A Reflective Winter Break

Ahhhh (sigh)…finally, a break from school! This is the time when I don’t feel too bad or too guilty about working on my writing and reading the Bible and devotions that enlighten me. Don’t get me wrong, I am always enlightened with my nursing classes and the different topics that we go over and discuss including ethical nursing care, leadership, management, and so forth. However, it is a requirement, nonetheless. For whatever reason, requirements seem to be more dreadful than other things we voluntarily do--things that interest us and feed our souls, things that shape us into who we are and who we have yet to become, things that we read about and through it we learn some valuable information about ourselves. With that said, I am going to spend my pastime during this winter break to indulge in what I love doing—and that is reading what I want to read and writing my thoughts down.

With Christmas behind us, and the crazy hectic schedule in our past now, we have something to look forward to. 2014 is knocking at our front door, are we ready for it? We just had a full year behind us. Do we ever get a chance to evaluate and analyze all the happenings and our growth this past year? Or should we just ready ourselves for this next year without reflection of the past year?

Personally, I like to look back at my year before this year ends and go over my accomplishments, failures, lessons, obstacles, and how those different things intertwined and shaped me into who I am today. Most importantly, in God’s eyes, did I have my act together? Maybe He is saying, “Hmmm. Not shaping like I’d hoped.” And, if that is the case, God is a forgiving God! His love never fails, never gives up, and never runs out on me. I will continue to allow the Lord to shape me into His image and watch as He turns the situations in my life around.

And, as I sit here and think about my past year, I think of those Tuesday evenings spent with my wonderful friend, Linda Bible studying and talking about our week. We share our stories and find resolutions to the problems in our lives with the guidance of Our God. How much I have grown through the counsel of a godly friend like Linda and I am forever thankful for her friendship.

I also think of the obstacles I overcame. There were definitely challenging moments…moments that left me on my knees praying to God, asking for His direction because He promises to “make our paths straight” (Proverbs 3:6, NIV). He is always at work in our lives, even during the most challenging and stress-filled moments. When we hand over everything we are and everything we have to God, when we rest upon his Truth instead of our own understanding and choose to walk in obedience, we can count on God for direction. And this is what I will continue to do into my new year. Yes, I am excited about the New Year, a fresh start, a brand new set of days filled with new dreams and unmarked possibilities, but I also know that I will be faced with new challenges. Challenges that I will perhaps question and may not understand fully why they happen the way they do, but I know that God will be with me every step of the way. With that said, I would like to end with a verse from the Bible reflecting on our New Year and what is to come:

“Do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own” (Matthew 6:30-34, NIV).

Planning for tomorrow is time well spent; worrying about tomorrow is time wasted. Careful planning is going over goals, steps, and schedules, and trusting in God’s guidance. Worry, in contrast, is consumed by fear and makes it difficult for us to trust God. And when we trust God with our plans, we need not to worry about a thing!

May you have a wonderful New Year filled with love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness, and self-control for these are the gifts to a starving world (Galatians 5:22-23). 

God Bless,

Seda

This is my daughter's creation of Mr. Fruit of the Spirit from Bible Class. How sweet! :)

Definition of a Dysfunctional Family

In my research of the topic, ‘dysfunctional family’, many articles come up in the ways of what a dysfunctional family comprises of. There are many factors involved, the different relationships between members of the family, the subsystems that are in control, the transactions that are made in the family’s structure, and the feelings and emotions that the members experience individually and as a family. The family structural theory can definitely be used to determine whether or not a family is dysfunctional. Many factors, when combined, are able to determine this conclusion. However, we must first define what a functional family means.

According to Salvador Minuchin, the family structural theory focuses on the family as a unit and how each member interacts and relate to one another. Along those lines, the family members belong to subsystems within the family: the husband and wife—spousal, parental—the relationship between the parents and the children, and siblings’ relationship (Vetere, 2001). In a family, there is also a structure of how the family functions and there are also boundaries that are identifying factors to determine whether the family is healthy and functional, or not. And, when those boundaries are crossed between the members and the subsystems leading to the breaking of the family structure, these anomalies result in a dysfunctional family (Connell, 2010).

Dysfunctional families come in all sizes, shapes and forms. When one factor is lacking, absent, or misconstrued out of the main premises of the family structural theory: structure, subsystems, and boundaries, the family is then identified as being dysfunctional (Connell, 2010). For instance, in my personal situation, currently, I am not communicating with my sisters due to the fact that they have disrespected my immediate family in a distorting manner that even authorities have questioned what possessed for them to behave in such ill manner and disrespect. They have humiliated my husband and me through the process, and had the audacity to involve my 8-year-old daughter through all of their misbehaviors and name-calling. Therefore, I have chosen to not communicate with them or allow for my daughter to visit with them because of the negative influences that they have on my daughter and our family. This is an example of a dysfunctional extended family. And this is not a recent case that happened just last year, but the dysfunctional part of it has built up and accumulated over time.  It is a dysfunction that derives from siblings’ rivalry from when we were children. My parents are fully aware of this dysfunction, and even when we were children, they knew it was not a normal thing. However, they have failed to find ways to resolve the issues between the siblings. There were not any consequences for my sister for when she routinely, physically abused me. All that my parents said to me was, “If you don’t want to get beaten, then you shouldn’t be around her!” That was it! No justification or punishment. No structure or consequences. Boundaries were crossed, but my sister was never told that she crossed the lines. Therefore, this extended family of mine will continue to be dysfunctional if all members refuse to resolve the ongoing issues. And the most ironic fact of this matter is, both of my sisters are social workers with a master’s degree working with abused children in the community. This is just one example of a dysfunctional family. Not to mention, the influences of the Cambodian culture amongst my parents and the fact that they are uneducated as to how to resolve the issues within the family.

Therefore, as nurses of the community, when the opportunity is appropriate, we must assess the family’s functionalities. We need to be cognizant of any issues that members of the family face; we need to be able to identify them, and coordinate a plan of action to proactively work towards a healthy, functional family. Because when a family is functional, the derivatives of that family, in other words, members from that family is able to contribute positively, so to people in this society. These individuals shall carry their values and perspectives of a healthy family and be able to relate that kind of healthy relationship to others in this society. To say the least, I am a bit leery of how my sisters counsel families in the community when they personally, are unable to define a functional family and what it takes to be of a functional family.

References

Connell, C. (2010) Multicultural perspectives and considerations within structural family therapy: The premises of structure, subsystems, and boundaries. InSight: River Academic Journal 2(6). Retrieved from http://www.rivier.edu/journal/ROAJ-Fall-2010/J461-Connelle-Multicultural-Perspectives.pdf

Vetere, A. (2001). Structural family therapy. Child & Adolescent Mental Health, 6(3), 133-139. doi:10.1111/1475-3588.00336

Meaningful Nursing Care

Some people just aren’t meant to be in the positions they were hired for. As a nurse, it is strictly crucial to have a caring and compassionate heart, a mind for teaching and learning, a soul for listening and understanding, and most importantly, the knowledge and ability to teach and care for those who are at their most vulnerable phases in life, whether they are going through a series of chemotherapy to treat cancerous cells, or pain from a car accident that happened over 20 years ago, or an invasive heart procedure that requires the harvesting of veins from their legs and using those veins as grafts in their sawed-open chests, these followings are pretty serious conditions. Therefore, we need be to mindful and considerate when it comes to these situations. And if you chose to be a nurse, you need to be caring and compassionate everyday in your life. There are those who would swear up and down, claiming that they are cold-hearted, inconsiderate, and selfish; yet, they are nurses or in the profession of ‘caring’ for people. This is no joke. I’ve come across a few of these people myself. And who am I to say, “Well, dear, you are in the wrong profession!” In all honesty, I so want to say that.

I am my patient’s advocate; I want the best for them! In some instances, these people are helpless; they are not only uneducated, but they are also unable to take care of themselves due to their mental illnesses, developmentally delayed conditions, age, weight, etc. Whatever the reasons may be, we need to pay close attention as to how we treat our patients. Literally speaking and mindfully speaking! They may not be fully aware of the appropriate ways to care for themselves, or what the consequences are for when they are not compliant with taking prescribed medications as directed by a physician, or do not have the resources available to help them out. When we walked gloriously and gracefully down that aisle on stage in our white uniforms to accept our pins and certificates during that pinning ceremony, along those lines and time, we also pledged to follow these duties as nurses, to provide the best care possible to our patients and the human race in general. Have we forgotten?? Well, please allow me to remind you…

Nurses Pledge of Service

“I solemnly pledge myself to the service of humanity 
and will endeavor to practice my profession with 
conscience and with dignity.

I will maintain by all the means in my power the honor 
and the noble traditions of my profession. The total
health of my patients will be my first consideration.

I will hold in confidence all personal matters 
coming to my knowledge.

I will not permit considerations of religion, nationality, 
race or social standing to intervene between my
duty and my patient.

I will maintain the utmost respect for human life. I make 
these promises, solemnly, freely and upon my honor (NMMU, 2005).”

Reference

NMMU. (2005). Nurses pledge of service. Retrieved from http://nursing.nmmu.ac.za/Home

Health Education Barriers and Communication

Communication is a tool of high significance. It is what creates for this understanding between one human being to another. It is how we come to learn things about relationships, health, education, feelings, emotions, and so forth. Without communication, there will be misunderstanding. Without communication, it is like basing life on assumptions. In the healthcare industry, we base a lot of our day to day work on communication—between the nurse to nurse, nurse to doctor, nurse to patient, nurse to family, nurse to the social worker, nurse to the interdisciplinary team. As we take a look at providing and delivering meaningful health promotion and illness prevention based education, we see challenges. Challenges that after communicating with our patients often lead us to question, “Did my patient understand my teaching? Did my patient understand the significance of the teaching? Will my patient be able to apply my teaching into her daily life?”

Living in a society or country that is such a melting pot, not only of ethnicity but also of medical coverage and the different needs involved is such an obstacle for nurses to deliver the best possible teaching that is according to the patient’s needs. When we prepare to teach our patient new information, we must consider all of the different backgrounds, learning styles, languages, lifestyles, their values, views, and aspects of health and what it will mean to them. And when we think of barriers to learning, we automatically go to language barriers. However, that is not the only barrier that is involved. Indeed, there are a few barriers to learning that we must take into account as nurses providing education to our patients. Just because they are in bad physical shape does not mean that they wished that upon themselves—diseases such as diabetes and hypertension. They must have not known any better to take care of their well-being. In addition to that, they may not have had medical insurance to see a primary physician for treatment. Value of health is also a critical factor in determining the best education method for a patient. There are many factors that impact the deliverance of an effective and qualitative education based on health promotion and illness prevention to patients (Module 7: Communication and health education, n.d.). These factors are determined upon the nurse gathering information specific to the patient and devising a teaching plan according to their needs. 

Understanding a patient’s view of health promotion and disease prevention helps to guide the nurse in teaching them successfully (Edelman & Mandle, 2010). Our goal should be a successful learning process for the patient and seeing positive changes that greatly affect and improve their health status. For example, let’s consider the case of a newly diagnosed diabetic patient who comes into the medical office managed by nurses for a follow-up. A finger stick blood sugar was obtained and the result is 341. As the nurse seeing this patient, her appointment with this patient shall be a long one that focuses on the education of diabetes to this patient. First, and foremost, the nurse shall ask the patient, “What does diabetes mean to you?” This question shall assess for the patient’s perspective of health promotion and disease prevention and her values. It will open up to a lot of teaching tools for the patient. If she considers the disease to not be as a serious chronic condition, then the nurse shall explain to the patient the nature of the disease and its complications when not effectively controlled. She must include in her teaching the serious consequences of diabetes because it can possibly happen to the patient. Therefore, knowing the patient’s view of health and disease can lead to a meaningful educational time spent with the nurse--one that is valuable, and can be applied to the patient’s daily life. We want for our patients to see the significance of the disease as we do.

As nurses, I am sure that we have all said it to others, and ourselves “Oooohh…I wouldn’t want to be a diabetic.” We say that because we know the impact it would have on anyone’s life, anyone who had been diagnosed with diabetes or other chronic diseases. And we need to instill that kind of mindset in our patients. After all, it’s been called a ‘disease’ because it is a negative condition. There is nothing positive about diabetes or hypertension or asthma or smoking. And, patients need to realize that and take it more seriously. Effective communication and teaching is the only way to achieve that mindset. This scenario is considering a patient who is well-versed with the English language without language barriers, lack of medical insurance, or developmental deficits.

As we reflect upon our teaching and educating our clients, we must consider the patient’s readiness to learn, the barriers involved, their emotional, mental, physical aspect of health promotion and disease prevention, their values of health, their ability to afford medical treatment or not, and coordinate a teaching plan, accordingly. The teaching needs to be based on all of these factors for it to be a positive change in their health. Their outlook and perspectives on health and disease prevention shall be enhanced and influenced by the nurse’s values (Kessler, 2003). Just like raising a child, in order for us to instill a great foundation in our children’s lives, we must have those special qualities, values, faith, and belief. Then we can give them that foundation that is true to us. Therefore, we must provide this strong foundation and our value of health to our patients. To have the same values and beliefs is the beginning of the process of elimination—and that is the elimination of health discrepancies.

References

Edelman, C. & Mandle, C. L. (2010). Health promotion throughout the lifespan (7th ed.) St. Louis: Mosby.

Kessler, T. A., & Alverson, E. (2003). Health concerns and learning styles of underserved and uninsured clients at a nurse managed center. Journal Of Community Health Nursing, 20(2), 81-92. doi:10.1207/153276503321828013

Module 7: Communication and health education. (n.d.) In Unite for Sight. Retrieved May 24, 2013, from http://www.uniteforsight.org/global-health-delivery-challenges/module6