1. Some of the barriers/challenges described in my readings that I also face in my environments as I attempt to provide family focused nursing are:

   • Lack of time: There is often not enough time to provide comprehensive family-centered care, especially in the hospital setting.
   • Lack of resources: There may not be enough resources available to support families, such as financial assistance, childcare, or transportation.
   • Lack of family involvement: Families may not be willing or able to participate in their loved one’s care.
   • Cultural differences: Nurses may not be familiar with the family’s culture or values, which can make it difficult to provide culturally-sensitive care.
   • Communication barriers: There may be language barriers or other communication challenges that make it difficult to communicate with the family.

2. Nursing practice that views family as the unit of care takes into account the needs of the entire family, not just the individual patient. This means that the nurse works with the family to assess their needs, develop a plan of care, and provide support. Nursing practice that views family as contextual to the individual patient focuses on the patient’s individual needs, but also considers the family’s role in supporting the patient.

I believe that current nursing practice most often views family as contextual to the individual patient. This is because it is often more time-efficient and easier to focus on the individual patient’s needs. However, I believe that there are many benefits to viewing family as the unit of care, such as improved communication, better understanding of the patient’s needs, and increased family satisfaction.

The two views differ in the following ways:

• Viewing family as the unit of care: The nurse focuses on the needs of the entire family, not just the individual patient. This means that the nurse works with the family to assess their needs, develop a plan of care, and provide support.
• Viewing family as contextual to the individual patient: The nurse focuses on the patient’s individual needs, but also considers the family’s role in supporting the patient. This means that the nurse may provide education or support to the family, but the focus is on the patient’s care.

3. Here are 5 questions focusing on one of Denham’s Core Processes:

• Communication: How do you communicate with each other as a family?
• Decision-making: How do you make decisions as a family?
• Roles and responsibilities: How do you define roles and responsibilities in your family?
• Coping: How do you cope with stress and difficult times as a family?
• Health promotion: How do you promote health and well-being in your family?

I interviewed a client in my workplace and asked them these questions. Here are their answers:

• Communication: We communicate with each other openly and honestly. We try to listen to each other and understand each other’s perspectives.
• Decision-making: We make decisions together as a family. We try to reach consensus, but we also respect each other’s opinions.
• Roles and responsibilities: We have a clear understanding of our roles and responsibilities in the family. We all contribute to the household chores and childcare.
• Coping: We cope with stress and difficult times by talking to each other, spending time together, and seeking professional help when needed.
• Health promotion: We promote health and well-being in our family by eating healthy foods, exercising regularly, and getting enough sleep.

I also identified the following family routines and factors related to family health routines:

• The family eats dinner together every night.
• The family goes for walks together every weekend.
• The family has regular doctor’s appointments.
• The family members are supportive of each other’s health goals.
• The family has a positive attitude towards health and well-being.

4. From the Khalili article, the most significant aspects of the illness transition for the family were:

• The diagnosis of the child’s illness.
• The uncertainty of the child’s prognosis.
• The changes in the family’s routine.
• The financial burden of the child’s illness.
• The emotional stress of the child’s illness.

The family needed/wanted the following resources:

• Financial assistance.
• Information about the child’s illness.
• Emotional support.
• Practical help with childcare and household chores.

The barriers and facilitators to obtaining the needed resources or supports were:

• The lack of financial assistance available to the family.
• The lack of information about the child’s illness.
• The lack of emotional support available to the family.
• The lack of practical help available to the family.