Scope of Caring (Nursing)

00:00 Now when we talk about scope of caring, this image provides all the different pieces and all the different variables that goes in to caring for a client. The first one we're going to start with is family. Now when we talk about family, this is defined biologically, legally, or as a social network with personally constructed ties and ideologies. Now as you can imagine, this can be very traditional or non-traditional. Now when we talk about families, each individual is influenced by the structure and the function in the health of that family. Now, providing confident care requires that the nurses understand those family strengths and weaknesses.

00:46 This is a particularly important topic if you're a community nurse, for example, that does home visits with clients and this is a good piece of assessment that is key to caring for that client. So 3 big topics when we're talking about family is the family durability, meaning that system of support and structure that's not just inside that house but extends beyond those walls. And also how resilient that family is. As you can imagine with family or with individuals, there are different expected and unexpected events and that family's ability to cope is very important in regards to the health of that family. And don't forget about diversity.

01:27 Uniqueness in characteristic and dimension and make-up can really contribute to the overall health of the family and also can create barriers. When we are talking about family health, we need to make sure we assess different areas such as how they interact, the developmental processes of that family, even how they cope, the integrity of the family as a whole, and the different type of health processes that they may participate in. Let's talk about some factors that affect family health. Now just remember when we're talking about familial health, this involves more than just a combination of each individual's health status. There are many things that influence the health of the family overall. One of those being the economic status of the family. It may be the family's ability to afford a healthcare. Supplemental healthcare provide basic financial coverage. Now, this can trickle down to even homelessness that can be another factor that affects family health, the inability to have access to shelter or food or even basic education. Now here's a big factor that can also be a big detriment to the overall family health such as abuse that can be emotional, physical, sexual, or even financial abuse. Lastly, one of the main factors that can affect family health is of course illness. This is something that I see a lot of the times as a nurse. Here's a great example. Now if there's a family member that is the main financial stability in that family becomes ill or hospitalized, that can have a really negative impact on the family health as a whole. Now when we're talking about caring, we need to remember that there is family-centered nursing and we've got to understand that all individuals or of course the members of that family but family can be viewed in 4 different types of ways. One of those is family as a context. Meaning we focus on the health development of an individual in the family and the extent that the family can provide basic needs for that client. Also keep in mind, we've got to keep the client or the family as a whole. So focusing on the family as a whole unit and the sum of each individual member's health, not only as a client, but family as a system is the other thing we need to think about when we talk about nursing. Focusing on the family system where the whole is more than the sum of its parts. And of course, family as a component of society. Focusing on that family as an institution in society, part of a larger system, or even their community.

04:19 Now next one we are talking about scope of caring, we've got to consider the spirituality of the client. Now to define this, this is being concerned with or connected to something larger than the physical world. And many time a patient's spiritual health is a balance between their values, their goals, their beliefs, and the relationships. Sometimes in the middle of lots of variables, illness for example, spiritual distress can occur and that balance can be disruptive. This could be from acute or chronic illness, definitely terminal illness, or even near death experiences. So we're talking about spirituality. The American Nursing Association Code of Ethics and the Joint Commission require nurses to provide spiritual, dignified, compassionate care to reflect those client's needs. So what that means is we've got to understand our own personal beliefs, seek to understand those beliefs of the clients, respect each individual's uniqueness, and of course have an attitude of fairness and equity.

05:30 In the circle of caring, we've got to remember also our culture and ethnicity of our client.

05:35 Now before we get too much farther, we want to make sure we define the difference between culture and ethnicity. Now when we talk about culture, this is the ideas, customs or social behaviors of a group. It is not associated with physical appearance or biologically inherited.

05:54 And it also is ever changing, so keep that in mind. Now the difference here with ethnicity is this is actually the state of belonging to a social group with the same national origin. Now, with ethnicity, it is associated with physical appearance and biologically inherited. And it definitely can be dynamic, but only if the ethnic groups are accepting. Now when we talk about culture and ethnicity, a cultural assessment is important to make sure that we consider the patient's ethnic history, their cultural history, any sort of religious or spiritual beliefs that are important to them, also we've got to consider what's appropriate communication patterns for that particular client. Do they have particular healthcare beliefs and practices that they may want to be incorporated in their care? And don't forget about certain social organizations that may be important. Now when we apply this to nursing practice, we got to support engagement from families and social networks. Seek culture care as a priority and form a care partnership with the client. Culturally confident care is really important to provide the best care and the best rapport for your patient.