Teaching family nursing: strategies and experiences

The traditional hospital-based approach to Australian nurse education curricula was primarily based on the medical model and directed towards the preparation of nurses who were able to give care to individual clients The major focus was on the needs of the individual A notable absence in curricula was any consideration of the role or importance of families to individual and family health This was despite the continuing involvement that nurses have in their practice with the families of their clients This paper describes the experiences of introducing a family nursing subject in an undergraduate, preregistration nursing programme which focuses on the family as a unit of care Educational strategies, clinical experiences, and evaluation of the unit of study are discussed     

Family nursing: walking the talk

This article discusses a study exploring the lived experience of family nursing for novice registered nurses. There has been an increased emphasis on including family content in Canadian nursing education curricula. Literature on family nursing is ambiguous about differentiating family nursing at the generalist and specialist level, and acknowledges that there is a blurring of lines between the two. The study utilized a phenomenological approach to examine how nurses with 2 years or less in practice experience family nursing in a variety of settings. Following ethical approval, invitations were sent to all nurses employed in two health authorities, who met the study criteria. Five nurses were interviewed using a semistructured interview. Participants shared how they practice family nursing in the current nursing situation of shortages and constraints. This study adds to our understanding of what happens at a beginning level of family nursing, how nurses understand and experience caring for families in the everyday enactment of their professional role, and barriers and facilitators to including family in nursing care. The findings provide important information for nurse educators in grounding the teaching of family nursing in the real world of nurses.     

Education for differentiated role development for NP and CNS practice: one nursing program''s approach

Development of nurse care providers who best meet the public's health care needs is imperative. Some nurses believe the functions of nurse practitioners and clinical nurse specialists should be combined. However, the experience of the authors' nursing program argues otherwise. Two graduate nursing tracks, family nurse practitioner and rural health specialist, were developed to meet the health care needs of rural populations. Although the two tracks share expected competencies and areas of expertise to some extent, differences in practice are apparent in identified domains of practice and terminal competencies. Family nurse practitioner practice focuses on assessment, diagnosis, and management of health and illness conditions of individuals and families across the life span. Clinical nurse specialist practice incorporates traditional roles of client assessment, monitoring and coordination of care, outcome assessment, and client, family, and community education, with a new focus on case management strategies. These differences are important to care delivery in the managed care era.     

Graduate education in geropsychiatric nursing: findings from a national survey

By 2030, the numbers of older adults with mental illness will strain our health care system. Sufficient advanced practice nurses (APNs) with specialized knowledge to provide care will be critical. All 339 graduate nursing programs in the US were surveyed regarding the extent and nature of geropsychiatric nursing (GPN) content in their curricula. Of 206 schools responding, 15 reported having a GPN subspecialty. Regarding the 60 schools with a psychiatric/mental health nursing (PMHN) graduate program, only one third (n = 23) included some GPN content, while more than half (n = 116) of all schools reported integration of GPN content in a non-psychiatric nurse practitioner program. Thus, currently, the greatest numbers of APNs receiving education on mental health needs of older adults are prepared in non-psychiatric nurse practitioner programs. This article discusses the implications for nursing education and practice.     

Transcultural nursing in Australian nursing curricula

As a result of the fact that Australia is a multicultural society with many people who come from non-English speaking backgrounds (NESB), the objective of the present study was to discuss the extent to which transcultural nursing education is incorporated into undergraduate nursing curricula. A survey was undertaken to determine the availability of nursing modules for undergraduate nursing students through Australian university websites on "transcultural nursing" or related modules. Although the inclusion of these modules into nursing education provide an opportunity for nurses to perceive and respond to different patient behaviors in multicultural societies, it is not sufficient to understand the complexity of the health care needs of a multicultural society. The survey findings suggest that many universities have not included transcultural nursing modules in their nursing curricula. To address this problem, more transcultural nursing modules need to be introduced into nursing curricula and nursing academics need to refine their attitudes about the importance of cultural aspects of patient care within nursing education.     

A follow-up study of professionals' perspectives on the development of family health nursing in Scotland: a questionnaire survey

BACKGROUND: In 1998 the World Health Organisation Europe introduced the Family Health Nurse concept. The envisaged role of this community-based nurse was seen as multi-faceted and included helping individuals, families and communities to cope with illness and improve their health. During 2000-2002 Scotland led enactment of the concept through education and practice, and the first research study evaluating its operation and impact in remote and rural areas was published in 2003. OBJECTIVE: This study's purpose was to follow up health care professionals' perspectives on the development of family health nursing in remote and rural areas of Scotland since 2002. METHODS: The main research method used was questionnaire survey of all the established family health nurses in these areas and all other health and social care professionals with whom they had regular work-related contact. Where novel contexts or practice patterns emerged, further investigation was undertaken through telephone interviews. FINDINGS: Twenty-three family health nurses (88%) and 88 of their colleagues (52%) returned questionnaires. Eight family health nurses were interviewed. The dominant theme within the findings was the gradual, positive development of a role which tended to maintain established community nursing service provision, yet also supplement this with a limited expansion of family health services and public health activities. The flexibility and wide scope of the FHN role in terms of providing generalist community health nursing services was clearly evident. However, capacity to engage with whole families was found to vary widely in practice. CONCLUSIONS: Within remote and rural Scotland family health nursing is gradually consolidating and developing, but its particular aspiration to engage with whole families is often difficult to enact and is not a priority within mainstream UK primary care policy, planning or provision.     

Development and testing of the theory of collaborative decision-making in nursing practice for triads

BACKGROUND: Although nurses depend heavily on informal family caregivers to provide care to clients and to be involved in care planning and decision-making, no nursing theories that include the client, the caregiver, and the nurse were available to guide collaborative care planning and decision-making. AIM: The purpose of this paper is to describe the construction and initial testing of the theory of collaborative decision-making in nursing practice for a triad. The theory represents an extension of Kim's theory of collaborative decision-making in nursing practice. Kim's theory was developed to describe and explain collaborative decision-making in a dyad (client and nurse). The inclusion of a third person (family caregiver) in the theory required the addition of concepts about the caregiver, coalition formation, and nurse and caregiver outcomes. The expansion of Kim's dyadic theory to a triadic theory was achieved by means of a modified version of the theory derivation process described by Walker and Avant. CONCLUSIONS: The theory of collaborative decision-making in nursing practice for a triad can be used to guide further research and clinical practice. The theory provides a framework for researchers who are interested in studying the effects of collaboration regarding decision-making among nurses, family caregivers, and clients. The initial testing of the new theory in home health care nursing revealed variety in the nature of the client-caregiver-nurse relationships, the many processes used by the nurses in proceeding with the home visits, a multitude of decisions considered and different collaborative, noncollaborative, and coalition-forming interactions. The limited evidence of the empirical adequacy of the theory precludes development of definitive guidelines for clinical practice at this time. More studies are required before clinical practice guidelines can be developed.     

Implementing child-focused family nursing into routine adult psychiatric practice: hindering factors evaluated by nurses

Aims and objectives. The aim of this study is to describe nurses’ evaluations of factors that are hindering implementation of child‐focused family nursing (CF‐FN) into adult psychiatric practice. In addition, it explains the nurses’ evaluations of the hindering factors related to the hospital organizational structure, the individual nurse, nursing and family. Background. There is an increasing amount of families with dependent children in adult psychiatry. Although these families have long‐term benefits from preventive family interventions, implementation of CF‐FN is not routine mental health practice. Design and methods. Data were collected via a questionnaire‐survey completed by Registered Psychiatric Nurses (n = 223) and practical Mental Health Nurses (n = 88) from 45 adult psychiatric units in five Finnish university hospitals. The response rate was 51%. Results. Family‐related factors, such as families’ fears and lack of time, were considered as ‘most hindering’ to CF‐FN. Nurses who used a family‐centred approach and had further family education considered most of the factors as ‘less hindering’ in comparison to other nurses. Conclusion. To meet the needs of the families in mental health services, it is essential to develop nursing intervention methods such as CF‐FN. There is a need for further education and use of family‐centred care to develop this preventive approach. Relevance to clinical practice. The results of this study could be considered when developing mental health services and family interventions for families with parental mental illness.     

Internationalizing nursing curricula in a rapidly globalizing world

Rapid transformations in our globalizing world means there is an urgency for nurse educators to revitalize curricula to prepare nurses better for practice and the emphasis on achieving global health for all has never been greater. Nurses are being urged to collaborate across borders to achieve the United Nations' Sustainable Development Goals, through research, practice, policy and education. Thus, nurse educators and leaders need to consider the critical importance of internationalizing nurses’ education at all levels, as well being committed to their roles in curricula reform and using innovative technology. There are challenges to internationalization, but the benefits include helping nurses to grow cultural competence, developing strength in nursing voices globally, capacity building in global health, health policy and advocacy, growing scholarship in nursing across borders, developing the skills and knowledge of nurses from low-income countries, and forming partnerships to work together to achieve global health.     

Nursing students' beliefs about families in nursing care

Caring for families is a growing part of nurses' professional work in various health care settings and consequently an important issue for nursing education. One way to determine the readiness for nursing students to meet families is to reveal their beliefs about families. Beliefs can be uncovered through interpretation of conversations, as beliefs are embedded in our stories. The aim of this study was to explore nursing students' beliefs about families in nursing care. Nine nursing students, three from each year of a three-year programme, were interviewed individually. The interviews were tape-recorded and transcribed verbatim. First, a manifest content analysis was performed followed by a latent content analysis in order to reveal underpinning beliefs. The results demonstrate beliefs about families and nurses and their relationship, for example, if family members are close to each other and when the patient is cared for in his/her own home, it reduces suffering for the whole family, and if nurses create a trusting relationship and atmosphere, it fosters the families' well-being. Although the beliefs uncovered are seen as facilitative ones, educational efforts are essential to implement family nursing both theoretically and practically in curricula throughout the nursing education.     

Family systems nursing: a guide to mental health care in Hong Kong

In Hong Kong, mental health care has traditionally focused on the individual and the concept of considering the family as the unit of care is relatively new. The purpose of this article is to describe the process of planning, implementing, and evaluating a family systems nursing project in a psychiatric setting in Hong Kong. Psychiatric nurses (N = 110) participated in seminars focusing on family systems nursing concepts and individuals and families suffering from mental illness. The Calgary Family Assessment Model and the Calgary Family Intervention Model formed the framework for practice. Significant changes were found both in the nurses' critical appraisal of their clinical practice related to family systems nursing and in their reflections on the reciprocity in their nurse/family relationships. In addition, hospital-wide systems outcomes were noted. This project appears to demonstrate that a family systems nursing approach is relevant for psychiatric nurses caring for Chinese individuals and their families suffering from mental illness.     

Emergency preparedness curriculum in nursing schools in the United States

With concern about bioterrorism and inadequacies in responding to mass casualty events, health care professionals have been placed in the category of first responders. The International Nursing Coalition for Mass Casualty Education (INCMCE) was established to plan strategically to address the educational needs of the nation's nurses. This study sought to determine the types and levels of disaster preparedness curricula being delivered or in development in nursing programs at all levels. INCMCE surveyed 2,013 deans or directors of nursing schools as to curricula for emergency preparedness prior to September 11, 2001, and during the two following academic years. Initial requests were sent via email and the US postal service. Respondents were invited to answer the online survey so data could be directly entered into a database for purposes of data analysis. Responses were received from 348 schools of nursing. Curriculum plans, followed by competency lists, were selected as most helpful for teaching content in disaster preparedness. The survey results validated the general assumption that nursing programs provide limited curricula in this area. The mean number of hours of disaster preparedness content provided, approximately four hours, did not change significantly over three academic years. The study also showed that 75 percent of respondents thought that nurse faculty were inadequately prepared in the area of disaster management. The study established a baseline for future curricular growth.     

Teaching in crisis. Patient and family education in critical care

Although the critical care setting is not always a positive teaching environment, it is possible to achieve the goal of optimal patient and family education. The critical care nurse must understand the unique learning needs of patients and families who are experiencing a life crisis a recognize that there are substantial obstacles to overcome to educate in this setting. In addition, it takes experience and resources to develop the teaching skills of the bedside nurse, so that those teachable moments are easily recognized and suitably used to give patients and family members valuable information in small doses. The advanced practice nurse is an essential nursing resource who can spearhead the development of teaching skills for all members of the health care team. In addition, the advanced practice nurse is a clinical expert who can assess the educational needs of patients and their families and provide more detailed and individualized health information from a different perspective. Achieving good patient and family education outcomes is possible when patient care continuity is a priority and the advanced practice nurse is an active part of the nursing team. Exploring the use of new technologies and resources to meet patient and family education needs is absolutely necessary. As hospitals continue to evolve and react to the financial demands placed on them, nursing leadership and critical care nurses will need to articulate clearly all of the essential components of patient care, including patient and family education. In keeping with the rich nursing tradition of patient and family education, critical care nurses and advanced practice nurses have the opportunity to demonstrate their unique teaching skills and continue to promote health education as a priority of patient care.     

Increasing importance of genetics in nursing

ObjectivesTo examine the empirical literature related to the incorporation of genetic research and genetic competency needed by the nurse in practice.DesignLiterature review.Data SourcesThis article will explore published research within the past seven years of 2008–2015 that address the need for the increased incorporation of genetic content in nursing practice in addition to the need for the nurse to effectively screen the patient at risk of a genetic disorder. This literature review specifically focuses on the inadequacy of nurses in addressing genomic health compromise and serving as advocates for patients and families facing genetic disorders.MethodsA review of the literature published from 2008 to 2015 related to the incorporation of genetics in nursing practice and the role of the nurse as a patient advocate for families facing genetic disorders with resulting genomic health compromise.ResultsThe research exposes the lack of adequate preparation of nurses to incorporate and utilize the recent advances in genomic healthcare. Practicing nurses lack understating and skill in the application of genetics and genomic technologies to patient care. The nursing profession, including nursing academia, need to enhance the integration of genetic and genomic content into nursing curriculum and practice.ConclusionPracticing nurses are inadequately prepared to apply genetic advancements in screening at risk patients and addressing the needs of the patient or family facing a genomic health compromise.     

Knowledge, perceptions, and attitudes of advanced practice nursing students regarding medical genetics

PURPOSE: To describe the current medical genetic knowledge and perceptions of graduate advanced practice nursing (advanced practice nurse [APN]/nurse practitioner and nurse anesthetist) students using survey data for future integration of genetic topics, principles, and healthcare issues into curriculum. DATA SOURCES: Survey data of APNs' perceived knowledge of genetics and a review of the literature from past research studies of students and current articles from professional journals and organizations. Web sites were those of the National Coalition of Health Professions for Education in Genetics and National Institutes of Health, Human Genome Research Institute; professional organizations; and the authors' professional, clinical, and educational experiences. CONCLUSIONS: Most APN students perceived they had minimum knowledge and prior training regarding medical genetics. There is a need to integrate genetic concepts, principles, and medical conditions into advanced practice nursing curriculum and to provide clinical experiences in genetic conditions across the life span and throughout the health and illness spectrum. APN students have positive attitudes toward integrating genetics into graduate curricula. Potential methods for program integration include readings, small group discussion, standardized patients, and role-play as measures to increase information. IMPLICATIONS FOR PRACTICE: The National Coalition for Health Profession Education in Genetics, the American Nursing Association, and the American College of Nursing Education have recommended integration of genetics knowledge and skills into routine health care to provide effective interventions for individuals and families. However, previous research and data from this study have revealed that many nurses have minimal training in genetics. Advanced practice nurses must be knowledgeable on genetic principles, topics, and the ethical, legal, and social implications related to medical genetics to increase the ability to diagnose, prevent, and treat diseases and to provide effective care for individuals and families.     

A family nursing educational intervention supports nurses and families in an adult intensive care unit

The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses’ attitudes towards and confidence in providing family care, as well as families’ perceptions of support from nurses in an adult critical care setting. An academic–clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members’ experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic–clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in other critical care settings.     

The influence of managed care on U.S. baccalaureate nursing education programs

The transformation of health care into managed care has raised many issues and concerns for nurse educators. The milieu in which nurses currently practice reflects the restructuring shaped by managed care principles. The shift from acute care to expanded community services has changed the way health care is provided within hospital settings. The organization of nursing programs has been affected by this shift, and the ramifications of these external forces on curriculum structure have altered the way nursing students are educated. This article presents research demonstrating the changes in the structure of the curricula for baccalaureate nursing education in 2001, which were caused by health care reform in effect since 1994.