PART 1

A sample genogram depicting the family structure of Hannah and Steven Williams

Summary of Hannah and Steven Williams family structure.

Hannah’s mother Marion is 52 years old and is still alive and has a postnatal disorder. Marion is retired and lives in the northern Gold Coast and is supportive of Hannah. She is separated from Sam who is 59 and is the biological father of Hannah. Sam lives in the Philippines and has remarried to Ariel who is 39 years old. Hannah can only get to meet Sam who visits Australia twice a year.

Hannah is married to Steven who works Gladstone, Queensland at an oil company. Together they have just given birth to a baby girl who is to be discharged today. The couple raises another child Billy (5) gotten from Hannah’s previous marriage with Barry (36) a neighbor and former lawyer who is currently dating Jane 34. Billy loves to spend time with his father Barry.

Steven’s mother Mavis (59) is alive and was widowed in 2016 after the loss of Henry (64) through coronary heart disease. Together they were married for 39 years and the loss is yet to settle with Mavis who lives in Sydney. Steven’s family do not meet often and he describes his father as a tough disciplinarian who occasionally used to whip him as a child.

Steven and Hannah live in Gold Coast having moved into a 3-bedroom house. Together they face the financial challenge of servicing their budging mortgage in the new house and raising two kids. Hannah’s caesarian delivery has come in between their sexual relationship. Steven believes two weeks is enough for Hannah to heal, he is constantly working and whenever at home he prefers golf over his newborn daughter.

Two Strengths of the Hannah and Steven Williams Family

Using the Australian Family Strengths Nursing Assessment Guide, the Williams family has two strengths namely; Acceptance and Commitment. According to Denny et al., (2014) acceptance is seen when sharing of things, the family respects, understands the distinctiveness and uniqueness of each person. Commitment in that, as family members the well-being of the whole entity is of priority and every member is dedicated towards this (DeFrain, 2014). The Williams family may be lacking in a number of strengths but the element of acceptance and commitment is clearly displayed across their ties. Marion shows acceptance to Hannah despite the fact that she is a retiree and separated from her husband, Sam, currently remarried and living in the Philippines. Hannah’s mother accepts her predicament as her own and is willing to be part of her two grandchildren’s lives. Barry and Steven portray acceptance in their new families despite their spouses having ties with their former relationships. Jane two children Ronan (12) and Emily (10) from her previous relationship and Barry accepts her as she is and together are building a family as Steven is with Hannah who had Billy (5) with Barry. Secondly, commitment is shown in portrayed through Hannah and Steven who move into a bigger house to raise their two kids and set everything in place in anticipation of the child for easier parenting.

PART 2

Social Isolation

Description

According to Gierveld et al., (2016), social isolation is the limited contact between an individual and significant others or society relating to the inability to participate in usual activities and events as a result of a prolonged immobility. This state can result from prolonged staying at home, lack of steady communication with family, friends or neighbors and the deliberate inadvertent avoidance of contact with other persons (Gierveld et al., 2016). Mace et al., (2014) further argue that prolonged cases of social isolation can result in cases of fear for others, negative self-esteem and loneliness similar to biomedical and psychosocial risk factors. Social isolation may be disguised as a relaxing and comforting condition on the part of the individual (Fitzgerald, et al., 2014). However, cases of self-realization may lead to individuals to make desperate efforts to reconnect to their social life. Studies show a close correlation between perceived social isolation and associated gene expression which leads to an elucidation that hereditary social isolative behaviors can be passed on to future generations (Cole, et al., 2015). According to Pettigrew et al., (2014), individually; domestic violence, living alone, unemployment, loss of a spouse, societal adversities, and transport issues age and health problems, have been noted as the leading risk factors that aggravate social isolative propensities in people.

In Family Scenario One, social isolation is an overriding problem from Marion, Hannah to Sam and Mavis. Hannah recently moved into Gold Coast and barely knows any person in the community save for the few women in Billy’s pre-school. She works in Gold Coast yet her closest confidant is her mother in the north. Her family commitments and work have limited her ability to go out and meet new people or join a community of mothers to help her settle easily. This affirms Gierveld et al., (2016) argument that persons with social isolative tendencies inadvertently can be a hindrance to interacting with other persons in the community.

Other cases include Sam who is comfortable and unperturbedly living in the Philippines miles and miles away from his family and a twice-a-year visit to Australia to him seems enough. Fitzgerald et al., (2014) that show individual resulting to isolation as a means comforting and relaxing from their problems. Mavis who is suffering the loss of her husband to coronary heart disease is also a good example of this in the text. Sam on his part is the idea of absconding his essential parenting responsibilities for golf portraying an isolative appeal.

Nrsing Care Plan

Hannah is a 29-year-old female patient who recently gave birth to her second child through a caesarian section delivery. She is overwhelmed by the challenge of giving birth, the tough financial situation in her family and the fact that she can little to help. Her perception of herself seems dumbfounded and expressively blunted. Hannah Williams, is of the view of first waiting till she fully heals in order to join a walking momthers’ group. However, a cross-analysis of the responses from the patient portrayed an honest avowal of her current situation.

From the diagnosis, Hannah seems to be having a n Impaired social interaction. The short term goal for this treatment is to have Hannah develop a trusting relationship with her neighbors and close family. And in the long term, by end of month, Hannah will be willing and apprehensive of socializing with others. By socializing, Hannah  will be reconnecting with the society and regaining that essential part of her life. According to Franck et al., (2016) socialization interventions are crucial to bettering isolative tendencies and reducing depression in these patients.

Implementing Nursing Care

Franck et al., (2016) propose that administering socialization interventions is effective in countering social isolation propensities in patients which can ultimately result in depression and anxiety if untamed in these patients. Socialization will include guiding the patient on how to behave suitably in her social groups for her to mingle easily. Recommending further assistance from the Healthdirect.gov.au which offers rapid attention to cases of social isolation to prevent loss of lives as result of depression and other psychosocial problems, will supplement these nursing interventions.

Evaluating Nursing Care

The effectiveness of this intervention will be measured by the number of meetings the patients have made to her walking mothers’ group or any other selected by the patients. The evolutions will also measure the number of visitors who have come to her home or visited recently. A more than one visit a week will show improvement with attendance of more than four meetings a month showing a success.

Transition to Parenting

Description

Transition to parenting is a family life-cycle literature that describes the addition of the first child in a marital system which can be unsettling and loading to any couple especially when the responsibility of raising the baby is in the picture (Feinberg, et al., 2016). The responsibility of raising the first child can have adverse emotional implications on a couple’s relationship causing irreversible lifetime relational changes. The transition to marriage is generally tough, a psychological preparedness and optimism as the two tools to improving and ‘easing’ the tasking parenting responsibilities.

A great percentage of couples report reduced marital satisfaction after conceiving their first child due to the challenging adjustments to the new family roles to accommodate the needs of these new born (Feinberg, et al., 2016). Negative projections towards the arrival of the child in the family may lead to negative experiences resulting in reduced communication between couples. An increased role segregation between couples with the entry of the child (McMahon, et al., 2015). The seemingly foreign parenting roles to couples tend to be an impeding factor and takes the time to return the chemistry in a relationship.

In Family Scenario One, Stevens being a first time parent portrays qualities consistent with difficulties in transition to parenting. He is reluctant to help out with the baby in morning instead prefers to go golfing absconding the collective duties to Hannah who is grappling with the burden of raising her two young children. Steven is conditional in the nature of his care to his newborn daughter. He is recorded to saying he will only be glad to spend weekends with the family if the baby does not cry too much despite this being the nature of newborns. Stevens’s urgent concern seems to be the financial position of the family now that Hannah is recuperating and their sexual life. His fatherly role to his newborn daughter seems ignored and untended as he spends most of his times working the little free time spared for golfing.

Nursing Care Plan

The patient Steven Williams, 32, works in a Gladstone, Queensland. Goes for four weeks working then rest for 2 weeks. Had a rough childhood where his father used to whip him. He recently lost his father and is survived by his mother who he rarely meets. Steven Williams is recorded to saying that Hannah can solely take care of the girl in the morning having previously done so for Billy. He prefers golfing to tending to his daughter and is conditional in the manner he extends his parental care to his daughter. Through this experiences, the insignificance of the family in Steven may be caused by his upbringing and the sentiments regarding his daughter’s care should be treated as biased and remediable. From this case, it can be diagnosed that Steven is suffering from impaired parenting.

Steven’s care will target at having Steven helping out Hannah in caring for the baby at least in two days by the end the week. Collective parenting and assistive approach to sharing the overwhelming responsibilities with the entry of a child lessen the transition to parenting while improving the mutual relationship between couples rather than segregating roles. Incorporating Steven in a couple-based parenting approach will bring the two together, bettering the bond and their relationship way beyond the sexual confines as seen in Steven’s persistence.

Implementing Nursing Care Plan

According to Whittingham et al. (2016), administering parenting therapy to Steven will help in conditioning him the right way to be a better parent. Parenting can be stressful and demanding to couples which some resolving to role segregation or absconding altogether in detrimental defense mechanisms that worsen a child’s upbringing (Whittingham et al., 2016). Parenting therapy will raise the acceptance of parenthood and foster commitment from a spouse towards the parenting process which Steven seems to lack as seen in the text. Recommending parentingideas.com.au will supplement parenting therapy in this case.

Evaluating Plan

Evaluating the efficiency of this plan will be measured through calculating the amount and frequency of the time spent by Steven with the daughter as compared to previous cases. Success will be when he spends more days with the daughter in the mornings and weekends more than golf.