Relational Practice: Reflections on Family Nursing

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Introduction

Engagement with resource family provides nurses with opportunities to apply perspective theories learnt in class. Scientists have developed theories to govern the domain of family nursing. Doane and Varcoe (2005) posit that experience with family is the best source of knowledge for family nursing (p.4). However, a nursing student can learn about family nursing through other sources including learning activities, CD discussion, and reflection.

Theories and definitions learnt in class offer nurses with only the structures for family nursing. Although theories and definition provide knowledge useful for family nursing, they do not reveal the challenges and complexities unique to every new family event (Doane & Varcoe, 2005, p.4). They do not predict family emotions and behavior that nurse experiences when having a moment with a family in line of duty. This essay describes an experience with resource family and its effects on family nursing knowledge.

Reflections

Habits and conducts

Objectivity means looking at things or situations as they are rather than from ones emotions or feelings. Philosophers believe that individuals can detach themselves from their own feelings or interpretations and evaluate situations in an objective way. Indeed, according to the Cartesian view, objective truth is not only possible, but also desirable (Doane & Varcoe, 2005, p.4). In this light, I tried so much to desist from the emotional involvement of the family situation and perform my responsibility on evidence-based practice.

The resource family allowed me to realize my ability to persuade people to do things they previously objected or did not favor. The experience taught me to address any health event with passion because it motivates a nurse to search all the possible interventions and settle on the best. In addition, I realized that respect is fundamental for a nurse to win the trust of a patient and subsequent compliance to any developed intervention.

Nevertheless, often I will find myself struggling to develop a personal interpretation of a family in terms of its socioeconomic status. My interpretation will influence my assessment of the family situation. For instance, I may connect a problem to poverty and dismiss other possibilities. I learned that I should not make conclusions based on my observation of family conditions; rather I should rely on information obtained from family members.

Ethical issues may arise in some family situations. In instances where a child is concerned, I may be required to seek consent from parents or the parent may respond on behalf of the child. This situation poses a challenge in the intervention choice because the information may be inaccurate or biased. Far worse is the situation in which a family member may be terminally ill. In this circumstance, I may be compelled to train other members to care for the terminally ill member so that in the absence of a nurse, they know what to do. However, other members often neglect the sick person, something that usually makes me guilty so that I consider spending most of my time with the terminally ill person and abandon my other responsibilities.

In some situations, ethical issues may arise which may compel a nurse to take legal action. In circumstances of conflict within the family, older family members may abuse and/or neglect the children. Such situations may demand a shift from objective stance to subjective, wherein I may be forced to seek intervention of agencies such as child support, a condition that makes me uneasy towards the decisions I made.

Although expert knowledge can enlighten the nursing practice, the problem often arise when expert knowledge is incorporated and applied as if it represents the outright truth about families. I released that when I assess a family, it is assumed that the conclusion I arrive at reflect the absolute truth of the familys health and healing situation. However, most often than not, objective information of a family is limited (Doane & Varcoe, 2005, p.5). In various perspectives, objective knowledge is superficial because it most often exposes only that which a nurse can access externally.

Relational practice

Relationship is fundamental to each event of nursing practice. We draw a relationship between two things viz. events or conditions. In addition, we can relate the same situation at different times. A nurse can tell whether the health situation is improving or worsening by relating to a previous or present health situation. Moreover, by relating an idea to health event, I am able to understand an intervention that best suits the situation.

Relationship may influence knowledge. In fact, Doane and Varcoe (2005) argue that, relationships are a site for developing and acting on knowledge (p.174). For instance, I am able to identify how a relationship with other families has altered my knowledge of health events in relevance to family situation. Particularly, relationships with families and other people have altered my knowledge in some ways including:

Through relationships, I have been able to exchange knowledge with the families or people I work;
I have opportunity to learn from the families and become better informed; and
The families knowledge and mine is developed, expanded, and enacted.

The proceeding paragraph relates my experience with a family situation. This encounter helped me understand myself regarding my habit and conduct. This relational moment was fundamental for shaping my habit and conduct as a nurse.

Relational moment with family

One day as I was attending to a car accident casualty, I walked quietly into her room and busily checked her IV, her tubes, and dressings. Throughout my task, I took caution not to wake her because I silently did not desire to engage her in any activity at that moment. The client suffered a fatal car accident that caused the physician to amputate her legs.

Her two months old baby was sleeping in the crib, and as I was winding up my tasks, the child started crying. I picked her up as slowly as I could, fearing that she might wake her mother up. Just then, the husband walked into the house, greeted me, and placed a soft kiss on his sick wife. He inquired her progress from me, which I responded in short form answers offering no observation for fear of arousing emotional events with him.

Clearly, I did not want any emotional involvement with the family. This was inappropriate because apparently the family needed emotional support and encouragement to move on with live; something I was not willing to give. Hence, I have learned that a nurse should offer emotional support and encouragement to help speed up recovery.

Factors that hinder nurse-patient relationship

Many nurses choose to desist from developing any relationship with patients. The authors explored the reasons why nurses choose to take that stance. Often, nurses assume that they must know how to manage a patients discomfort (Doane & Varcoe, 2005, p.176); therefore, they resort to just giving advice or decide not to talk about challenging situations. A nurse owns discomforts about his/her inability to improve the situation and/or the uncertainty of what may transpire sometimes causes nurses to distance from the familys emotion. A nurse may occasionally withdraw because they do not wish to experience such an in-depth emotion and pain.

In addition, nurses may distance themselves partially because of the messages they receive with respect to that which is and is not necessary and valuable in nursing practice. Regrettably, it is evident that nurses undervalue other nurses for being excessively emotional or involved (Doane & Varcoe, 2005, p.5). Therefore, nurses develop and promote emotional distance so that emotional involvement does not match with the general work pattern whatsoever. In fact, during their free time most nurses usually decide to sit down at the desk engaging with peers instead of patients and their families.

Conclusion

The nurses habits of distancing themselves from emotional engagement with family hinder their ability to honor, respect, and sustain peoples health and healing process. This detachment diminishes their capacity to guarantee that they are fully knowledgeable on top of being informed about families (Doane & Varcoe, 2005, p.260). In this regard, I appreciate relational practice as highly focused and deliberate. Nevertheless, I will take into account that the goals and assumption driving me should be different from those that guide me when I am practicing from a business perspective, a perspective of liberal individualism, or a biomedical perspective.

Reference

Doane, G. H., & Varcoe, C. (2005). Family nursing as relational inquiry: developing health promoting practice. Philadelphia: Lippinncott Williams & Wilkins.

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