Assuming the role as caregiver for her mother will pose challenges to Susie and her family. While the primary role of caregiver may be placed squarely on the shoulders of Susie, her family—husband and children—will be impacted as well. Beyond what a nurse would bring to this situation as a healthcare practitioner, her role may shape into that of adjunct educator or even group facilitator, bearing in mind that the nurse must consider how such changes to the family unit affect the health and well-being of the patient. Under the guise of two theories, family structure and family development, a nurse is poised with unique perspectives on how best to care for the needs of the patient.
In essence, a family structure is identified through the arrangement of roles assumed by each family member. It may be that in this case there is the father, mother, and three school-aged children. Much the same as family development theory, the roles within a family structure are developed around shared values, norms and what is determined within the family as mutual obligation and responsibility (Kingsbury & Scanzoni, 2004). Yet, these two factors perhaps simplify things a bit because family structures are also comprised of relationships that are bound to one another, something that does not occur outside of the family. Thus, the addition of Mrs. Jones to the family structure requires a host of changes to the existing structure, changes that call for an outsider to be admitted into the unit. Mrs. Jones coming into the fold will have a disrupting impact on family homeostasis, or everything that had been established by the family as it went through its own life course trajectory (Kingsbury & Scanzoni, 2004). As is also indicated in the following paragraph concerning family development, the impact of caring for Mrs. Jones may be a challenge to established norms and values, while placing stressors on agreed upon family obligations and responsibilities. Roles may change, and at least initially there will be disruption to family homeostasis until the family structure begins to adapt. The role of the nurse in this example remains one of caregiver and educator; perhaps instructing the family about change while supporting the notion of seeking counseling along with a great deal of respite.
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From a family development theoretical perspective, the ambivalence expressed by Susie may have less to do with a reversal of roles as caregiver and instead relates to prevailing normative aspects of the family structure. In other words, her concerns may have to do with the disruption to an extent by which established family norms will radically change. On a social level, families are considered institutions and as such are comprised of their own ways of functioning (Rogers & White, 2004). Even without the element of caring for Mrs. Jones, concerns would perhaps take shape about the manner by which the family institution must change, and with the extra burden of caring for her mother Susie may see this addition in terms of how adapting to her medical needs changes the character of her family. Secondly, with school-aged children the family, as a group, has established specific roles for each member (Rogers & White, 2004). The concern in this case may relate to ways by which the roles are altered or redefined, because there is some potential that more group members—Susie’s family—may have to assume caregiver responsibilities. Lastly, caring for the medical needs of a loved one is quite stressful and may impact relationships within the family unit (Rogers & White, 2004). Communication within the family may change as well, as the challenge will be to incorporate the burden as caregiver in a manner that does not hamper lines of communication. Taking these issues into consideration a nurse may need to assume the role of educator, providing insight to the family concerning the changes that will occur to family norms, how the addition of caring for Mrs. Jones may alter the character of established roles within the family and to instruct the family on shared responsibility and communication.
- Kingsbury, N., & Scanzoni, J. (2004). Structural-Functionalism. In P. G. Boss, W. J. Doherty, R. LaRossa, W. R. Schumm, & S. K. Steinmetz (Eds.), Sourcebook of family theories and methods: A contextual approach (pp. 195-217). New York, NY: Springer.
- Rogers, R. H., & White, J. M. (2004). Family development theory. In P. G. Boss, W. J. Doherty, R. LaRossa, W. R. Schumm, & S. K. Steinmetz (Eds.), Sourcebook of family theories and methods: A contextual approach (pp. 225-254). New York, NY: Springer.
