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When should professional boundaries be asserted in nursing
Conceptual approaches to family nursing
Family centred care in nursing
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Nurses interact with families in a variety of community-based and clinical settings. The family nursing process is the same, regardless of the setting or whether the focus is on the family as a whole or on an individual in that family (Crisp & Taylor 2005). In the case of a 3 year old girl just diagnosed with leukaemia, it is important for a nurse to critically analyse the situation and address any immediate concerns. The nurse must address any professional issues that may arise and any potential impacts of hospitalisation that may affect the child and the family. Also provide support and education to reassure and comfort them. The primary concern for paediatric nurses is the welfare of the child and the family (Crisp & Taylor 2005).
‘It is the nursing profession’s commitment to respect, promote, protect and uphold the fundamental rights of the people who are both the recipients and providers of nursing and health care’ (Nursing & Midwifery Board 2010). Nurses must also have an understanding of the legal and professional boundaries of their daily nursing practice (Crisp & Taylor 2005). In this case there are professional boundaries that need to be considered when caring for the child and the family. Nurses have the responsibility to maintain their professional and personal boundaries, as well as assisting people in their care and colleagues, in maintaining theirs. ‘Professional boundaries in nursing are defined as limits which protect the space between the professional’s power and the client’s vulnerability’ (Australian Nursing and Midwifery Council 2010). Confidentiality, privacy and consent play a very large role in this situation as the mother has disclosed her wishes that her husband not be told of her daughter’s diagnosis...
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Leukaemia Foundation 2008, Providing Support, viewed 6 March 2011,
Nursing and Midwifery Board 2010a, Code of Ethics for Nursing in Australia, viewed 6 March 2011,
Parenting and Child Health 2009, Child Development 3-4 years, viewed 2 March 2011<,http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=122&id=1888#1>
Raising Children Network 2010, Language Development 2-3 years, viewed 2 March 2011,
Sanjari, M, Shirazi, F, Heidari, S, Salemi, S, Rahmani, M, & Shoghi, M 2009, “Nursing support for parents of hospitalized children”, Issues in Comprehensive Paediatric Nursing, pp.122
Winland-Brown, J. L. (2015). The New "Code of Ethics for Nursing With Interpretive Statements". Practical Clinical Applications Part I. MEDSURG Nursing 24(4),
Nurses play a big role in supporting the parents while their child is in the NICU. Showing compassion and demonstrating caring actions when caring for the patient makes it more likely that the parents will trust the nurse and the information the nurse gives them regarding their child’s condition. This trust is important as it helps the parents feel confident in the decisions they are making about their child’s care. When the parents of an ill child in the NICU have decided to terminate treatment palliative care by the nurse and other healthcare providers comes into play. Palliative care is keeping the child comfortable by treating the symptoms and being there for the parents and child physically, emotionally, and spiritually (Eden & Callister, 2010).
...Council, M., & Federation, A. N. (2008). Codes of Professional Conduct & Ethics for Nurses & Midwives, 2008: Australian Nursing and Midwifery Council.
NMC, 2010. The code: Standards of conduct, performance and ethics for nurses and midwives. [online] Available at: [Accessed 13 November 2013]
Children with chronic illnesses live a lifestyle that changes, and different problems that arise, as the child passes through developmental changes up to adulthood. Using knowledge of child development a nurse can recognize regressions in the child’s development and put preventive strategies in place. Nurses can plan and implement therapeutic regimens such as given medicine. Young people with chronic illness and their families are faced with coping with the demands of chronic conditions on a daily basis. Nurses can assist parents with different coping strategies that can be used by parents to minimize impact of diagnosis. For instance, they can provide explanations to parents about diagnosis, and support, and encourage family.
Ethics is an integral part of the foundation of nursing (ANA, 2011). Provision three in the ANA code of Ethics states that each nurse must promote, advocate for, and strive to protect the health and safety of each patient cared for (ANA, 2011). Provision three includes the patient’s right to privacy, confidentiality, and protection. It is the nurse’s responsibility to protect the patient’s rights, maintain high standards of care, and address impaired practice.
Wright, L. M., & Leahey, M. (2013). Nurses and families: A guide to family assessment and intervention (6th ed.). Philadelphia, PA: F. A. Davis
Also, the whole family needs to come to term with the health condition, make change in priorities and schedule, and keep the family. For example, it can be much more stressful for a young or a newly married couple because they may have more experience to overcome life's difficulties. As a result, as with individual maturation, family development can be delayed or even revert to a previous level of functioning (Hockenberry, p 762.) Therefore, health care providers need to apply family development theory while planning care for a child and family with chronic health condition. Indeed, family centered care should be a part of that intervention. Parents and family members have huge and comprehensive caregiving responsibilities for their chronically ill child at home or at hospital. Moreover, the main goal taking care of chronic ill child is to “minimize the progression of the disease and maximize the child’s physical, cognitive, psychological potential” (Hockenberry, p 763). Therefore, it is essential to family being part of the child care to give highest quality of care. On the other hand, we are as a part of the health care provider need to give attention to all
Family centred care (FCC) encompasses the concept of parental participation in their infants care (Franck and Callery 2004). It aims to place the needs of the infant in the context of the family (Saunders et al 2003). FCC is adopted within many neonatal units and is considered the gold standard of care aiming to underpin and guide neonatal care towards the partnership between health professionals and parents (Hutchfield 1999). Subsequent to the interruption of the bonding process between infant and family when a baby is admitted to the Neonatal Intensive Care Unit (NICU) it is suggested that the NICU provides an ideal opportunity for FCC practice (Allerman Beck et al 2009) as nurses and parents are compelled to develop an effective relationship in order to satisfy the infants care needs (Reis et al 2009). However a study by Higman & Shaw (2008) found that it appears to be more difficult to achieve on the neonatal unit as FCC is reliant on the family’s relationship with the child. In order to deliver effective FCC neonatal nurses need an understanding of parents needs and how to address them. Mundy (2010) in a study researching the assessment of family needs in neonatal Intensive Care Units found that assumptions of parent’s needs were often made by healthcare professional’s resulting in unfounded and inappropriate conclusions. The importance of treating each family as individual is paramount when assessing how best to involve parents in the care of their infants (Higman & Shaw 2008). Review of the literature shows a lack of research into these assessments and highlights that enhancing family centred care requires appropriate assessments of family needs and the incorporation of this into individualised plans of care. A study into nurse’s perceptions about the delivery of FCC by Higman and Shaw (2010) supports this view, throughout the study it is apparent that although nurses realise the importance of FCC it is not always consistent within their own practice. Peterson et al (2004) suggests reasons for these inconsistencies could be the deficiency of adequate training and, the stress implementing FCC can impose on nursing staff due to an already demanding workload, potentially creating negative attitudes towards the relevance and practicalities of its delivery. The consensus view of FCC is positive although limitations to its execution are manifested throughout the literature. Staff shortages are suggested to hinder the performance of FCC within the clinical area, creating time constraints with nurses having very little opportunity to build good relationships with the families (Higman and Shaw 2008).
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stephan Helbra.
1. Legal, ethical and professional principle frameworks underpin all fields of nursing, and it is a requirement for all Registered Nurses to be competent and knowledgeable, act with integrity and maintain professional standards set out by Nursing and Midwifery Council (NMC, 2015). Working with multidisciplinary teams within our profession, it is important to acknowledge and recognise the way in which all the professionals are guided by law and their independent regulatory bodies. The needs of the individual patient is to be considered by doctors and nurses alike, who share professional values and are set out in the respective codes of practice, The Code (NMC, 2015) and GMC (2013).
Nursing theories are essential to effective and efficient nursing practice. The use of nursing theories has, and continues, to contribute to the development of nursing knowledge and its practice (Ahmed, 2001). Integrating these theories into practice provides guidance in achieving the goals of health promotion and disease prevention (Ahmed, 2001). The middle range nursing theory of Family Stress and Adaptation by Geri LoBiondo-Wood, requires nurses to understand the various processes and stages of the illness and the illness experience. Nurses must also understand that a family’s experience of stress, crisis, adjustment and adaptation is an ongoing and dynamic process (Smith & Liehr, 2008).
Nursing and midwifery council (2008) The Code: standard of conduct, performance and ethics for nurses and midwives. London: Nursing and Midwifery council
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.