Sheila and Jenson's Marital Challenges

This assignment delves into the marital difficulties experienced by Sheila and Jenson, whose relationship is strained due to a 14-year age difference. The case study examines various aspects of their struggles, including communication breakdowns, differing life experiences, and Scott's lack of support for Sheila. Nursing interventions aimed at helping Sheila cope with stress and isolation are also discussed.

Nursing process applied to family

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
1.Genogram depicting the family structure............................................................................1
2. Structure of the family........................................................................................................2
3. Determination of Strength of the family using AFSNAG..................................................3
PART 2............................................................................................................................................3
1. Challenges being faced by the family................................................................................3
2. Implementation and Evaluation of the issue .....................................................................4
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
A nursing process can be considered as a procedure consisting of a sequence of steps
specially made for nurses so that they can be able to provide appropriate and efficient care. The
process is divided into five phases such as assessment, identification, planning, executing and
finally evaluating (George, 2011). The subjective data in the procedure is the views and ideas
from the point of view of a client. There is a nursing goal in the process which means a desirable
change in the behaviour and status of the patient. The report is about the nursing care of the
family and its proper implementation and evaluation in order to stay away from the issues.
PART 1
1.Genogram depicting the family structure
A genogram can be termed as a pictorial display of family relationships of a person
including the medical history. Following is the genogram for the whole structure of the family
case discussed in the report. Scott and Sheila are married from two years. They have a daughter
and a son named Jessie and Grant. Keith and Mary are parents of Sheila who come to visit her on
a regular basis. Scott have already lost his father and the last time Sheila met both of them was
at the time of their marriage. Before this marriage, Scott was already married twice. From the
first wife, he has three sons and from the second, he has none. After the birth of Grant, Jessie
behaves abnormally sometimes. Scott as well as her grandparents are tired of her annoying
tantrums. Despite of that, they still adore her a lot.
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2. Structure of the family
Sheila and Scott met at the time they were studying accountancy in the TAFE course
together. Since two years, they have been married. There was an age gap of 14 years between
them. They have two kids, one daughter Jessie and son, Grant. Before this marriage, Scott was
already married two times. From the first wife, they had three sons and from the second, they
have none. Scott wants Sheila to spend some quality time with the children but she wants to be a
working women like she wishes of becoming a teacher in future (Maurer & Smith, 2013). She
has already planned that when Grant become older, she might search for some book keeping
work for the house to be managed. From the time, Grant has born, Jessie had become short
tempered and for Scott, it is very frustrating. They have been recently moved to a four bedroom
set which has been made on a property of 20 hectares. It is quite far from their town, approx 40
km away from their town. As Scott is not welcoming all-time, Sheila parents prefer to visit to her
when he is not at home. Scott's father is no more but her mother lives alone. Her husband was
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suffering from bowel cancer at the age of 84. Sheila has met his parents once in a lifetime at the
time of their marriage.
As there is a huge age gap between the couple, it is obvious for them to face as many
issues. This is so because the understanding level differs at different stages of age. As now,
Grant is not yet toilet trained and it seems difficult for Sheila to manage him as well as Jessie.
They have only one car in the house and that too is used by Scott (Morton & et.al, 2017). Neither
Sheila can go anywhere as they live far away from the city, it becomes very hard for her to
manage. On a regular basis, her parents come to visit her but they prefer to visit in the absence of
Scott.
Although both of them are working, they come to visit her on the weekends and
moreover when Scott is not present at home. Her daughter, Jessie has in a habit of doing useless
tantrums after the birth of Grant. Her grandmother and father also adore her a lot but is annoying
of her tantrums (Yildirim & Ozkahraman, 2011). As the other children of Scott were not
immunised, Sheila is worried about Grant getting immunised. After going through the pre term
birth notes, I noticed there were major complications, his APGAR scores were 3 at the time of
birth and 6 at five minutes. Also, it was found that Sheila Scott should have cleared the fact with
Sheila and as their age gap was major as of 14 years, it was possible enough for them to face
these issues of compatibility.
3. Determination of Strength of the family using AFSNAG
Very few strengths can be seen in the following family case as there is a huge age gap
difference between the both. In this case, affection can be seen between Sheila and her parents as
even after the rude attitude of Scott, they still come to visit her when he is not at home. It is the
love and the care they have for their daughter. Although they both are working, but they still take
time and visit to her daughter on the weekends. They live two hours far from Sheila, but
whenever possible, they visit. They provide a support to Jessie and she can consider the fact that
there is someone to take care of her. They love Jessie a lot but her tantrums are very annoying for
the old couple. Sheila behaves very adjusting as well, despite of Scott being non cooperative at
various ideas, She is adjusting for her kids, so that they may not have to suffer further.
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PART 2
1. Challenges being faced by the family
There are various challenges that the family is facing. Even more than any other member
of the family, Sheila is facing the most of it. She wants to be a teacher but Scott wants her to
spend the quality time with the kids before they get big enough to go to school. Jessie is two
years old and Grant is just four weak older. She has to manage both the children with home too.
Despite, Scott seems not at all cooperative to her. He often comes late to home and that too
brings his office work (Morton & et.al, 2017). They live approximately 40 km from their town,
so the medium for their transport is car only, which Scott takes to the office. Sheila is not even
able to go anywhere. She has become frustrated of the isolation there. The bus stand is also one
km away from their home. After the birth of Grant, things have become complicated for her.
Jessie's behaviour has also changed. She and her annoying tantrums have become annoying for
them to manage. Although Grant is breast fed, still he cries a lot, because of which she even
cannot be able to sleep well. This is affecting her health also. Sheila wants to send Jessie to a day
care but then, she have to face transport problem.
2. Implementation and Evaluation of the issue
Description of the issue
Stress and Isolation
It was obvious enough that Sheila must be needing some means of transport in case if she
wants to go somewhere. But, Scott was unable to understand the fact because he used to go
office by car daily. It does not matter for him if Sheila had to go somewhere out or in case of any
emergency. She was not getting support from him (Tomlinson, Peden‐McAlpine & Sherman,
2012). Although, Scott does not welcome her parents, they come to visit her as many times as
possible.
As Scott takes car with himself to the office, Sheila was unable to go anywhere else.
Also, their home was 40 km away from the town, there was no public transport to be used. So,
they were properly dependent on the car which Scott used to take (Morton & et.al, 2017). She
has got irritated and frustrated from that isolation. She was not even able to visit to her parents.
They often come to visit her, despite of Scott not welcoming them. They just for love and
support, visit her when Scott was not present at home. She was so helpless that even after having
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everything and was suffering from isolation. At this time, Scott should provide her total support
and care.
Planning nursing care
A proper plan for nursing care can be prepared, which can help in providing the direction
of the specific type of care the person needs and which will prove beneficial for it, helps in
solving the issue completely (Maurer & Smith, 2013). If the problem is not solved completely,
but to an extent that Sheila must be able to come out of the depression. The plan consists of some
specific components such as assessment, expected results, interventions, evaluation and
rationale. Providing inclusive care in consideration with the person's social, physical and mental
needs (Morton & et.al, 2017). This nursing goal can prove relevant for Sheila as she must be
suffering from frustration and depression this time. These plans help in guiding a particular
direction for the individualised care of Sheila.
Also, it can help in providing a comfortable and friendly environment. It includes the
support methods also such as care bundles and care pathways. They consider the team effort
regarding to all the standards of care and the expected results. Bundles considers the best
practices considering the care for stress and mental illness. It can be considered as any mental
issue like frustration, extraordinary stress etc.
Implementation
Nursing interventions can prove very beneficial for Sheila. These can be considered as
actions or activities which are specially designed to get the outcome from that specific nursing
goal. A Physician very often starts the medical orders for servicing the patients that are being
reviewed by the hospital admitting nurse (George, 2011). The nursing service interventions
usually consist of two factors and that are firstly the specific intervention, activities and services
and secondly, the type of action that exceeds the actual scope of the particular intervention. Both
these factors are very important for the documentation process and providing proper care and
support to Sheila so that she can be able to fight with the stress and exclude her out of the
isolation. There are three categories of nursing interventions and these are dependent,
independent and interdependent intervention. Sheila can adopt independent invention. It can help
her soothing the mind and maintaining the blood pressure level. She can be able to minimise the
stress and frustration level and can stay happy.
Evaluation of the nursing care
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The process of independent intervention helped Sheila in managing the stress level and
to be able of developing proper focus on her kids. This can help her in balanced levels of blood
pressure and other factors (Doenges & Moorhouse, 2012). Although the intervention helped her
a lot in modifying the inappropriate activities , it is a time consuming process and after a while,
the person alone has to focus on these factors to keep it working. It may result better and may
result worst also, the reasons may be lack of attention. This also helped her in excluding herself
from isolation, stress and the related activities which led her to depression and helped her in
focusing on her family and kids. This technique of intervention changed Sheila's life to an extent
that she became able to fight with the stress levels and making her husband understand that she
cannot be able to survive happy without his support.
CONCLUSION
It has been concluded from the report that Sheila and Jenson were facing many issues in
their married life because of a huge age gap of 14 years. It was obvious that their level of
understanding and maturity differs from each another. Scott was not even interested in
welcoming Sheila's parents when they visit their home. Although they were living 40 km far
away from their town, Scott never cooperated with her in any of the household issues. Various
nursing interventions are there to help. Sheila adopted independent intervention for reducing
these factors like stress and isolation, it helped her to be out of these problems.
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REFERENCES
Books and Journals
Doenges, M. E., & Moorhouse, M. F. (2012). Application of nursing process and nursing
diagnosis: an interactive text for diagnostic reasoning. FA Davis.
George, J. B. (2011). Nursing Theories: The Base for Professional Nursing Practice, 6/e.
Pearson Education India.
Gerrish, K., & Lacey, A. (2010). The research process in nursing. John Wiley & Sons.
Kaakinen, J. R. & et.al., (2014). Family health care nursing: Theory, practice, and research. FA
Davis.
Maurer, F. A., & Smith, C. M. (2013). Community/public health nursing practice: Health for
families and populations. Elsevier Health Sciences.
Morton, P. G. & et.al., (2017). Critical care nursing: a holistic approach. Lippincott Williams
& Wilkins.
Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.
Pillitteri, A. (2010). Maternal & child health nursing: Care of the childbearing & childrearing
family. Lippincott Williams & Wilkins.
Szanton, S. L., & Gill, J. M. (2010). Facilitating resilience using a society-to-cells framework: a
theory of nursing essentials applied to research and practice. Advances in Nursing
Science. 33(4). 329-343.
Tomlinson, P. S., Peden‐McAlpine, C., & Sherman, S. (2012). A family systems nursing
intervention model for paediatric health crisis. Journal of advanced nursing. 68(3). 705-
714.
Yildirim, B., & Ozkahraman, S. (2011). Critical thinking in nursing process and education.
International journal of humanities and social science. 1(13). 257-262.
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