Lecture 2 - What is Family Nursing?

What is the significance of family-focused care according to research?

Family-focused care has positive health benefits for both the patient and their family.

What are some challenges faced by nurses in providing family nursing care?

Discordant family dynamics, family absence, distant and uninvolved family members, uniqueness of each family, incongruences, time demands, and nurse vulnerability.

What are some perceived benefits of family nursing care?

Improved communication, inclusion in care, trust in nursing, appreciation of the nurse, unity of purpose, meaningful connections, and family care being part of usual practice.

List the IFNA generalist competencies for family nursing practice.

1. Enhance and promote family health.

2. Focus on families' strengths and support individual growth.

3. Demonstrate leadership and systems thinking skills.

4. Commit to self-reflective practice.

5. Practice using an evidence-based approach.

What does IFNA competency 4.1 emphasize for nurses?

It emphasizes reflecting on one's own expectations regarding families in health and illness, including beliefs, values, attitudes, judgments, strengths, and limitations.

Who is associated with the concept of intersectionality and its urgency?

Kimberle Crenshaw.

What is positionality?

How differences in social position and power shape identities and access in society.

What does IFNA competency 4.2 emphasize for nurses?

It emphasizes recognizing that family nursing happens in relationships, which evolves through the nurse's and family's interactions.

How do adverse childhood experiences affect health outcomes?

They can lead to negative health outcomes later in life, influencing family functioning and health.

What role does self-reflective practice play in family nursing?

It helps nurses understand their own beliefs and biases, improving care for families.

What is the importance of understanding sociopolitical contexts in family nursing?

It helps address health inequities and better understand the challenges families face.

What does trauma-informed care involve in the context of family nursing?

It involves recognizing and responding to the impact of trauma on families, ensuring care is sensitive to their experiences.

What are some examples of social dynamics that can affect health according to intersectionality?

Racism, classism, heterosexism, ableism, ageism, and sexism.

How can nurses enhance family health according to IFNA competencies?

By promoting family strengths, supporting individual growth, and facilitating successful life transitions.

What is the significance of meaningful connections in family nursing practice?

They foster trust and improve the overall health experience for families.

What does 'authentication of the worth of family-focused care' mean?

It refers to the need for recognizing and validating the importance of family involvement in health care.

What is the relationship between nurses' attitudes and family care practices?

Nurses' attitudes significantly influence how family care is integrated into nursing practice.

What is meant by 'nurse vulnerability' in the context of family nursing?

It refers to the emotional and psychological challenges nurses face when engaging with complex family dynamics.

What does intersectionality reveal about individual experiences?

Individual experiences are linked to broader structures and systems that shape and are shaped by power relations.

What is the importance of reflexivity in intersectional approaches?

Scholars, researchers, policy makers, and activists must consider their own social position, role, and power before setting priorities in research, policy work, and activism.

What is the primary goal of intersectionality?

Intersectionality is oriented towards transformation, building coalitions among different groups, and working towards social justice.

Why is understanding one's positionality important?

It helps one increase their self-awareness of how their backgrounds, experiences, and identities influence how they interact and work with others.

What is IFNA Competency 4.1 focused on?

Reflecting on one's own process and identifying expectations regarding families in health and illness, including beliefs, values, and limitations.

What does IFNA Competency 4.2 emphasize?

Recognizing that family nursing occurs in relationships that co-evolve through the contributions and interactions of both the nurse and the family.

What is relational inquiry?

A way of looking at your patients that moves beyond an individualistic view to consider the broader context of relationships and social systems.

What are the three levels of relational inquiry?

Intrapersonal (within the person), interpersonal (between people), and contextual (around the situation).

What are reference points in the context of relational inquiry?

Developed based on individual experiences, backgrounds, and social locations, shaping how we interpret the world.

How do reference points influence behaviour?

They create informal or unconscious rules that guide how we behave or work.

What does relational inquiry encourage nurses to consider about their patients?

To extend their reference points to include who constitutes their patient and what nursing obligations they have.

What is the significance of relational dynamics in nursing practice?

Relational dynamics help nurses understand the complexities of patient care beyond individual circumstances.

What is the role of inquiry in relational inquiry?

Inquiry is used across multiple levels to understand the interactions and dynamics affecting patients.

What is the origin of the term 'Census family' in Canada?

It originates from the Western idea of the nuclear family.

What is a limitation of the Canadian 'Census' family definition?

It is limited to pre-defined categories and does not include those who live alone or those who live together but do not fit those categories.

What does reciprocity in family nursing refer to?

The relationship between the nurse and patient/family characterized by shared affect, asymmetric recognition, dynamic equilibrium, and an alliance of humanity.

What is dynamic equilibrium?

Ongoing, patterned exchanges where both professional and service user behave and respond to each other, partially meeting each other's needs, even if the roles are unequal.

What is shared affect?

Mutual emotional involvement, where professionals and clients express and share feelings, practice empathy, acceptance, and reduce anxiety together.

What is asymmetric alliance?

A relationship based more on alliance than equal partnership, recognizing the inherent inequality but still achieving shared understanding and decision-making

What does recognition of humanity involve?

Emphasizing respect, value, and equality, not as professionals and patients, but as humans with rights and interests.

List 5 reasons why reciprocity is important in family nursing.

1. Builds trust

2. Balances nurse-family power dynamic

3. Increases family participation and engagement.

4. Fosters a therapeutic relationship.

5. Supports family resilience.

What does IFNA Competency 4.2 emphasize about family nursing?

It emphasizes that family nursing happens in relationships that co-evolve through the nurse's and the family's contributions and interactions.

What does IFNA Competency 1.4 emphasize about family nursing?

It emphasizes taking the cultural and contextual nature of families and the environment into consideration.

What are structural determinants of health?

The cause of the social determinants of health.

What gap exists in policies related to the social determinants of health?

Families are often missing from policies and practices related to the social determinants of health.

What are some different ways that family can influence health as a social determinant of health?

Emotional support, health behaviours, access and navigation of healthcare, early childhood development, social network, and genetic factors.

What does the IFNA competency 1.2 emphasize?

I emphasizes evaluating how family responses to health and illness are interactional.

What does the IFNA competency 1.7 emphasize?

It emphasizes incorporating health promotion and illness management principles/actions in clinical decision-making with families.

What does the IFNA competency 1.11 emphasize?

It emphasizes acting by safeguarding the fundamental rights of the patient and family.

What does IFNA Competency 1.4 emphasize?

It emphasizes considering the cultural and contextual nature of families in the societal environment.

What is trauma?

A single or repeated experience that overwhelms one's ability to cope.

What are 3 common elements of trauma?

It's unexpected, the person was unprepared, and there was nothing that they could do to stop it.

What are some effects of trauma on individuals?

Changes in the brain, compromised immune system, attachment difficulties, hyperarousal, and physical and mental stress.

What are common sources of family trauma?

Relationship loss, abuse, assault, humiliating circumstances, death or injury of others, severe illness, and sudden job loss.

What are Adverse Childhood Experiences (ACEs)?

Potentially traumatizing experiences in the first 18 years of life, such as abuse, neglect, and household dysfunction.

What is the correlation between ACEs and health outcomes?

Adults with 4 or more ACEs are 12 times more likely to experience adverse health outcomes.

What are some impacts of ACEs on individuals?

Disrupted neurodevelopment, cognitive impairment, health risk behaviors, and increased risk of chronic diseases.

What demographic reports more ACEs?

Women and queer individuals.

What is intergenerational trauma?

Cumulative emotional and psychological wounding across generations.

What are adverse community environments?

Conditions such as poverty, racism, violence, and poor housing that affect health and well-being.

What is trauma-informed care?

Type of care that views the whole picture of a patient's life and acknowledges the impact of trauma on health.

What shift in questioning does trauma-informed care advocate for?

From 'What is wrong with you?' to 'What has happened to you?'

What are the principles of trauma-informed care?

Acknowledgment and trauma awareness, safety and trustworthiness, collaboration and connection, and empowerment.

What are the 4 R's of trauma-informed care?

Realize, recognize, respond, and resist.

How does trauma-informed care affect clinical practice?

It encourages clinicians to consider the trauma history of patients to provide effective care.

What does the acronym DEF stand for in the context of trauma-informed care?

Distress, Emotional support, Family support.

What should be assessed regarding family distress in trauma-informed care?

Assess and manage physical/emotional pain and gauge family worries.

How can practitioners encourage hope and resilience in families?

Acknowledge the family's ability to grow from adversity, recognize their strengths, use trauma-informed language, and ask them what healing looks like to them.

What is the ACE test used for?

It measures traumatic experiences and examines the relationship between ACEs and adult health/social outcomes.

What are some examples of Benevolent Childhood Experiences (BCEs)?

Having a safe caregiver, a good friend, teachers who care, and a predictable home routine.

What is the purpose of the Benevolent Childhood Experiences scale?

To mitigate the effects of ACEs through corrective experiences.