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2810NRS Child and Family Nursing Practice Assessment 1, Trimester 2, 2017

Written assignment:

“Nursing Process applied to a Family” 2,000 words

Weighting: 40 % Due Date: Monday 21st August, 2017 by 5.00 pm

Aim:

The aim of this written assessment item is to apply the nursing process in providing family centred care. When an infant, young child or adolescent experiences a health or social issue, the issue can impact upon all family members. Nurses working in acute care and community settings need to understand the functioning of the family unit so they can care for and assist the whole family. This written assignment addresses course learning outcomes 2 and 3:

2. Demonstrate an understanding of the functioning of the family unit using family

assessment models that enable families to make health decisions;

3. Plan and evaluate evidence-based nursing for families across the lifespan.

Instructions:

This 2000 word written assignment has two distinct parts that you should address separately. Please use headings for each part. You do not need to provide an introduction or a conclusion for the written assignment or any of the parts. There are two family scenarios for you to choose from; select ONE scenario and use this for your entire assignment.

Part 1 - Nursing Care of the Family: Assessment (500 words)

 Create a genogram to visually depict the family’s structure. You must use the PowerPoint slide which will be supplied to you within the Assessment Folder on [email protected] course site to create your genogram. Save the slide as a picture file (*.jpeg), and insert the picture into your document.

 Below the genogram, summarise the structure of the family to demonstrate your understanding of the family assessment findings.

 Use the Australian Family Strengths Nursing Assessment Guide (AFSNAG) to identify and briefly describe two (2) strengths of the family you are assessing.

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Part 2 - Nursing Care of the Family: Planning, Implementing and Evaluating (1,500

words)

 Select two (2) issues/challenges for the family or a member of the family you have selected. These issues may be identified by the nurse, family or both. These can be health, social, or developmental family issues/challenges e.g., breastfeeding, social isolation, transition to parenting; they should not be ‘medical’ issues e.g., diabetes, high blood pressure.

 For each issue/challenge identified in the family assessment (allow approximately 750 words per issue):

a) Describe the issue

o Use appropriate evidence from scholarly literature to describe the issue and discuss what is known about the issue/challenge.

b) Plan nursing care

o Provide a relevant nursing goal and justify the goal (explain why it is relevant to the issue) using appropriate evidence or policies.

c) Implement nursing care

o Outline one nursing intervention that supports the family to achieve the goal. Each nursing intervention should be supplemented by the recommendation of an existing online resource for the family and an appropriate referral.

d) Evaluate nursing care

o Describe how you would evaluate the effectiveness of the intervention to address whether it met the planned goal of care.

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Other elements:

 Do not include a Griffith University cover page at the start of your assignment. You will agree to the assignment submission statements when you submit electronically.

 Refer to the Griffith Health Writing and Referencing Guide for guidance on writing, and referencing according to APA 6th style and presentation.

 Ensure that you use relevant scholarly literature1 (digitised readings, research articles, relevant Government reports and text books) that has been published within the last seven (7) years. If you use literature older than 7 years, you will need to justify why you are not using recent literature. Please note it is preferable to locate and use Australian sources if you are describing the extent or magnitude of the issue.

 Use academic language2 throughout and write in the third person.  Refer to the marking criteria when writing your assignment. This will assist you in

calculating the weightings of the sections for your assignment.

 State your word count (excluding your reference list) on your assignment title page.  Maintain academic integrity.

 Submit your assignment as a word document (not a PDF).  Submit a draft assignment via Turnitin and check your Turnitin report (allow up to 24

hours for report generation). If you need more information about Turnitin, make use of the online resources.

 Submit your final assignment via Turnitin as per the instructions on the 2810NRS [email protected] course site [Submit in the ‘Assessment’ tab].

 Keep your Turnitin receipt as a record of successful submission.

1Some papers are of central importance to a research topic, often because they report a major breakthrough,

insight, or a new and generative synthesis of ideas. This kind of paper may describe a study that changes our

understanding of a topic, or describes and illustrates a new and highly useful research method. These kinds of

articles are often referred to as seminal or classic papers.

2 Everyday language is predominantly subjective. It is mainly used to express opinions based on personal

preference or belief rather than evidence. Written academic English is formal. It avoids colloquialisms and

slang, which may be subject to local and social variations. Formal language is more precise and stable, and

therefore more suitable for the expression of complex ideas and the development of reasoned arguments.

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Family Scenario One: The Williams Family

Parents:

● Hannah Williams, 29, operates a successful clothes boutique business. ● Steven Williams, 32, is an electrician for an oil company in Gladstone, Queensland. Steven is

away for four weeks, then returns home for two weeks leave. Background:

● Steven and Hannah have been married for 3 years, following Hannah’s bitter divorce from her first husband, Barry. Steven has not been married before.

● Hannah has a 5 year old son, Billy from her first marriage and shares joint custody of her son. ● Hannah had an uneventful first pregnancy and a normal delivery. ● Billy attends the local prep-school. ● Hannah has had trouble conceiving with Steven, but is now 32 weeks pregnant with her

second child. ● Hannah plans to stop working at 38 weeks gestation and employ a manager to take care of her

business for six months following the birth. After this, Hannah plans to return to work whilst the baby will attend the local day care centre.

● The couple relocated to a larger three bedroom home in a coastal suburb on the southern Gold Coast at three months gestation, increasing their mortgage to do so.

Extended family:

● Billy’s father (Hannah’s former husband) Barry (36) is a lawyer and lives in a nearby suburb. He is in a relationship with Jane (34), a primary school teacher. Jane and her two children (from a previous relationship) Ronan (12) and Emily (10), live with Barry. Billy enjoys spending time with his father.

● Hannah’s mother, Marion (52), had postnatal depression (PND) after the birth of Hannah. This remained undiagnosed and untreated until Hannah went to school.

● Two years ago Marion retired to the northern Gold Coast. She is very supportive of Hannah and is looking forward to helping more with her grandchildren.

● Hannah’s father, Sam (59), lives and works in the Philippines. He has a new Filipino wife, Ariel (39) and they visit Australia twice a year.

● Steven’s father, Henry, died last year at 64 years of age from coronary heart disease. He and Steven’s mother, Mavis (59) had been married for 39 years. Mavis lives in Sydney, and is

trying to cope with the loss of her husband. Steven and family do not see her very often. Steven describes his father as a harsh disciplinarian who was not warm and hit him with a belt occasionally if he misbehaved as a child.

Current situation:

● Hannah gave birth to a baby girl, eight weeks premature. Hannah was discharged from hospital six weeks ago, and has been visiting her baby every day in the Special Care Nursery in the hospital. The baby is now breast feeding, having been tube fed expressed breast milk for the first week of life. The baby will be discharged from hospital tomorrow, into Hannah and Steven’s care. Hannah is planning to breastfeed the baby for the first six months before she returns to work. She also plans to paint and make new curtains for the baby’s bedroom,

the lounge and dining areas to save some money. She likes to keep fit and hopes to join a new parents walking group to meet other new mums.

● Due to work commitments over recent years and with the new move, Hannah and Steven have not met many people on the Gold Coast, except for a small group of mothers met through Billy’s prep-school. Since moving to the Gold Coast Steven has taken up golf during

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his time off work. He has joined the local Golf Club and plans to take the family there for lunch soon, declaring that this might be a good place to meet some people.

● Due to Hannah’s caesarean section delivery, she has declined to resume any form of sexual relationship with Steven, which he says he understands. He is anticipating that they will be able to resume sex within a week or two, stating that ‘things will be back to normal again soon’. He adds that because Hannah is taking time off work he thinks she will be rested, more relaxed and willing to resume their sexual relationship.

● Steven is a little concerned about how they will manage financially during the first six months, while a paid manager is looking after Hannah’s business, so is keen for Hannah to return to work full time. When asked about how he will manage being woken up by the baby early in the mornings he says that, ‘Hannah can sort that as I will go for an early round of golf in the mornings when I’m home. And besides, she has done this all before when Billy was a baby’. He adds that he still plans to help with the cooking in the evenings when he is home. In the weekends he is looking forward to family time as long as the baby ‘doesn’t cry too much’.

● Hannah is concerned how she will cope with two small children, especially when Steven is away working his four week rotation.

As the Child and Family Health nurse, the Midwife has notified you about Hannah and her baby’s impending discharge. You meet the family at the home visit when they are discharged from hospital.

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Family Scenario Two: The Jenson Family

Parents:

● Sheila Jenson, 24, is a stay-at-home mum, and Scott Jenson, 38, is an accountant. They have been married for 2 years.

Background:

● Sheila met Scott while she was undertaking a TAFE course studying accountancy. Sheila has completed a Diploma in Accounting but has not been employed since finishing this qualification.

● They have one daughter Jessie (2 years old) and a newborn son Grant (4 weeks old). ● Scott has been married twice before and has three sons (10, 8 and 6 years old) from his prior

marriage to Shelly and no children from his first marriage to Lydia. ● Sheila stays at home with the children as Scott prefers Sheila to be able to have quality time

with the children before they go to school. Sheila would like to work part time as a teacher in the future however she will have to study again to do this. She might look for part-time bookkeeping work when Grant is older.

● They recently moved to a four bedroom house set on 20 hectares of property 40 km from town.

Extended family:

● Sheila’s parents Mary (55) and Keith (60) live over 2 hours away although they visit whenever they can.

● Mary and Keith would like to come and help Sheila more often but they prefer to come when Scott is not home as he is not always welcoming. They generally come on weekends as they are both still working so this makes it difficult. They adore Jessie but find her temper tantrums difficult, particularly since the birth of Grant.

● Scott’s mother Brydey, 79, lives alone in an assisted living unit two hours away, but does not feel settled there and is becoming increasingly forgetful and agitated. She moved there after her husband Robert passed away suddenly two years ago from bowel cancer at 84. The only time Sheila has met Scott’s parents was at her wedding to Scott.

Current situation:

● Sheila is finding it quite difficult having a toddler who does not sleep much, who is not toilet trained and still in nappies, in addition to a new baby. Sheila is feeling rather isolated, particularly as they only have one car and Scott needs the car to drive to work. They live one kilometre away from the closest bus stop which makes it difficult to go anywhere.

● Scott regularly comes home late from work and often brings work home with him. Scott expects the house to be immaculate and dinner ready on the table when he arrives home from work. Sheila has found this very difficult particularly with the arrival of Grant.

● Sheila is feeling very tired and discusses this with you when you attend a newborn home visit. Grant is breast fed although Sheila says he cries all the time. Sheila has not had much sleep over the past 4 weeks.

● Sheila is also worried about Jessie and would like to have her toilet trained. Jessie does not sleep well and is eating very little. Jessie is also quite withdrawn and Sheila would like to take her to day care but this is too far away by public transport. Her tantrums are also annoying Scott who gets very cross with her. You notice that Jessie is still sucking her thumb.

● Sheila raises some concerns about the children when you do a home visit. Sheila discusses Jessie’s increasing temper tantrums and not being toilet trained in addition to her poor

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sleeping. She is also unsure about getting Grant immunised, as Scott’s other children were not immunised.

● You refer to the hospital discharge notes regarding Grant's pre-term birth and notice that there had been some complications and Sheila had an emergency lower segment caesarean section [LSCS] for foetal distress during her labour at 34 weeks.

● His APGAR scores at birth were 3 at one minute, and 6 at five minutes. ● He was in Neonatal Intensive Care Unit (NICU) on CPAP for 24 hours and spent two weeks

in Special Care Nursery (SCN) prior to discharge. As the Child and Family Health nurse, you check Grant’s progress and notice that he is tracking along the 10th percentile line for weight, length and head circumference measurements since discharge from hospital.

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MARKING CRITERIA POSSIBLE MARK

Nursing care of the family: Assessment

 Uses the supplied template to create a genogram and insert it into the body of the assignment.

 Correctly uses text and symbols to visually represent the family and creates an accurate, comprehensive genogram.

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 Accurately summarises the family structure and demonstrates understanding of the family assessment findings

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 Clearly identifies and describes two family strengths using the AFSNAG 5

Nursing care of the family: Planning, Implementing and Evaluating For each issue: Issue 1 Issue 2 a) Description of issue/challenge  Describes an issue/challenge experienced by the family or its members  Clearly and logically discusses what is known about this issue/challenge

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b) Planning nursing care  Provides a relevant nursing goal  Provides a clear, logical justification for the chosen goal (why it is

relevant to the issue)

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c) Implementing nursing care  Discusses one appropriate nursing intervention to achieve the goal  Provides a clear, logical justification for the chosen nursing intervention  Supplements the nursing intervention by recommending an online

resource for the family and providing an appropriate referral

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d) Evaluating nursing care  Describes how the nurse would evaluate the effectiveness of this nursing

intervention and whether it met the planned goal of care 5 5

All parts – REFERENCING and USE OF EVIDENCE

 The written assessment task is appropriately supported by no fewer than 10 different sources

 The sources are scholarly and are appropriately inserted in-text to provide relevant evidence to support the point/s made

 Referencing (in-text citations and reference list entries) strictly adheres to APA Style 6th Edition guidelines.

 Reference list starts on a separate page.

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All parts - PRESENTATION and STRUCTURE

 Conforms to the Assignment Presentation Formatting Guidelines  Includes assignment title page (not Griffith University assignment

submission cover sheet)  Essay is well presented, with correct spelling, grammar, and well-

constructed sentence and paragraph structure  Uses academic language throughout  Word count is stated and 2,000 words or less.

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Total marks 100