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FreeWriteAssignmentDescriptionandRubric.pdf
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FreeWriteAssignmentDescriptionandRubric.pdf

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N362 Family and Societal Nursing for RNs

Family Free Write Assignment Description

Family Free Write

Early in the course, each student will write a 2-page (minimum 250 words and no more than 500 words) open

write on four topics. Each free write is worth 10 points (40 points total).

1. Healthy Families—250-500 words (Module One) 2. Family during Acute Care Experience—250-500 words (Module Two) 3. Family in Crisis or Trauma—250-500 words (Module Three) 4. Chronic Illness Experience—250-500 words (Module Five)

The free write is not an edited piece of work, but you must use at least two sources for each topic. The work

will be evaluated for its clarity, creativity, and relevance. Please write about your thoughts, insights, stories,

cases, examples, experiences, for that particular topic. These papers may be used to complete the Family Theory

Interview Project later on in the course.

This free write is meant to help you access your deepest and most powerful feelings about family, as well as

building on your past and your developing knowledge of family: academically, professionally, and personally.

The 250-500 word free write on healthy families (for example, there are four categories), may include ideas

gleaned from your text, stories from your childhood, something you read in the newspaper, a novel or poem, or

an interaction you witnessed in the grocery story. The objective of the free write is to help you decide what

most interests you in family health nursing and what literature you might use for your annotated bibliography

and your final research work with a family. Examination of the course topics will organize your thoughts and

focus your ideas on the desired outcomes of the learning you are doing.

This is not an edited piece of work. This material is rich in image, story and insight. The free write is meant in

part to get in touch with this material. Thoughts from your readings may also be included and will spark new

ideas unique to you. Use at least two resources (do not need to be scholarly) in your initial post for full

points.

Free Write Rubric

Components:

1. Initial post: Posted a free write on the given subject;

2. of at least 250 words;

3. incorporating at least two resources in correct APA format (do not need to be scholarly).

4. Reply post: Replied to one person in the group;

5. of at least 100 words (no resources required).

10 points

Missing 1 component 9 points

Missing 2 components 8 points

Missing 3 components 7 points

Missing 4 components 6 points

Did not participate 0 points

Chapter121.pptx

Family Health Care Nursing; Theory, Practice, and Research, Seventh Edition.

Chapter 12

Trauma and Family Nursing

Critical Concepts

Trauma is a key experience affecting individuals and the family system.

Trauma-informed care (TIC) is an important part of nursing care for all clients, including families, to improve outcomes, avoid biased and inaccurate assessments and interventions, and prevent unethical decision-making processes.

Critical Concepts (continued_1)

Adaptive responses to trauma are more likely to become problematic when resiliency traits are underdeveloped.

Post-traumatic stress disorder is based on a cluster of symptoms in response to trauma that can be acute or chronic and can occur months, or even years, after a disaster or traumatic event such as war.

Critical Concepts (continued_2)

The Ecological Systems Model can guide nurses in applying TIC.

When one or more family members are traumatized, all family members and family relationships can be affected.

Perpetrators of trauma can experience trauma.

Critical Concepts (continued_3)

Nurses who focus on TIC can address the dilemmas of caring for perpetrators through mandatory reporting and family-focused care.

Secondary trauma can occur whenever a family member, or caring provider, is exposed to victims of trauma, and is affected by their response to the traumatic event(s).

Critical Concepts (continued_4)

The family response to trauma of one or more of its members cannot be understood or treated by focusing on individual family members alone.

Family members can provide key contextual information about past traumatic events and experiences that help explain current responses.

Critical Concepts (continued_5)

Community systems can prevent, treat, and measure negative outcomes to traumatic events.

Larger political and social systems can influence and be influenced positively or negatively by individual, family, or community trauma.

Critical Concepts (continued_6)

Nursing focuses on the individual, family, community, and societal reactions to trauma in order to optimize positive outcomes and prevent or treat problematic stress responses.

Nurses have an essential role in supporting health and resilience, rather than focusing on the pathology of trauma response.

Introduction

The care by nurses of families experiencing traumatic stress revolves around:

Preventing trauma when possible

Supporting the development of resiliency

When not preventable, working toward positive outcomes

Nurses are among the professional group most likely to experience vicarious or secondary trauma due to their exposure to traumatized clients.

(APA, 2013)

Post-Traumatic Stress Disorder

Differences in symptoms across developmental ages and stages

Different types of trauma have different rates of severity and incidences of PTSD symptoms

Symptoms cross ethnic groups, ages, and time

Number of individuals with PTSD affects communities

Post-Traumatic Stress Disorder (continued_1)

DSM-IV and DSM-IV-TR categorized PTSD under Anxiety Disorders with three categories of symptoms:

Re-experiencing the trauma

Avoidance and numbing

Increased arousal

Post-Traumatic Stress Disorder (continued_2)

DSM-5 developed a separate category, Trauma and Stressor Related Disorders, with four categories of symptoms:

Intrusion of thoughts about the trauma

Avoidance of discussion or other stimuli reminding the person of the trauma

Increased arousal or sensory sensitivity

Negative cognitions and moods

Theories Applied to Trauma

Substance Abuse and Mental Health Services Administration's (SAMHSA's) Guide for TIC in Behavioral Health Services

Ecological Systems Model

Family Systems Theory

Trauma Informed Care (TIC)

SAMHSA (2014) identified six key principles guiding TIC:

Safety

Trustworthiness and transparency

Peer support

Collaboration and mutuality

Empowerment and choice

Cultural, historical, and gender issues

Early Trauma

Early childhood trauma

A relationship between the number of adverse childhood experiences and the number of comorbid outcomes:

Adulthood depression

Panic disorder

Substance abuse

Sexual promiscuity

Relationship problems

Domestic violence

Early Trauma (continued)

Resilience refers to positive outcomes, adaptation, or the attainment of developmental milestones or competencies in the face of significant risk, adversity, or stress.

Research has focused on identifying factors or characteristics that are consistently found in individuals who are resilient.

Family Trauma

The National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD:

Increased sympathy is felt by family members.

Increased negative feelings develop about the person with PTSD.

Avoidance is a common reaction by individuals with PTSD and by family members.

Family Trauma (continued_1)

The National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD (continued):

Depression is common among individuals with PTSD and their family members.

Anger is common among family members as they struggle to cope with changes in the person with PTSD.

Family Trauma (continued_2)

Ten key areas

Guilt and shame are common for family members.

Health problems increase in individuals with PTSD and their family members.

Fear and worry develop as their worldview changes given the intimate knowledge that terrible things can happen.

Family Trauma (continued_3)

Ten key areas (continued)

Drug and alcohol abuse occur as a way to escape their negative feelings.

Sleep problems develop, especially when it is a problem for the trauma survivor.

Family Trauma (continued_4)

Families affected by war

Unidentified and untreated PTSD presents special risks for family reintegration and puts the veterans and their families at higher danger for maladaptive responses to stress.

Risk for trauma-related symptoms in children from their parents’ traumatic experiences increases with prolonged separation from parent(s) and decreased time between recovery from one traumatic event and the onset of another.

Family Trauma (continued_5)

Family violence and trauma

Family violence is often both a cause and an outcome of PTSD in family members.

Generally divided into three categories:

Physical violence

Emotional violence

Sexual abuse

Family Trauma (continued_6)

Families affected by disasters

Events that cause widespread destruction of property, dislocation of people, and immediate suffering through death or injury

Either natural or human caused

Interrupt meeting basic daily needs for an extended period

Some of the many stressors that occur include loss of significant others, injuries to self or family, separation from family, or extensive loss of property

(Norris, 2007).

Family Trauma (continued_7)

Family functioning and post-traumatic stress disorder

PTSD symptoms of avoidance and emotional numbing have deleterious effects on parent-child relationships.

Trauma symptoms such as sleep problems, dissociation, and severe sexual problems predict lower marital satisfaction.

Family Trauma (continued_8)

Secondary traumatization

Only recently has been described and is not yet a diagnostic category in the DSM-V

Can affect family and nonfamily members of traumatized victims

Community and Trauma

War, terror, and natural disasters have resulted in disaster syndrome symptoms.

Children are particularly at risk due to isolation and fear of losing loved ones.

The community has a key role in the prevention and treatment of trauma.

Agencies have a responsibility to become trained for their role in trauma care.

Systemic Trauma

Many argue that the United States is suffering from PTSD because of repeated traumatic events such as wars, natural disasters, and economic traumas across time without resolution or intervention.

This leads to toxic stress.

Management of trauma symptoms should expand to include national and international traumas and the impact on the nation as a whole.

Nurses and Trauma

Nurses are key in helping with the diagnosis and treatment of PTSD in individuals and families.

Trauma-informed nursing assessment and intervention

Certain conditions must exist to be diagnosed with PTSD

Primary care PTSD screen

Nurses and Trauma (continued_1)

Risks associated with trauma

For adults and children

Suicide risk

Danger to others

Ongoing stressors

Risky behaviors

Personal characteristics

Limited social support

Comorbidity

Nurses and Trauma (continued_2)

Risks associated with trauma (continued)

For children

Dysregulation

Poor connection

Poor cognitive development

Poor attunement skills

Inability to trust

Hyperarousal

Nurses and Trauma (continued_3)

Secondary family traumatization assessment and intervention

Nurses should first realize that traumatized families rarely seek family-focused intervention.

Nurses should learn the parallel processes of individual and systemic stress reactions that follow a traumatic event.

Initial steps of treatment

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