Child Nursing: Family-Centered Care, Risk, & Resilience

This essay delves into the principles of family-centered care within child nursing, emphasizing the importance of involving families in the care process. It examines the concepts of risk and resilience, particularly within the context of a Syrian refugee family, highlighting challenges such as poverty, trauma, and health issues. The essay analyzes potential interventions, including cognitive behavior therapy, community support, and psychological counseling, tailored to address the family's specific needs. It also considers the possible trajectory of the family's health and well-being if family-centered practices are not effectively implemented. The essay concludes with a reflective analysis using Gibbs' model, evaluating the student's personal experiences and understanding of family-centered care in nursing practice.

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Child Nursing
By (Name)
Course
Instructor
Institution
City and State
Date
Introduction

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Child Nursing
It is vivid that most health centers nowadays are offering family-centered cared services, where
patients and their families are listened to, considered and involved in the care process. Families
appreciate the services provided by the health organizations when they partner with the patient's
families regardless of their cultures and family background. The family-centered care program is
structured in a way that it recognizes the significance of family situation with their hospitalized
child, (Davidson, 2017 P.136). The FCC program objectives are to strengthen family roles and
the bond between the family and their child. Family-centered care emphasizes personal physical
care, detachment of the emotions, technical abilities considered as a threat to patient recovery
(Hill, et.al 2018. p 22). Nurses through their knowledge, guide, provide social support and help
their children in self-management. The nurse, therefore, updates the family on their child
recovery process and the reason for the administration of certain medications (Coyne et al., 2011,
p2561). The clinicians importantly work with the child's family to ensure the child's health and
wellbeing are beneficial safeguarded (D, 2016 p.3.)
Risk and Resilience
Risks are factors or reasons that may find it challenging to keep families safe. These factors may
make people worry much about their safety and wellbeing. These may include, unemployment,
diseases, poverty and even violence. (Pérez 2019). As a result of violence, many families become
exposed to various risks, which doesn’t only affect the family but the community as a whole.
Children's exposure to violence impacts their emotional behavior, (Masten, 2018 p.12). Besides,
violence exposure to families has proved to cause mental health problems. Concerning Karim’s
scenario, they have recently fled Syria on a one-way journey into the UK. Correspondingly,
Terek suffers from post-traumatic stress disorder as a result of torture from Syria, making it
difficult to care for his family. Therefore, the family is at risk of starvation and they need urgent

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help in this situation, such as more food donations. The main breadwinners are unwell and
cannot care for their families. They entirely depend on Sima to take care of them. The family
also depends on donors for food and clothing. The parents are unable to provide social and
physical support that the children need.
Rima and Elias are at risk of negligence seeing that their parents are unable to take care of
them. They may lack proper parental care and love which they mostly need at their tender age.
They need to be fed and well clothed (Lucas et.al 2018 P.41) In contrast, Rima and Elias still
depend on the well-wishers. Sima may be psychologically stressed up due to the state of their
family and being the main care of her family. At her critical adolescent stage, she should be
receiving parental guidance and moral support rather than taking the roles of her parents, even
though children are obligated to assist their parents in times of need (Rede and Lucey,2014 P 11)
Rima and Elias are at risk of starvation seeing that their two parents are unable to take care of
them. They are also at risk of malnutrition as a result of poor feeding. Besides, these also puts
them under malnutritional diseases such as kwashiorkor and marasmus (Nisar et al., 2016 p.1).
This calls for children organizations such as UNICEF and Children international which will be
able to feed the children and cater to their nutritional needs through their volunteer programs
(Michaud‐Létourneau,2019 p.12683). The community, food banks, as well as individuals, should
take an initiative to support the family with food and necessities. The community can also
perform rallies that can be used to collect food and clothing for the family.
Resilience is the ability to face life challenges or adversities, and remain focused and optimistic
for the future. Through resilience family members can withstand family adversities, establishing
positive adaptation to the challenges they face, and therefore strengthen their intellectual skills,
family unity, parenting quality and it lowers stress reactivity (Dagdeviren, Donoghue and

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Promberger, 2015 P.20). Arima is suffering from Multiple sclerosis, if the condition is not well
treated, it may cause brain problems. It might cause severe disability and cognitive impairment.
(Macías Islas and Ciampi, 2019 p.22). Later this may lead to more dependency among her
relatives in such a way that she cannot perform her private duties. She may be a burden to the
family and community as well since she would require expensive medication which may not be
easily available due to the extent of poverty. On the same, Terek may not be able to perform his
parental duties due to posttraumatic stress. It is a risk of more complicated brain problems such
as depression. It may be difficult for Terek to make upright decisions for his family. If not
treated Terek will be forced to go to mental hospitals, forcing him to abandon his family ( Ferry,
et.al 2012 p.1). Abandoning his family means the children will remain fatherless and with no
parental security. The family is prone to live in poverty as there will be nobody working, neither
mother no the father. The family will entirely depend on donations for survival.
Interventions
Based on the two cases, of Arima and Terek resilient therapy methods of intervention may be
appropriate. Cognitive behavior therapy may be very significant to both Terek and Amira as it
doesn't only relieve the bad aspects of their condition but also help in building positive values
such as social support and healthy physiology (Durrani, 2005 p.692). Community interaction
with the family may as well help fade the negative symptoms of Syria and help in their healing
process. This can be done religious leaders such as bishops and evangelist, who should dignify

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the family, show acceptance, promote self-esteem (Paris, et al.2019 p.11) Establishing Cognitive
therapy improves and reinforces treatment to individuals suffering from post-traumatic life
events (Feliccia, et.al 2018 P.2) as it helps in the reduction of psychopathological symptoms.
Arima needs medical attention which may help control her condition. Health practitioners such
as the psychology therapist may volunteer to help her manage her condition. Cognitive therapy
will help reduce the symptoms of the condition by recognizing the unhelpful thoughts and erase
them before the beginning of a vicious cycle. Taking Arima to the hospital for medication may
equally help her recover from the condition. Helping Arima with personal duties such as
washing, and cooking will help her feel appreciated. According to Sharma et.al 2017, health care
organization, as well as the clinicians, should collaborate with the community, to leverage and
coordinate health promotions, in improving health outcomes of the patients through the provision
of medical facilities and basic needs like food and clothing which can help in reducing the
disease impact to the patient families. Seeing that the family depends on well-wishers for
donations, social support may be implied. They may get support from non-governmental
organizations, individuals or from sponsors who may volunteer. This can be done by involving
community social health workers who may advocate the needs of the family to the local
government organization (Vaidyanathan et.al 2017 p.41). Their role is making sure the given
donations by the government are accessible to the needy families.
The community may as well help in caring for the family as the parents recover, which may
include, preparing meals for the family, caring for the children and monitoring the parent’s
recovery process (Gage, 2012 p.405). Rima and Elias need more parent love and support.
Showing love to the small children will make them feel wanted, appreciated and certainly forget
the tragic events in Syria. Sima is the eldest child in the family and she is obligated to take care

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of the rest of the family members. She is a teenager, who is faced with youthful challenges. She
needs counseling and psychological therapy to understand her current situation and forget the
bad memories she may have on Syria. At her age, she may feel stressed up as she is doing almost
everything for her parents and siblings (Lau, A.C. ed., 2000) Psychological therapy and
counseling may be an appropriate intervention for Sima. Community health workers through
intervention programs such as food and health programs can help the family in accessing food
and quality health care. The health workers can intervene by communicating the needs of the
family to the policymakers who may come I as donors to the family (Niang, 2019 p.1) The
community health workers will provide family counseling especially to Sima who is an
adolescent on how to care for the family. The multidisciplinary team consisting of the
psychiatrist, and the occupational therapists should coordinate counseling and mental therapy to
the parents who are traumatized.
.
Possible trajectory.
Du to Terek and Arima's condition, they may no longer make decisions for their family. Hence
the children will be obligated to take the full responsibilities of their parents. These mental
conditions may be severe leading to critical mental illness such as depression, anxiety, and even
death. (E DeLisi, 2014 p.2). Elias and Rima, are likely to suffer from emotional and physical
Negrete. This is because the parents may not in a position of meeting their fundamental and
emotional needs due to their illness which is likely to affect their development. The children will

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be exposed to social abuse and proper caring. The children as well may lack medical facilities
due to the long strain of poverty. The community medical practitioners such as the physicians
should unite and help with medication and vaccination. Such children may develop stress and
even depression in their adulthood (Ragnarsdóttir, 2016, p.1) which will be driven by the tough
experience in their childhood. Sima who is a teenager may opt not to attend school to continue
caring for her siblings. The community with the help of community social workers should take
the social responsibility of the parents and take Sima to school. Taking Sima to school will help
get released off from the family responsibilities and get to learn. The school provides a safe
environment for learning and identifies the child who is at risk of abuse and trains the pupil on
self-protection (Stafford et.al 2019 p.12). Being at school, she will have access to good care and
guidance. She will be protected the risk of sexual harassment as there will be teachers for her
guidance (Ainscow, 2018 p.64) It will not only help her learn social skills but will also allow her
to interact with other students, academically emotionally and socially. Later she may be a
solution to her family problems after completing her studies Sima at her early stage may be
tempted to take drugs as an alternative tare stressed up, they often take drugs to relieve their
stress (Darke and Torok, 2014, P.616). Additionally, the girl is at risk of sexual harassment as
she may lack proper protection and emotional support from the family. This can be prevented by
taking the girl to school where she will have protection and counseling since schools have a
statutory obligation of safeguarding and promoting the welfare of the children (Howard et.al
2019 p.674) The school should safeguard the procedures regarding pupils who are under risks of
sexual harassment and be transparent on the measures to put in such cases.
Reflection

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In my reflection, I will use the gibs model to explain my experience in children's homes. Gibbs's
model is a framework structure for reflection that helps one to explore on one’s experience. The
model will help me to think systematically using the six structures of the reflection which are to
describe, feelings, evaluation, analysis, conclusion and action plan (Reljić et.al 2019 pp.61).
Gibbs's model helps one to make a sense of the situation, to understand what was done well and
what to improve to do better in the future.
Before I joined the module, I had negatively viewed family centered care, especially when
having the parents all the time, answering their questions one after another. Before the module, I
thought that nurses are not involved in family-centered care and the platform is meant only for
NGOs and government, and the nursing role in the family center care is only to provide medical
care. Regarding Karim’s family, my view was that the government should take full responsibility
for the poorly displaced people without involving the local communities as it should make sure
that people are protected and safe. My perspective was that Elias, Rima, and Elias should have
been taken to children's homes for good care instead of community and health care interventions.
My thinking was that the nursing role in family-centered care comes in when the patients are in
the hospital only. Previously I thought the family was only involved in the patient care, in case
the patient was unable to pay the hospital bills and we have to involve the family, in case the
patient needs a transplant or a surgery and the patient had to be involved or in case the patient
dies. The importance of care in this situation was to ensure the family either donated the organ
for transplant, signs for patient surgery and can pay the hospital bills. I did not consider the
family until there was an issue of the bill payment or surgery. I considered the family as less
important in-patient recovery journey. However, since I undertook this module, my approach has
changed. my perspectives of family-centered approach by understanding that the nurse has a

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critical role in family-centered care in uniting and providing social contact between the family
and the patient. I came to understand that not only the government, and the NGOs but also the
heath fraternity are involved in family-centered care.
Feelings
From Karim’s scenario, I feel sorry for how had suffered and traumatized in their country, till
they run off to seek refuge in another country. I imagine the mental toucher they faced such that
they are unable to provide for their family. It was such a great bad experience to the family being
exposed to so many risks including mental disorders due to trauma.
What went well and not (Evaluation)
Family center care practice is very clear in the scenario. The Greek coast guard managed to
rescue the family to Athens where they could later travel to Macedonia. Although the family
faced a lot of violence challenges while they were in Syria, they managed to escape to a more
peaceful country where they could get help from the community. They slept in tents with the
guidance of the Red cross. Individuals and the donors assisted the family with food and housed
in the sixth-floor council flat. However, the Greek coast guard charged them a lot ferrying them
to Athens seeing that they were refuges with just a little money for their upkeep. Moreover, the
family is unfamiliar with the language of the UK. Terek and Amira are fluent in their native
language but have little knowledge of English.
What I have learned (Analysis)

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From this experience, I have come to understand that nurses have the role of improving the
health and wellbeing of the children by educating them on disease prevention, nutritional
practices, and physical growth (Gees, et.al 2018 pp.2808). Nurses should join the NGO in
supporting the children, both financially and socially in their development. Contributing their
funds will help in supporting the children in education and getting their necessities (Harmer,
2018 P.15). Health practitioners have the role of supporting poor families and improving the
lives of the marginalized, vulnerable population. This can be done by developing policies and
initiatives for feeding the poor such as food for all, support the child., I have learned that nurses
equally should partner with the family in maximizing the child's growth. Nurses and parents
working together can make more personal and informed decisions, on the best treatment for the
child. Alternatively, health care practitioners are obliged to listen and educate the family on
caring plans and procedures (K`uo et al., 2011 p .297). The nurses collaborate with the
community, intending to improve the health status of the children in the disadvantaged
population by advocating their needs to the government and children institutions (Smithies, and
Webster, 2018 p.1)
Conclusion
Family-centered care is very significant in today's health setting, in improving patient and family
satisfaction. Through the process, there is an effective use of health care resources as well as
reducing health care costs. Engaging the parents in the caring process enables the nurses to
collect the patient information which they might lack. It also gives room for giving feedback to
the parents regarding their child. Health organizations are therefore called to practice the family-
centered care which has proved to improve the patient's recovery as well as sharing the
challenges met during the healing process of the patient, In a recent article, written by the

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American Academy of Pediatrics, it confirmed that parents and the children have less suffering
by including the family in patient care.. (Tyler et.al 2017 p.139) Children were confirmed to
have cried less, required only a small amount of medicine and even discharged early if the family
was included inpatient care. Other studies conclude that patients with specialized care do
significantly well in handling stress in adjustment periods. (Park et.al 2018.p 61)
Action Plan
From my experience in the module, it will help me promote patient wellbeing by providing a
good satisfactory health environment that enables patient and family interaction. Through my
clinical practice, I will spend most of my time guiding the patients as well as educating the
parent on health measures of self-management maintaining their child at home (Stanhope, et.al
2019 p.3). From this module, I will be able to advocate for children in need through
policymakers who will be able to reduce the scarcity of resources and mitigate the sufferings that
family undergoes when caring for their children (Abdi, et.al 2017 p.3). Learning the family-
centered care will help nurses’ partner with patient families, understand the family d-tours and
challenges and negotiate on hospital bill payments. Relatively, through this module, I will help
the patients participate in their health care through patient education (Street and Mazor 2017
p.1612). The module has sharpened my skills, which I will use for future family-centered care.

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