Family is a term that can be interpreted differently by every individual, as it defines itself by one’s personal experiences and expectations. In health care, one would define a family as a support system to an individual in a state of compromised health. The family role in the health care setting can vary based on the patient’s condition. In the intensive care unit the families play a large role especially, for those individuals whom lose his or her ability to provide self-care and make self-care decisions.
As a health care provider it is important to understand the role of family system, family concept, and the application of an appropriate family nursing theory. Family System/Concept of Family For a family system to have a positive role in the intensive care unit the family must serve as a system in support of the individual family member. The family often plays a role in the plan of care, as the individual suffering the illness cannot serve as the sole provider of self-care.
In some cases the ill individual cannot play a role in self-care. The family can play a role in the individual’s recovery by coming together as one to support healing, or simply identifying, and achieving individual health goals. All individuals in the intensive care unit develop a plan of care with the assistance of a multi-disciplinary team, including nursing, physicians, social work, and case management. In some cases end-of-life ecisions must be made primarily based on known individual wishes or documents, and the support of the family. Even when a patient in the intensive care unit has an opportunity for a positive outcome there are difficult decisions, difficult messages, and difficult conversations to be had. According to a study completed by Caroline Williams; the family plays a larger role than providing information about the individual; including emotional support to the patient, and a positive psychological effect (Williams, 2005).
In the situation which a family members health is compromised to the level that they need to be in the intensive care unit, not only does the family need to come together to serve as a support for the patient, but also a support for one another. As health care providers one must serve a role in this process as well. According to Damboise and Cardin, the family’s needs include; information, reassurance, support, and the need to be near the patient (2003).
Family Nursing Theory. Orem’s Self Care Model of Nursing involves the understanding that patients not only have the ability, but also the right, and responsibility to care for themselves (Clark, 1986). One believes that Orem’s model is important in the intensive care setting, often-times we rely too heavily on the families and support personnel, and forget to rely on the theoretical framework to encourage and guide the individual to provide self-care and make self-care decisions (Orem, 2001).
When an individual is cannot provide self-care, as often is the case in the critical care setting it is important for the family to approach oneself needs as a system. One believes it is important for the family to understand the complexity of the self-care needs. Decisions for plan of care can be based on what the family perceives as the individual needs, which can be a deception of reality if nursing and health care personnel are solely providing such care needs. Many families visit the hospital and see the best of the patients day.
The health care professional provide all self-care; they never see the patient struggle to take a bite of food, be cleaned up from numerous incidents of incontinence, or the struggle to get he or she into the chair prior to his or her visit. When this happens, the families’ reality of taking the individual home does not seem so unreachable. It is when the family plays an active role in such activities that they see the reality of providing care to an individual with debilitating health conditions. By managing ones hospital stay be Orem’s Self Care Model, a family can make educated decisions on the plan of care.
Conclusion Anytime an individual is in the hospital no matter what level of care the emotional stress on the individual and family can be very overwhelming. By supporting the individual with the concept of the family as a system, one is on track for the best outcomes. In some cases the best possible outcome is making a difficult decision to maintain the integrity of the individual involved. By practicing nursing care based on theories such as Orem’s we can ensure that one has done everything he or she can do to support positive individual outcomes.
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