Child and Family Nursing: Assessment and Care Plan Report

This report presents a child and family nursing assessment of the Williams family, addressing two key issues: social isolation and the transition to parenthood. The report begins with a genogram of the family, highlighting key relationships and dynamics. It then identifies family strengths, such as support and shared activities. The core of the report focuses on the nursing care plans developed to address the identified issues. For social isolation, the plan emphasizes emotional support and strategies to rebuild the family network. For the transition to parenthood, the plan aims to promote the father's engagement in childcare through educational sessions. The report details the implementation and evaluation of each care plan, including specific interventions and methods for assessing outcomes. The evaluation methods include observations and the use of tools such as the Lubben Social Network Scale. The report provides a comprehensive overview of the nursing care process in the context of family health.

1Running head: CHILD AND FAMILY NURSING
Child and Family Nursing
Name of student:
Name of university:
Author note:

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Family scenario 1- The Williams family
Assessment
Figure: Genogram of the Williams Family
Description of the genogram
The present genogram focuses on the Williams family, namey Hannah and Steven
Williams. The two have been married for three years, after Hannah go divorced from her
former husband, Barry. The two have a child named Billy. Barry at present is in a
relationship with Jane, who has two children, the elder one Ronan and the younger one
Emily, from the previous relationship whose name has not been mentioned. Steven’s father
Henry passed away a year ago while his mother Mavis is alive. Hannah’s father Sam is
presently married to his second wife Ariel, while his first mother Marion, Hannah’s mother is
alive.
Family strengths
The first strength that the Williams family is having is support. Hannah has been
receiving the required physical support from her mother at frequent intervals. Her mother has

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come forward to share the load. She has relocated to the area the Williams have been living
recently and has expressed a desire to help Hannah with taking care of the new born.
According to Hockenberry and Wilson (2014), support from an elderly family member is
crucial for a family that is struggling to cope up with the pressures of parenthood. If there is a
pillar of support, parents are better to fulfil the responsibilities assigned to them. Positive
family support enhances the ability of a new parent to make healthier life choices. Support
from the mother would probably be thee best form of support one can receive. The support at
the times of crisis has been indicated to have a good impact on the individual.
The second strength that the Williams family is having is instances of shared
activities. Steven expresses his wish to help her wife with cooking in the evening when is at
home. This is the time frame when the couple gets to spend some time together while
completing the household chores. As pointed out by Lowdermilk et al., (2014) sharing tasks
with the spouse is a positive approach. While the couple shares a certain family responsibility
and engages in an activity, the communication and bond between the two individuals are
enhanced. There is an increased opportunity to understand the opposite person’s feelings and
perceptions. Shared activities lead to harmony and peace in the family.
Planning, Implementation and Evaluation
Issue 1- Social isolation
Description of the issue- The prime challenge that the Williams family is facing is social
isolation. From the case study, it is found that Hannah and Steven have relocated to their
present location recently and have not been successful in establishing social contacts with the
community. Due to commitments of their professional life and relocation, they have not met
new people, except for a group of mothers through Billy's school. Steven has recently joined
the local golf club and wishes to take his family to the club so that they can meet new people.

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The only source of support for Hannah is her mother Marion as Steven’s mother stays away
and does not visit them often. It is therefore evident that the family, and more precisely
Hannah is suffering from social isolation. According to Kaakinen et al., (2014) social
isolation is the state of lack of contact between a person and the society. Social isolation can
have a deep impact on almost all aspects of the existence of the person, including parenting.
It is feared that a new parent might develop feelings of loneliness due to social isolation,
resulting in depression. This would ultimately have a negative impact on her parenting style.
Once loneliness engulfs a new mother, as a result of becoming disconnected from the outer
world, negative responses are expected to come in. Since there are no peer groups with whom
the new mother can share her ideas and thoughts, the person is likely to suffer from low self-
esteem and loss of energy. It is imperative that a new mother has enhanced self-confidence
and esteem, and adequate energy to establish a stable relationship with the family members.
Nursing care plan- The nursing goal for Hannah, in relation to social isolation would be
aligned with the present situation she is facing. The goal would be to use recognisable and
repetitive strategies that are valid for increasing the morale of the individual and provide her
with emotional support. The rationale for this nursing goal is that emotional support and
guidance would provide Hannah with the human companionship she seeks. The
establishment of a new relationship based on trust and exchange of feelings would cover up
for the solitary existence she is living in. Engaging in regular conversations with an
individual outside the family would increase possibilities of social engagement and maintain
the uniqueness of relationships within the family (Denham et al., 2015).
Implementation of care plan- The nurse would play the role of a counsellor and supporting
the individual to assist Hannah to cope up with her feelings os isolation. It is advised that the
nurse visits her on a regular basis and spends a considerable amount of time with her at her
home. Such regular periods of interaction would help in enhancing her self-esteem as the

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nurse would suggest ways to cope up with the pressures of parenting a new born. The client is
to be assisted in expressing their concerns and the challenges they face on a daily basis.
Discussing barriers to social interactions would be a beneficial approach. In addition,
motivational devices can be used by the nurse to develop the discussion between the nurse
and the client. These can be in the form of videos, pictures or audio recordings. The nurse
must engage in an effective commucniation with the client that is based on trust and mutual
respect. The communication must be transparent and culturally sensitive (Ammerman et al.,
2013).
The very important step of helping the client rebuild the family network would also prove to
be beneficial in this respect. Since rebuilding and keeping family networks has a lot to offer,
the nurse must help Hannah build up a strong relationship with her family members
(Widarsson et al., 2014). The user can consider making contact with her husband for
discussing strategies by which he can help in reducing the issues pertaining to social
isolation. It is crucial that Steven supports Hannah for combating social isolation. He,
therefore, needs to be motivated and encouraged by the nurse for the same.
Evaluation of care plan- Ideally, the preferred outcomes of the provided intervention would
be to reduce social isolation and increase the integrity of the client. The outcomes of the
intervention could be evaluated through two distinct processes; observations taken for the
client and using a tool for the same. The nurse must consider taking regular observations
regarding client’s change in behaviour and expressions of self-esteem. Whether the client
exhibits increased energy and enthusiasm and points out an improved relationship with her
husband, are the other aspects to be evaluated. A measurement instrument could be used for
the same purpose if required. One such example of a tool is the Lubben Social Network
Scale. This scale applies 10 items, placing individuals into four different quartiles each with a
cut-off score for indication of social isolation (Denham et al., 2015).

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Issue 2- Transition to parenthood
Description of the issue- The second issue that coms up in light of the presented case study
are difficulties in transition to parenthood as experienced by Steven. Steven is found to be
concerned about the financial condition of the family. Moreover, he is unable to cope with
the needs of parenthood and is not emotionally prepared to embrace fatherhood. This is
evident from the fact that he wants his wife to manage and take care of the baby early in the
mornings while he is away for his golf sessions. To add to the issue, he is only looking to
family time if the baby does not cry too much. As highlighted by Bennett et al., (2017)
transition to parenthood is considered as a vital adjustment period for the family members,
especially the father. With the addition of a baby to the family, a drastic change in lifestyle is
to be expected. This developmental period has serious implications for fathers. Research has
been continually indicating that it is stressful for an individual to embrace fatherhood and
cope up with the profound sudden changes. Since these changes are often problematic,
chances are high that the father is not able to establish a strong relationship with the baby or
the mother.
Nursing care plan- The nursing goal in relation to the issue above would be to promote better
engagement of Steven in the care process of the newborn. He would be demonstrating
increased intentions to help out Hannah with the care taking of the baby and handle tactfully
instances of the baby crying or similar concerns. The rationale for this goal is that fathers
play a crucial role in the upbringing of the child and his involvement is as necessary as that of
the mother (Roy et al., 2014). Steven is in need of promoting his parental competencies and
provide support to his wife in times of need. The necessity of the father figure is required in
the first few months after child birth as the mother alone is not able to handle the challenges
of parenting alone.

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Implementation of care plan- Parenthood is a relevant ensuring topic in the contemporary
society and probably the most vital developmental transition in nursing. Promotion,
facilitation and empowerment of the father are the key aim of nurses in this regard (Gross &
Marcussen, 2017). According to Ateah (2013), the best proven strategy for enhancing the
experiences of fathers and motivating them to take part in the child caring process is to
conduct educational sessions. Such sessions are known to help new fathers cope up with the
burdens faced while undergoing the transition. Educational sessions have the key focus on
imparting information to the parents on different effective strategies using which the
individual can better handle the challenges coming up. The authors emphasises that the
education session content must have the focus on case study examples where parents combat
challenges similar to the faced by the client. Steven can relate the information provided to
him with his real life experiences to come up with logical solutions to problems.
Through the different adaptation strategies, Steven would be helped to make a healthy
transition to the reality of becoming a father. The participation of the parent needs to be
upheld throughout the entire education session. By doing so, there would be a reduction of
the rejection that Steven might feel while taking care of the baby. Since Steven is a working
father and has rotational job schedule, it would be advisable to conduct the sessions just after
he gets back home on leave. However, the time and duration of the sessions are to be decided
as per the convenience of Steven (Sethna et al., 2017).
Evaluation of care plan- The best possible method of evaluating the improvements shown by
Steven is to receive feedback from Hannah. Hannah would be the person who would provide
information on whether Steven shows changes in his behaviours in relation to parenting. For
achieving this, Hannah needs to be educated with strategies to observe behaviours and note
them over a considerable period of time. Since Stevens is known to remain at on-job sites for
certain time frames, the same can be challenging. Hannah needs to be motivated to remain

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patient and enduring while engaging in any conversation with steven regarding his change of
behaviour. Feedback needs to be taken on a regular basis whenever there is a chance of
getting so. It is vital that the nurse answers any doubts or questions that Hannah has in
relation to what to expect from Steven. Reinforcing the skills of Steven to the advancement
of his parental role would be a justified approach (Denham et al., 2015).

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