions

For the Parents

Both Pedro and Maria have shown the marks of hard work and determination in taking the brave decision to migrate to a foreign land and have worked hard for sustaining themselves and nurtured the natural ambition for good education and life for their children. There dream lies shattered at this stage and they must be in deep depression bordering on despair. They not only need medication for depression but community support as well in order to compromise with the situation and face the reality. High prevalence rates of depression have been encountered in the society in migrant families, primarily due to financial constraints (Lindert et al, 2009). The Perez family belongs to the Latino community which has attained the status of the highest minority within the United States (Lassetter & Baldwin, 2004). Finding members with similar backgrounds and with the same religious inclinations is therefore not difficult and an appropriate community setting should be identified where they can attain some solace by sharing and participating in productive activities. There primary concern is still the welfare of their children and an effective strategy to address the medical condition of both children has to be formulated. Appropriate evaluative tests for the psychological status of both parents need to be conducted and the degree of depression evaluated which can be treated with the combination of appropriate anti anxiety and anti depression drugs and psychotherapy.

For the Children

Both Marco and Jose are young adults and mature enough to realize the gravity of their situation. Marco being more sensible needs to be treated adequately for Hepatitis B as well as his original diabetic condition which puts him in a higher risk category. He needs to be hospitalized. His blood glucose needs to be monitored and the health of the liver needs to be evaluated with proper diagnostic techniques. Hepatitis B is a lifelong disease and people remain lifelong carriers. If the extent of damage is less, then a combination of hepatitis B vaccine and immunoglobulin may be successful in preventing the chronic condition if the extent of damage is not much at this stage (www.merck.com). Marco is also in dire need of counseling and psychological support as his dream of becoming an engineer must have been affected by the condition he finds himself in. He will need continuous medical support for the immediate period until some remission of symptoms has been achieved from where he can take control of his own life.

Jose on the other hand needs desperate help and should be immediately transferred to a de-addiction and rehabilitation centre as he is hooked to drugs. Heroin addiction needs comprehensive treatment at a special facility. Hepatitis B has complicated his condition too and if he is not provided the recommended treatment he is likely to deteriorate further and his drug addiction habit might put him at a risk of getting infected with AIDS. He needs social rehabilitation and probably the component of law may also creep into his life which can affect his future.

The Perez family is thus in dire need of family counseling and appropriate therapeutic interventions based on each member’s condition.

Reference

Bridge T.J., Massie E.G. & Mills C.S. (2008). Prioritizing cultural competence in the implementation of an evidence-based practice model, Children and Youth Services Review, 30 1111–1118

Hepatitis, Liver and Gallbladder Disorders, online article assessed October 22, 2009 at: http://www.merck.com/mmhe/print/sec10/ch137/ch137a.html

Hockenberry-Eaton M., Barrera P. & Kline N.E. (1998). Evidence-based Practice: A Role for Nurse Practitioners, J. Pediatric Health Care, Vol.12, 338-339

Lassetter J.H. & Baldwin J.H. (2004). Health Care Barriers for Latino Children and Provision of Culturally Competent Care, Journal of Pediatric Nursing, Vol 19, No 3

Lindert J., Ehrenstein O.S., Priebe S. et al (2009). Depression and anxiety in labor migrants and refugees – A systematic review and meta-analysis, Social Science & Medicine, 69  246–257