Adult roles of nuclear family duvall-Chapter Marriage and Family – Introduction to Sociology – 2nd Canadian Edition

For the past two years, they have been living together in a condo they purchased jointly. While Christina and James were confident in their decision to enter into a commitment such as a year mortgage , they are unsure if they want to enter into marriage. The couple had many discussions about marriage and decided that it just did not seem necessary. Was it not only a piece of paper? Did not half of all marriages end in divorce?

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Basel, Switzerland: S. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Although societies differ greatly to the degree that that they place limitations on sexual behaviour, all societies have norms governing sexual behavior. Sociologists study families on both the duvsll and micro level to Adult roles of nuclear family duvall how famjly function. Despite the greater difficulties in conducting research into internalizing versus externalizing problems, some relevant findings have been obtained. The way that parents work together in their roles as parents, the coparenting relationship, has been linked to parental adjustment, parenting, and child outcomes.

Free elephant sex galleries. 14.1. What Is Marriage? What Is a Family?

One of the central propositions of the general London charles nude pic theory is that the system is not the total sum of its parts but is characterized by wholeness and unity. The family's organization, structure, and function have significant impacts on children during growth and development. School nurses can also help decrease the school child's susceptibility to communicable diseases by confirming whether a child's health record indicates whether he or she is up-to-date on all required immunizations. For children who are immunosuppressedcaregivers must be notified if these diseases occur in classmates because of the need Adult roles of nuclear family duvall special monitoring or prophylactic treatment to prevent serious complications. Adult roles of nuclear family duvall will take weeks or months for a problem to be resolved. Home care services can be provided for either shortterm or long-term needs. The structure of the family refers to how it is organized— i. Definitions of the family differ depending on one's discipline and theoretical orientation. Referral to other health care professionals and community organizations is appropriate in these situations. Shifting of parent-child relationships to permit adolescent to move in and out of system. The family then enters the second phase of the stress and coping Adult roles of nuclear family duvall the adaptation phase. School nurses participating in scoliosis screening usually provide this service between 5th and 9th grades NASN,

The way that parents work together in their roles as parents, the coparenting relationship, has been linked to parental adjustment, parenting, and child outcomes.

  • The Child in Context of the Family.
  • Family Stress Theory is a developmental theory borrowed from family science which explores why some family systems adapt and even grow and thrive when faced with situational stressors or transitional events, while other family units deteriorate and disintegrate under similar circumstances McCubbin, , p.
  • .

For the past two years, they have been living together in a condo they purchased jointly. While Christina and James were confident in their decision to enter into a commitment like a year mortgage, they are unsure if they want to enter into marriage.

The couple had many discussions about marriage and decided that it just did not seem necessary. Neither Christina nor James had seen much success with marriage while growing up.

Christina was raised by a single mother. Christina and her mother lived with her maternal grandmother, who often served as a surrogate parent. James grew up in a two-parent household until age seven, when his parents divorced. He lived with his mother for a few years, and then later with his mother and her boyfriend until he left for college. James remained close with his father who remarried and had a baby with his new wife. Recently, Christina and James have been thinking about having children and the subject of marriage has resurfaced.

Christina likes the idea of her children growing up in a traditional family, while James is concerned about possible marital problems down the road and negative consequences for the children should that occur.

Despite having been divorced and having a live-in boyfriend of 15 years, she believes that children are better off when their parents are married. Statistics Canada reports that the number of unmarried, common-law couples grew by 35 percent between and to make up a total of Cohabitating, but unwed, couples account for Some may never choose to wed Jayson With fewer couples marrying, the traditional Canadian family structure is becoming less common. The relationship between marriage and family is an interesting topic of study to sociologists.

What is marriage? Different people define it in different ways. Not even sociologists are able to agree on a single meaning. For our purposes, we will define marriage as a legally recognized social contract between two people, traditionally based on a sexual relationship and implying a permanence of the union.

Other variations on the definition of marriage might include whether spouses are of opposite sexes or the same sex, and how one of the traditional expectations of marriage to produce children is understood today. Both marriage and family create status roles that are sanctioned by society. So what is a family? But what about families that deviate from this model, such as a single-parent household or a homosexual couple without children? Should they be considered families as well?

The question of what constitutes a family is a prime area of debate in family sociology, as well as in politics and religion. Social conservatives tend to define the family in terms of structure with each family member filling a certain role like father, mother, or child.

Here, we will define family as a socially recognized group usually joined by blood, marriage, or adoption that forms an emotional connection and serves as an economic unit of society. Sociologists identify different types of families based on how one enters into them. A family of orientation refers to the family into which a person is born.

A family of procreation describes one that is formed through marriage. These distinctions have cultural significance related to issues of lineage. Drawing on the three sociological paradigms we have been studying in this introduction to sociology, the sociological understanding of what constitutes a family can be explained by symbolic interactionism, critical sociology, and functionalism. Symbolic interactionist theories indicate that families are groups in which participants view themselves as family members and act accordingly.

In other words, families are groups in which people come together to form a strong primary group connection, maintaining emotional ties to one another over a long period of time.

Such families could potentially include groups of close friends as family. In addition, the functionalist perspective views families as groups that perform vital roles for society—both internally for the family itself and externally for society as a whole. Parents care for and socialize children, a function that prepares new members of society for their future roles.

North Americans are somewhat divided when it comes to determining what does and what does not constitute a family. In a survey conducted by Ipsos Reid, participants were asked what they believed constituted a family unit. Eighty percent of respondents agreed that a husband, wife, and children constitute a family. Sixty-six percent stated that a common-law couple with children still constitutes a family.

The numbers drop for less traditional structures: a single mother and children 55 percent , a single father and children 54 percent , grandparents raising children 50 percent , common-law or married couples without children 46 percent , gay male couples with children 45 percent Postmedia News Another study also revealed that 60 percent of North Americans agreed that if you consider yourself a family, you are a family a concept that reinforces an interactionist perspective Powell et al. It is also very important to society.

While the design of the family may have changed in recent years, the fundamentals of emotional closeness and support are still present. Alongside the debate surrounding what constitutes a family is the question of what North Americans believe constitutes a marriage. Many religious and social conservatives believe that marriage can only exist between man and a woman, citing religious scripture and the basics of human reproduction as support.

Social liberals and progressives, on the other hand, believe that marriage can exist between two consenting adults—be they a man and a woman, a woman and a woman, or a man and a man —and that it would be discriminatory to deny such a couple the civil, social, and economic benefits of marriage.

The institution of marriage is likely to continue, but some previous patterns of marriage will become outdated as new patterns emerge. In this context, cohabitation contributes to the phenomenon of people getting married for the first time at a later age than was typical in earlier generations Glezer North Americans typically equate marriage with monogamy , when someone is married to only one person at a time.

In many countries and cultures around the world, however, having one spouse is not the only form of marriage. The reasons for the overwhelming prevalence of polygamous societies are varied but they often include issues of population growth, religious ideologies, and social status.

While the majority of societies accept polygyny, the majority of people do not practise it. Negev Bedouin men in Israel, for example, typically have two wives, although it is acceptable to have up to four Griver As urbanization increases in these cultures, polygamy is likely to decrease as a result of greater access to mass media, technology, and education Altman and Ginat The act of entering into marriage while still married to another person is referred to as bigamy and is prohibited by Section of the Criminal Code of Canada Minister of Justice Polygamy in Canada is often associated with those of the Mormon faith, although in the Mormon Church officially renounced polygamy.

The prevalence of polygamy among Mormons is often overestimated due to sensational media stories such as the prosecution of polygamous sect leaders in Bountiful, B. It is estimated that there are about 37, fundamentalist Mormons involved in polygamy in the United States, Canada, and Mexico, but that number has shown a steady decrease in the last years Useem North American Muslims, however, are an emerging group with an estimated 20, practicing polygamy.

Again, polygamy among North American Muslims is uncommon and occurs only in approximately 1 percent of the population Useem This pattern of tracing kinship is called bilateral descent. In partrilineal societies, such as those in rural China and India, only males carry on the family surname. This gives males the prestige of permanent family membership while females are seen as only temporary members Harrell North American society assumes some aspects of partrilineal decent.

In matrilineal societies, inheritance and family ties are traced to women. Matrilineal descent is common in Native American societies, notably the Crow and Cherokee tribes. In many cultures, newly married couples move in with, or near to, family members.

Patrilocal systems can be traced back thousands of years. In a DNA analysis of 4,year-old bones found in Germany, scientists found indicators of patrilocal living arrangements Haak et al. The Minangkabau people, a matrilocal society that is indigenous to the highlands of West Sumatra in Indonesia, believe that home is the place of women and they give men little power in issues relating to the home or family Joseph and Najmabadi As we have established, the concept of family has changed greatly in recent decades.

Today, however, these models have been criticized for their linear and conventional assumptions as well as for their failure to capture the diversity of family forms. While reviewing some of these once-popular theories, it is important to identify their strengths and weaknesses. The set of predictable steps and patterns families experience over time is referred to as the family life cycle.

One of the first designs of the family life cycle was developed by Paul Glick in This cycle will then continue with each subsequent generation Glick Table The family life cycle was used to explain the different processes that occur in families over time. This type of model accounts for changes in family development, such as the fact that today, childbearing does not always occur with marriage.

It also sheds light on other shifts in the way family life is practised. Although family dynamics in real North American homes were changing, the expectations for families portrayed on television were not. The late s and the s saw the introduction of the dysfunctional family. Shows such as Roseanne , Married with Children , and The Simpsons portrayed traditional nuclear families, but in a much less flattering light than those from the s did Museum of Broadcast Communications Over the past 10 years, the nontraditional family has become somewhat of a tradition in television.

Even those that do feature traditional family structures may show less traditional characters in supporting roles, such as the brothers in the highly rated shows Everybody Loves Raymond and Two and Half Men.

The show follows an extended family that includes a divorced and remarried father with one stepchild, and his biological adult children—one of who is in a traditional two-parent household, and the other who is a gay man in a committed relationship raising an adopted daughter.

The combination of husband, wife, and children that 80 percent of Canadians believes constitutes a family is not representative of the majority of Canadian families.

According to census data, only Sixty-three percent of children under age 14 live in a household with two married parents. This two-parent family structure is known as a nuclear family , referring to married parents and children as the nucleus, or core, of the group. Recent years have seen a rise in variations of the nuclear family with the parents not being married. The proportion of children aged 14 and under who live with two unmarried cohabiting parents increased from Single-parent households are also on the rise.

In , Of that

Parenting is a highly valued activity both on a personal as well as a societal level. These were: Unexpected or unplanned events are usually perceived as stressful. It could be said that this is also the goal of discipline, which comes from the root word disciplinare —to teach or instruct American Academy of Pediatrics [AAP] Committee on Psychosocial Aspects of Child and Family Health, However, concern has been raised about the limited number of adult role models in this type of family structure. The agency ensures that if the child is to remain at home under the care of a nurse, and the caregiver is absent overnight, a designated substitute caretaker with power of attorney is appointed Hogue, Reducing or Eliminating Undesirable Behaviors When undesirable behaviors occur, discipline strategies are necessary to reduce or eliminate such behaviors.

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall.

It could be said that this is also the goal of discipline, which comes from the root word disciplinare —to teach or instruct American Academy of Pediatrics [AAP] Committee on Psychosocial Aspects of Child and Family Health, Discipline should be approached in the broadest sense of helping the child learn rules, regulations, and goals of living in a world with others— and not just as setting limits and punishing Murphy, The AAP suggests that effective discipline should include three components: 1 a positive, supportive, nurturing caregiver—child relationship, 2 positive reinforcement techniques to increase desirable behaviors, and 3 removal of reinforcement or use of punishment to reduce or eliminate undesirable behaviors.

Increasing Desirable Behavior. Many desirable behaviors occur as part of a child's normal development; however, others need to be taught such as empathy, sharing, telling the truth not lying , and good study habits. Family members can teach these behaviors by role modeling since children naturally learn through imitation.

Other strategies that help children learn positive behaviors are listed in Box Reducing or Eliminating Undesirable Behaviors. When undesirable behaviors occur, discipline strategies are necessary to reduce or eliminate such behaviors.

Undesirable behaviors are those that put the child or others in danger, do not comply with expectations of caregivers or other appropriate adults e. However, effective discipline cannot occur if caregivers do not develop their abilities to be positive and rewarding.

An important quality of discipline is that the consequences are effective, constructive, and not unduly harsh Box Wolraich , Several disciplinary strategies are used by caregivers to deal with undesirable or unacceptable behaviors, including disapproval, verbal reprimands, time-out, and corporal punishment. Disapproval can be verbal or nonverbal, and can be very effective.

Tone of voice, facial expressions, and gestures often convey the caregivers disapproval of a specific behavior. Even young children can learn when a their caregiver is irritated by observing and responding to voice inflections, facial expressions, and gestures.

Many caregivers use disapproving verbal statements to alter undesired behavior. Such reprimands may be effective in immediately stopping or reducing the behavior when used infrequently and targeted toward specific behaviors. However, if caregivers use verbal reprimands frequently and indiscriminately, they may reinforce the undesired behavior because the child gets attention.

It is important that reprimands should refer to the child's behavior rather than him or her as a person. They should not slander the child's character. Time-out is an effective discipline strategy that involves removing positive reinforcement for unacceptable behavior. It is a defined period of time in which the child is removed from activities and social interactions.

The goal of time out is to interrupt a pattern of negative behavior. The child should be placed in an area that is unstimulating and safe for a given amount of time usually 1 minute per year of age. A timer can be used so the child knows when time is up.

Verbal or physical interaction with the child tends to negate the effects of time-out because the child is given attention for unacceptable behavior. Parenting is a highly valued activity both on a personal as well as a societal level. Good parenting is necessary for the healthy functioning of children and to produce successful members of society. Parenting is learned through imitation, acquired knowledge, and practice. Nurses can play a vital role in supporting parenting as they work with families.

Too often health care providers talk to parents rather than with them. Merely giving advice based on the providers' background and knowledge may fail to address the parents' personal and cultural beliefs. If the advice given is not congruent with the parents' valued beliefs, then it will be ignored.

Assessment of parenting includes:. Potential sources of problems can be identified from the assessment data. The identified problems should:. When a problem is identified, then the parents and nurse can collaborate on creating a plan of care. Collaboration with parents can improve the success of the plan as parents will be involved with identifying:. The nurse will need to follow up with the parents at subsequent encounters to determine:. It is crucial that nurses work with parents rather than against them if parenting is to be supported.

Nurses should continually ask themselves whether they are imposing their personal beliefs about parenting when they evaluate others' parent-child relationships. Parenting issues or problems will not be resolved in a single encounter. The work of parenting is ongoing and dynamic. It will take weeks or months for a problem to be resolved. By establishing an open exchange of ideas, and respecting parents' personal and cultural values, nurses can support the work of parenting.

According to a report by the U. Department of Health and Human Sendees DHHS, , in there were , community health nurses practicing in a variety of settings. Approximately one in four community health nurses were employed by local and state health departments or community health centers. School health, occupational health, hospice, and other settings make up the remaining areas where community health nurses are employed. School health nursing is discussed further. This chapter will focus on a broad discussion of community health nursing and home health nursing for children and their families.

The community health nurse has a focus on health promotion and disease prevention. While that focus may be on the individual or family, the well-being of the community as a whole is the final objective. The community health nurse can focus on health promotion at an individual child or family level while promoting the well-being of the community by conducting well-child assessments, giving immunizations, conducting screening tests, teaching, and making referrals for the child and family to other health care associates and resources.

The community nurse also has an instrumental role in immunization programs. The nurse may have a primary or team role during the delivery of services. Table lists the various roles of community health nurses.

Governmental Influence. The government has influenced community health nursing for children and their families through federal programs such as Medicaid, public laws, and the Healthy People documents.

The role of the community health nurse includes implementation of government-supported programs and referral of families who are eligible for these services. Community health nurses can be instrumental in referring children and families for services under this program. Community and school nurses can assist families in obtaining services through the sup plemental food program for Women, Infants, and Children WIC and the federally funded school breakfast and lunch programs.

In the mids, federal amendments to Medicaid expanded services to low-income pregnant women. As part of case management for these women, many states now reimburse for home visits by nurses employed by local health departments or health centers. The Early and Periodic Screening, Diagnosis, and Treatment EPSDT program entitles qualified children to having their medical histories taken, physical examinations, immunizations, screening tests, nutrition assessment, and education at specified age levels from birth to 18 years.

Nurses in well-child clinics and on home health visits can perform screenings. Healthy People 2O1O Objectives. Changes and additions to the Healthy People national health objectives, which were reflected in Healthy People DHHS, , will specifically affect community health care of children and their families.

Some of the primary goals of community health nursing are also goals of Healthy People These are health promotion, health protection, and disease prevention. Health Promotion. Health promotion is a major goal of community health nursing practice. Community health nurses facilitate health in the population through direct nursing interventions for health promotion and disease prevention with individuals, families, groups, and populations.

These health promotion strategies are implemented by nurses through counseling, education, and anticipatory guidance. Health Protection. Health protection is defined as "activities designed to maintain the current level of health, actively prevent disease, detect disease early, thwart disease processes or maintain functioning within constraints of disease" Hitchcock et al.

Screening programs for infants, children, and adolescents include blood lead levels, phenylketonuria PKU , growth and development, hearing and vision, dental health, scoliosis, and testicular and breast self-examination. Screening programs are conducted by nurses through health departments, clinics, schools, health fairs, community centers, and well-child clinics. Firearm and playground safety and car-seat loan programs are other examples of health protection programs.

Community health nurses can assess these areas and provide guidance and educational resources for families who have needs in these areas. Community nurses need to routinely inquire about the presence of firearms. Disease Prevention Services. Programs included in the area of preventive services for children and their families include immunization programs, environmental screening programs, hearing and vision screening programs, and screening programs for children at risk for developmental delay.

Community health nurses have a major role in administration of immunizations to children at well-child clinics, at immunization clinics, and during special immunization days at schools. They also assist in measuring serum lead levels, performing vision and hearing screenings, and administering assessments to screen for developmental delays. Once an area of risk is identified, the community health nurse follows through by making referrals as needed, following up with home visits, or arranging return visits to the clinic.

These interventions may be initiated through community health centers, school-based clinics, home health programs, public health departments, or health maintenance organizations.

Some federally and state-funded programs can provide these services. These standards reflect the steps of the nursing process and indicate that community health nurses are to apply this process to individuals, families, and groups to promote health and wellness throughout life.

These standards provide guidelines for competent levels of practice and behavior for the community health nurse. Stanhope and Lancaster define home health care as " an arrangement of health-related services provided to people in their place of residence" p. The health-related services provided for children and their families range from providing direct hourly nursing care to children who are dependent on technology, to intermittent visits from nurses, home health aids, physical therapists, occupational therapists, speech therapists, or social workers.

Home care for children is growing in the area of referrals for home antibiotic therapy, pediatric hospice programs, nursing care for children who are dependent on technology, home phototherapy, private-duty nursing, and home visits to new mothers who are discharged with their babies after brief, routine hospital stays because of uncomplicated deliveries.

Home care services can be provided for either shortterm or long-term needs. Referrals for home antibiotic therapy, home phototherapy, and home visits to new mothers are examples of children and families needing short-term home care services.

The focus for short-term care is on primary and secondary prevention of disease. Primary prevention involves interventions for children that promote health and prevent disease processes from developing. Teaching new mothers how to perform infant care is one example of a home care service that is primary prevention. The goal is to reverse or reduce the severity of the disease or provide a cure.

Tertiary prevention is directed toward children with clinically apparent disease. The aim is to ameliorate the course of disease, reduce disability, or rehabilitate. Many different factors have an impact on home care for children and their families. The three factors this section will focus on include 1 types of agencies and the impact of managed care on these agencies, 2 family needs family and nurse interactions, respite care , and 3 the scope of nursing care skills, case management, and the home visit.

Home Care Agencies and Managed Care. Home care agencies that provide care for children and their families fall into five categories: official, voluntary, combined, private, and hospital-based agencies. An explanation of these types of agencies is found in Table Managed care refers to cost-effective delivery of health care services. Home health care services are supported by managed care organizations in situations where they will result in shortened hospital stays.

Caring for children at home with the assistance of home care services continues to be cost effective as compared with prolonged hospital stays. Early-discharge programs are encouraged by managed care organizations because of their cost effectiveness.

Children with acute and chronic illnesses are being affected by early-discharge protocols. Managed care, by supporting these early discharges, has created a need for comprehensive home care programs for children. These children and families have special needs and require comprehensive nursing care and teaching. Respite Care. Respite care is short-term, temporary care that is normally provided in the home for a child who requires specialized care; it provides relief for the caregivers, which may help to prevent burnout and increase the caregivers ability to cope with stress.

The home care nurse may provide this relief or may be instrumental in referring the family to sources for this care Mausner , Unfortunately, respite care has often been viewed as a luxury rather than a necessity, and it has been arranged only after the family exhibits significant stress Mausner , Families taking care of children at home who have medical complications have complex and conflicting feelings about using respite care services if they are unfamiliar with the caretakers who will provide the respite care.

Families want to be familiar with the person to whom they are entrusting the care of their child. When caretakers begin to think in terms of their need for a break, it is natural for them to turn to the home health care nurse to assist them in making arrangements. Some agencies have successfully developed formal programs of respite care that are available to families taking care of children with a chronic illness at home.

The agency ensures that if the child is to remain at home under the care of a nurse, and the caregiver is absent overnight, a designated substitute caretaker with power of attorney is appointed Hogue, When respite time is well planned, it can be therapeutic for the family and the child. Refer to Chapter 17 for additional information about respite care. The Home Visit. Reifsnider describes how therapeutic relationships are developed between the nurse and caregivers when home visits are planned and implemented in phases.

The phases of the home visit are:. Preinteraction Phase The preinteraction phase includes activities performed prior to the first home visit. Physician's orders and the medical plan of care should be reviewed.

The home health care nurse should review available family data, including referral information and previous records, and establish a plan for the visit. The nurse should prepare for a safe visit e. The neighborhood should also be assessed for environmental factors that may affect personal safety, including location of the home in relation to high crime areas and known drug and gang areas.

During this phase the home health care nurse begins to build the nurse-client relationship. The nurse carries out an initial client, family, and environmental assessment. Thorough assessments should be conducted. Collaboration with the child and caregivers and clarification of roles are done in the active participation phase Reifsnider , Assessment of the adequacy and safety of the general living environment should be conducted.

Does the equipment require a three-pronged outlet but the outlets are two-pronged? Documentation of assessment findings is necessary through all phases of the visit. Home care equipment should be assessed during the initial visit and reassessed periodically for adequacy of routine and emergency maintenance and replacement, and the presence of explicit instructions about the care and operation of the equipment.

In the home, the family may initially view the nurse as a stranger or intruder since the nurse is basically a guest in their home. An awareness of and respect for the cultural and ethnic diversity of families is essential to gaining their trust.

The family may have specific beliefs and practices about health and healing that the nurse should help them integrate into the treatment plan. If these customs are breached, it may prevent the nurse from being able to interact effectively with the child and family. Box provides guidelines for providing culturally sensitive nursing care for children in the home. Providing culturally sensitive nursing care in the home. For example, wipe your feet, or take off your shoes if it is a family custom, before entering the home; ask permission before moving items in the child's room, and replace them after you have finished a task.

Cultural clues may include:. Children who have complex medical conditions, are dependent on technology, and are being cared for in the home may be at risk for developmental delays and problems. A developmental assessment should be performed by the home health care nurse initially and periodically.

When the child is assessed at regular intervals, objective data can be obtained so small developmental changes can be noticed. The nurse needs to provide feedback to families about their child's developmental level, strengths, and deficits.

Caregivers need this information in order to meet the developmental needs of the child. The home health care nurse should assess the appropriateness of third-party reimbursement systems and discuss with the caregivers the estimated length of service, including limits set by third-party payers.

The home care nurse should become familiar with financial resources and therapeutic programs. Termination Phase. The home health care nurse evaluates the child's status and the caretakers' ability to assume responsibility for the child's total care. Part of the termination process involves collaboration and coordination with other disciplines involved in the care of the child.

Plans for terminating home care should begin during the engagement and active participation phase so that the continuity of care that was started can be maintained. During the termination phase, it may be necessary to continue with some rehabilitative services, such as speech, physical, or occupational therapies.

Allowing for the family to evaluate the home care services is important at this time. The home care agency should have standard forms that are sent to families that allow them to routinely evaluate the home care service received. What does the nurse do all day in the school? In a place where children are supposed to sit in class and learn all day, why would a nurse be needed?

This chapter will provide a brief review of the history of school nursing; types of health services, including the various screenings performed by the nurse; health education programs taught; and psychological services offered in which the nurse may be involved. Both models will be discussed and their similarities and differences explored. Finally, the current roles of the school nurse will be described, as well as future issues facing her or him. The school nurse is involved in many school health services, including direct or indirect nursing care.

Direct services include providing nursing procedures or care to individual students; indirect services include consulting with staff on behalf of a child's health needs and providing community referrals and health education. Health services also include screening programs, communicable disease control, emergency care, and medication administration. Education and health promotion activities include presenting subjects such as personal care, sex education, substance abuse, and violence prevention programs.

The school nurse may also collaborate with social workers and school psychologists to provide services to families after unusual events in a child's life. One task of the school nurse is organizing and performing a variety of screening programs for school children. These screening programs assist in the early identification of possible problems related to children's health.

Traditional screening programs offered in the school include vision and hearing testing, height and weight measurement, scoliosis and pediculosis screening, immunizations, and, in some districts, dental and tuberculosis screening Adams, ; Kane, Vision and Hearing Screening.

The purpose of vision screening is to identify children with potential problems in visual acuity and muscle balance so treatment can begin as soon as possible. Early vision screening can assist in detecting conditions such as strabismus, or lazy eye. Screening also often includes inspecting the eye and evaluating visual acuity, muscle balance phoria , excessive farsightedness hyperopia , and color vision. Ideally, all students should be screened annually. Numerous instruments are available for assessing vision in children, and the school nurse needs to be familiar with these products.

The traditional Snellen chart, which uses letters in various sizes, is also available in tumbling letters and pictures to match the age and ability level of the child being screened.

Stereoscopic instruments, which use mirrors, lenses, and occluders to screen for vision problems and require special training, are also used in mass screening programs. Hearing screening is another responsibility of the school nurse Figure Hearing difficulties can have an impact on the child's ability to learn. If the child cannot hear adequately, directions and important information may be missed, speech development impaired, and reading affected.

The nurse can help prevent or limit this problem by annually testing the child's hearing at , 1,, 2,, and 4, hertz in both ears at a fixed decibel dB level. Children with hearing loss between 70 and 90 dB are considered hard of hearing, and those with hearing loss greater than 90 dB are defined as having a severe or profound hearing loss Copmann , Statistics show that 1 in 5 children will need corrective lenses by the time they graduate from high school Yawn et al.

In the school setting, that equals about a grade level and a half without proper treatment. The nurse can play a vital role in speeding up this process by consistently following up on students who failed screenings and knowing about existing local resources to share with caregivers.

The school nurse also needs to be aware of organizations that can assist families in obtaining vision and hearing services for their children. If a permanent vision or hearing loss is detected, the nurse can assist in obtaining specialized services or needed adaptations. Height and Weight Measurement.

Height and weight measurements are usually taken at the physician's office as part of a physical exam. However, some states require these measurements only on entry to kindergarten and 9th grade. Unless the child receives a yearly exam, height and weight can go unchecked for several years. A school nurse's annual measurements of a student's height and weight can provide valuable information for the health care provider, especially if a growth abnormality or weight problem is suspected.

Scoliosis Screening. It can cause gait disturbances, inflexibility, and back pain, and can affect posture. Scoliosis affects 0.

School nurses participating in scoliosis screening usually provide this service between 5th and 9th grades NASN, Treatment options for scoliosis depend on the type of scoliosis diagnosed and are aimed at straightening and realigning the spine with exercise, external bracing, or surgical intervention.

Immunization Monitoring. Another important role of the school nurse is monitoring student immunization records. Since the introduction and use of vaccines, the occurrence of communicable diseases such as diphtheria, tetanus, polio, and measles has decreased Selekman , The school nurse is responsible for knowing about current immunizations, protocols, and schedules, and should also know when communicable disease outbreaks occur that may affect children.

Communicable Disease Control. Specifically, the nurse's role in communicable disease control revolves around the three factors necessary for spread of disease: transmission, susceptibility, and a favorable environment.

An infectious agent is an organism, such as a virus or bacteria, capable of producing an infection Benenson , Handwashing has been shown to be an effective way to decrease the spread of communicable diseases Kimel , The school nurse can provide valuable and creative ideas for educating children about the importance and correct method of washing hands.

School nurses can also help decrease the school child's susceptibility to communicable diseases by confirming whether a child's health record indicates whether he or she is up-to-date on all required immunizations. When a child's immunization status does not show adequate protection, referral is necessary.

Some school districts provide this service directly if they have established school-based or schoollinked clinics, and the nurse may be responsible for administering the immunizations Figure The nurse can also help decrease susceptibility to disease by providing education about health issues and promoting healthy living habits in students, especially in the early grades.

Nutrition, exercise, adequate rest, and personal care can affect one's ability to fight off infectious diseases; these are possible topics for health promotion classes.

Lastly, the school nurse can help contain the spread of communicable diseases by providing a less favorable environment for their growth. By identifying children with communicable diseases and excluding them from school as policies dictate, the number of other children exposed can be decreased.

Although the incidence of serious communicable diseases has decreased because of vaccination, other illnesses, such as strep throat, scabies, and lice, still need to be monitored. Even though these diseases are less serious than measles, they can spread quickly through the classroom and lead to complications in some children. For children who are immunosuppressed , caregivers must be notified if these diseases occur in classmates because of the need for special monitoring or prophylactic treatment to prevent serious complications.

Emergency Care. Because the school nurse is often the only health professional in the school, that individual must have excellent physical assessment skills and be able to make quick and accurate decisions regarding the extent of illnesses or injuries.

When a student comes into the nurse's office, an acrossthe - room assessment of the child is necessary in order to decide on the best course of action. The nurse must think:. Then the nurse should:. Figure 5- 3 A school nurse is responsible for administering emergency first aid. This information can assist in deciding if the child's caregiver needs to be notified.

Sometimes physicians' standing orders allow the nurse to treat minor illnesses at school with medications such as acetaminophen or cough syrup. However, before dispensing any medications, the nurse must know the district medication policy. See Box for a list of first aid supplies the school nurse should have readily available.

One would think that school is the safest place for a child to be, but the potential for injuries in a school is nearly endless. Playground equipment, participation in gym and sports, and injuries in classes such as metal shop and chemistry can all lead to serious accidents. If the child has fallen in gym and is complaining of ankle pain and difficulty walking, the nurse should look for swelling, bruising, deformities, and decreased movement, circulation, and sensation in the extremity.

If abnormalities are found the extremity should be splinted as necessary. If there is a head injury, the child should never be left alone. Vital signs as well as vision disturbances, headaches, nausea, vomiting, and changes in level of consciousness or seizure activity should be noted.

Since extensive medical supplies and equipment are not always available in schools, help from paramedics who are often only minutes away can be essential. When the nurse assesses the child's illness or injury, she can also teach children to care for themselves, promote self-esteem, and encourage healthy habits. Ongoing Health Situations. An increasingly common school emergency today is a child experiencing difficulty breathing due to an asthma attack. Symptoms vary in severity and can include wheezing, cough, difficulty breathing, prolonged expiration, chest tightness, tachypnea , and excessive mucosal secretions.

The number of children diagnosed with asthma has risen in recent years and is estimated at 4. Individualized Health Plan. When a child returns to school after having had a health problem, the school nurse must evaluate the incident and develop a plan for the child while at school. Since nurses are not always present when needed in an emergency, other school personnel may become responsible for administering first aid care and deciding when and if to transport a child to an acute care facility.

Having a written plan available to assist in emergency situations can be invaluable. In the hospital, this is called the nursing care plan. The IHP can consist of a brief health history, base-line assessment data, medications, nutritional considerations, specialized equipment, possible problems, and interventions, and an emergency plan individualized for each child with a health problem Porter, et al.

Box provides an example of an Individualized Health Plan that could be used for Jimmy, the boy described in the case study. Since plans can be developed for the student with any health problem, school personnel should be educated on the IHP and how it works. In fact, the best health plan is of little use if others responsible for first aid are unable to follow it.

By taking the time early in the year to provide the staff with a list of students with special health needs and to familiarize them with emergency procedures, health care can be delivered to students quickly and competently, and problems avoided. Another important service the school nurse provides is the monitoring and administration of medication children receive while at school Figure The nurse is responsible for making sure that children who must receive medication at school have written orders from their physicians and written permissions from their caregivers to receive the medication at school.

All medications should be stored in a locked cabinet, and if the principal or another designated staff member is to administer medications in the nurse's absence, the nurse should train these personnel and provide information on the medication itself and the five rights right patient, right medication, right dose, right route, right time. All medication must be labeled by a pharmacy with the child's name, medication name, dose, and time to be administered.

Many medications are controlled substances Ritalin, Dexedrine and must be treated as such. However, medication is not the only treatment these children receive. Other measures include behavior modification, psychological counseling, and classroom intervention.

By being knowledgeable about all medications and interventions, the school nurse can assist students, families, and teachers in delivering appropriate care. Health education and health promotion principles have existed for many years, but how they have been defined has changed over time. The National Task Force on the Preparation and Practice of Health Educators described health education as assisting individuals to make informed decisions about matters affecting their personal health, which can include disease prevention, promoting optimal health, and illness treatment.

A health education curriculum should include information about these five preventative behaviors that often cause intentional or unintentional injury and increased morbidity in children Vernon et al.

Other important topics include personal and dental hygiene, safety, first aid, anger management, and conflict resolution.

Key Concepts. These include: balancing the illness with other family needs, maintaining clear family boundaries, developing communication competence, attributing positive meanings to the situation, maintaining family flexibility, maintaining a commitment to the family as a unit, engaging in active coping efforts, maintaining social integration, and developing collaborative relationships with professionals Patterson, Fine states that," personal perceptions and responses to stressful life events are crucial elements of survival, recovery, and rehabilitation, often transcending the reality of the situation or the interventions of others" p.

Enhanced quality of life, self? Allen, M. Traditional parenting and childrearing: Promoting harmony and beauty for life. Navajo parenting workshop at Northern Arizona Museum. May 15, Flagstaff, AZ.

Fine, S. Resilience and human adaptability: Who rises above adversity? The American Journal of Occupational Therapy , 45 6 , ? Friedman, M. Family nursing.

Haase, J. Quality of life in children and adolescents with cancer. Quality of life: Theory , research, and practice. King Ed. Mc Cubbin, M. Family stress theory and the development of nursing knowledge about family adaptation. Feetham, S. Meister, J. Gillis Eds. The Nursing Family. New Bury Park: Sage Publications, McCubbin, M. Families coping with illness: The resiliency model of family stress, adjustment and adaptation. In, C.

Danielson, B. Louis: Mosby. Patterson, J. Family resilience to the challenge of a child's disability. Pediatric Annals , 20 9 , Sept, ? Promoting resilience in families experiencing stress. Pediatric Clinics of North America , 42 1 , Feb, 47? Polk, L. Toward a middle? Advance Nursing Science , 19 3 , Sobralske, M. Perceptions of health: Navajo Indians.

Topics in Clinical Nursing , 7 3 , Adjustments for divorced, re-married, extended, and alternate life style families are not included. The above chart was developed to assist students in comparing three family theories to be used in the process of: assessing families, identifying strengths and needs of families individuals as well as entire families , and developing plans for referrals, interventions, and evaluation of care.

Family Nursing. In, Feetham, S. B; Bell, J. The Nursing of Families. New Bury Park: Sage. Wright, L. Philadelphia: F. Davis Co. Go back to Family and Related Theories. McCubbin and McCubbin in defined the concept of person as: Person, or family, is viewed as encountering hardships and changes as an inevitable part of family over the life cycle.

Developing intimate peer relationships. Establishing work and financial independence. Development of intimate peer relationships. Establishment of self re: work and financial independence. Persong, "family":viewed as encountering hardships and changes as an inevitable part of family life over the life cycle. Environment: The family system is viewed as an open system and a component of the larger community and society.

Health: Defined as "family resiliency" or "the ability of the family to respond to and eventually adapt to the situations and crises encountered over the family life cycle. Planning a family decisions about parenthood. Realignment of relationships with extended families and friends to include spouse.

Setting up the young family as a stable unit integrating of new baby into family. Reconciling conflicting developmental tasks and needs of various family members. Maintaining a satisfying martial relationship.

For the past two years, they have been living together in a condo they purchased jointly. While Christina and James were confident in their decision to enter into a commitment such as a year mortgage , they are unsure if they want to enter into marriage.

The couple had many discussions about marriage and decided that it just did not seem necessary. Was it not only a piece of paper? Did not half of all marriages end in divorce? Neither Christina nor James had seen much success with marriage while growing up. Christina was raised by a single mother. Christina and her mother lived with her maternal grandmother, who often served as a surrogate parent. James grew up in a two-parent household until age seven, when his parents divorced. He lived with his mother for a few years, and then later with his mother and her boyfriend until he left for college.

James remained close with his father who remarried and had a baby with his new wife. Recently, Christina and James have been thinking about having children and the subject of marriage has resurfaced. Christina likes the idea of her children growing up in a traditional family, while James is concerned about possible marital problems down the road and negative consequences for the children should that occur.

Despite having been divorced and having a live-in boyfriend of 15 years, she believes that children are better off when their parents are married. Cohabitating, but unwed, couples account for Some may never choose to wed Jayson, With fewer couples marrying, the traditional Canadian family structure is becoming less common. The relationship between marriage and family is often taken for granted in the popular imagination but with the increasing diversity of family forms in the 21st century their relationship needs to be reexamined.

What is marriage? Different people define it in different ways. Not even sociologists are able to agree on a single meaning. For our purposes, we will define marriage as a legally recognized social contract between two people, traditionally based on a sexual relationship, and implying a permanence of the union. Other variations on the definition of marriage might include whether spouses are of opposite sexes or the same sex, and how one of the traditional expectations of marriage to produce children is understood today.

Both marriage and family create status roles that are sanctioned by society. So what is a family? But what about families that deviate from this model, such as a single-parent household or a homosexual couple without children? Should they be considered families as well? The question of what constitutes a family is a prime area of debate in family sociology, as well as in politics and religion.

Here, we will define family as a socially recognized group joined by blood relations, marriage, or adoption, that forms an emotional connection and serves as an economic unit of society. Sociologists also identify different types of families based on how one enters into them.

A family of orientation refers to the family into which a person is born. A family of procreation describes one that is formed through marriage. These distinctions have cultural significance related to issues of lineage the difference between patrilineal and matrilineal descent for example. However, the forms that families take are not random; rather, these forms are determined by cultural traditions, social structures, economic pressures, and historical transformations.

In these debates, sociology demonstrates its practical side as a discipline that is capable of providing the factual knowledge needed to make evidence-based decisions on political and moral issues concerning the family. The family is an excellent example of an institution that can be examined at the micro-, meso-, and macro- levels of analysis. For example, the debate between functionalist and critical sociologists on the rise of non-nuclear family forms is a macro-level debate.

It focuses on the family in relationship to a society as a whole. On the other hand, critical perspectives emphasize the inequalities and power relations within the family and their relationship to inequality in the wider society. These are analyses that set out to understand the family within the context of macro-level processes or society as a whole. At the meso-level, the sociology of mate selection and marital satisfaction reveal the various ways in which the dynamics of the group, or the family form itself, act upon the desire, preferences, and choices of individual actors.

At the meso-level, sociologists are concerned with the interactions within groups where multiple social roles interact simultaneously. Similarly, it is possible to speak of the life cycle of marriages independently of the specific individuals involved.

This area of study is another meso-level analysis. Marital dissatisfaction and divorce peak in the 5th year of marriage and again between the 15th and 20th years of marriage.

The presence or absence of children in the home also affects marital satisfaction — nonparents and parents whose children have left home have the highest level of marital satisfaction. Thus, the family form itself appears to have built-in qualities or dynamics regardless of the personalities or specific qualities of family members. At the micro-level of analysis, sociologists focus on the dynamics between individuals within families.

One example, of which probably every married couple is acutely aware, is the interactive dynamic described by exchange theory. What happens to the family dynamic when one spouse is a net debtor and another a net creditor in the exchange relationship? In The Unbearable Lightness of Being , the Czech novelist Milan Kundera describes the way every relationship forges an implicit contract regarding these exchanges within the first 6 weeks.

It is as if a template has been established that will govern the nature of the conflicts, tensions, and disagreements between a married couple for the duration of their relationship.

Afterwards, it acts as a structure that constrains their interaction. Because of traditional gender roles and family structures, this was typically a working father and a stay-at-home mom. In , Sociologists interested in this topic might approach its study from a variety of angles. How is a child socialized differently when raised largely by a child care provider rather than a parent?

Do early experiences in a school-like child care setting lead to improved academic performance later in life? How does a child with two working parents perceive gender roles compared to a child raised with a stay-at-home parent? Another sociologist might be interested in the increase in working mothers from an economic perspective.

Why do so many households today have dual incomes? Has this changed the income of families substantially? What impact does the larger economy play in the economic conditions of an individual household? Do people view money — savings, spending, debt — differently than they have in the past? Has the increase in working mothers shifted traditional family responsibilities onto schools, such as providing lunch and even breakfast for students?

How does the creation of after-school care programs shift resources away from traditional school programs? What would the effect be of providing a universal, subsidized child care program on the ability of women to pursue uninterrupted careers? As these examples show, sociologists study many real-world topics.

Their research often influences social policies and political issues. In modern individualistic societies on the other hand, romantic love is seen as the essential basis for marriage.

Despite the emphasis on romantic love, it is also recognized to be an unstable basis for long-term relationships as the feelings associated with it are transitory. What exactly is romantic love? Neuroscience describes it as one of the central brain systems that have evolved to ensure mating, reproduction, and the perpetuation of the species Fisher, It manifests as a seemingly involuntary, passionate longing for another person in which individuals experience obsessiveness, craving, loss of appetite, possessiveness, anxiety, and compulsive, intrusive thoughts.

In this respect, romantic love shares many physiological features in common with addiction and addictive behaviours. In a sociological context, the physiological manifestations of romantic love are associated with a number of social factors. Love itself might be described as the general force of attraction that draws people together; a principle agency that enables society to exist. Fromm argues therefore that love can take many forms: brotherly love, the sense of care for another human; motherly love, the unconditional love of a mother for a child; erotic love, the desire for complete fusion with another person; self-love, the ability to affirm and accept oneself; and love of God, a sense of universal belonging or union with a higher or sacred order.

Only when the object of love is individualized in another, does it come to form the basis of erotic or intimate relationships.

This suggests that for couples who remain together, romantic love eventually develops into companionate love characterized by deep friendship, comfortable companionship, and shared interests, but not necessarily intense attraction or sexual desire.

In particular, people tend to select mates of a similar social status from within their own social group. The selection process is influenced by three sociological variables Kalmijn, Secondly, third parties like family, church, or community members tend intervene to prevent people from choosing partners from outside their community or social group because this threatens group cohesion and homogeneity. Symbolic interactionist theories indicate that families are groups in which participants view themselves as family members and act accordingly.

In other words, families are groups in which people come together to form a strong primary group connection, maintaining emotional ties to one another over a long period of time.

Such families could potentially include groups of close friends as family. However, the way family groupings view themselves is not independent of the wider social forces and current debates in society at large. North Americans are somewhat divided when it comes to determining what does and what does not constitute a family.

In a survey conducted by Ipsos Reid, participants were asked what they believed constituted a family unit. It is also very important to society. While the design of the family may have changed in recent years, the fundamentals of emotional closeness and support are still present.

Alongside the debate surrounding what constitutes a family is the question of what North Americans believe constitutes a marriage. Many religious and social conservatives believe that marriage can only exist between man and a woman, citing religious scripture and the basics of human reproduction as support. Social liberals and progressives, on the other hand, believe that marriage can exist between two consenting adults — be they a man and a woman, a woman and a woman, or a man and a man — and that it would be discriminatory to deny such a couple the civil, social, and economic benefits of marriage.

The institution of marriage is likely to continue, but some previous patterns of marriage will become outdated as new patterns emerge. In this context, cohabitation contributes to the phenomenon of people getting married for the first time at a later age than was typical in earlier generations Glezer, North Americans typically equate marriage with monogamy , when someone is married to only one person at a time.

In many countries and cultures around the world, however, having one spouse is not the only form of marriage. The reasons for the overwhelming prevalence of polygamous societies are varied but they often include issues of population growth, religious ideologies, and social status.

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall

Adult roles of nuclear family duvall