Did you know that most practicing nurses have never observed a therapeutic conversation with a family? For those of us immersed in family nursing education, practice, and/or research for many years, it is surprising, disappointing, and even a bit shocking to realize. But it’s a clear message that family nursing is still a pioneer endeavor and we all have to “put our shoulder to the wheel”. We need to increase the opportunities for nursing students and practicing nurses to observe and learn the skills of involving families in practice through therapeutic conversations.
When nurses say “I’ve never seen a family interview”, what exactly have they not seen? Nurses report not having witnessed a discussion about the impact of a patient’s illness on family relationships. And conversely, they have never observed a discussion about how a patient’s family has influenced an illness. They also report that they have not participated in therapeutic conversations about families’ illness beliefs and illness suffering.
If family interviews are not visible or familiar in nursing education and/or health care settings, how can we expect that involving families will be embraced as an essential part of nursing care?
The Question: Where and how can nurses observe and practice family nursing skills?
The Answer: Three approaches have the potential to transform nursing practice to include families.
1. Observation of Videotaped Family Interviews
The most passive but still useful method is the observation of videotaped family demonstration interviews by experienced nurse clinicians. Despite being passive, this approach is excellent for developing conceptual/perceptual skills. Many nurse educators and practicing nurses worldwide have found the courage and confidence to conduct family interviews after observing educational family nursing videos. In other words, they were able to “see one, do one”. I admire the forthrightness of these colleagues to forge ahead and conduct family interviews with their students.
I have contributed to this approach by producing several educational DVD’s. My most recent contribution is a new video entitled: Therapeutic Conversations with Families: What’s Love Got to Do with it? (2016) (https://www.lorrainewright.com/lovedvd.htm).
My colleague Dr Maureen Leahey and I have written and produced eight Family Nursing educational videos demonstrating family interviews (http://www.FamilyNursingResources.com). I have also written and produced the educational DVD Spirituality, Suffering, and Illness: Conversations for Healing. (https://www.lorrainewright.com/sufferingdvd.htm).
Perhaps we will soon be using social media to substantially broaden our scope and enable many more students and practicing nurses to observe family interviews. For example, on Facebook, you can now video live to anyone in the world who is on your Facebook page.
2. Observation/Participation in Simulated Family Interviews
The second avenue is to conduct family nursing interviews with standardized patients in simulation centers. This is a much more sophisticated and more helpful method than role playing family situations, as we did back in the day.
I had the opportunity to participate in this process at the University of Calgary-Qatar (UCQ) in Doha, Qatar. Nursing students in the Family Nursing course at UCQ are able to observe and participate in family interviews with standardized patients. The standardized patients are well trained and take this assignment very seriously and provide a most realistic experience for students. They are given very specific scenarios involving an illness in a family. Each student has the opportunity to observe/participate in these realistic family interviews. Of course it takes dedicated faculty and interviewing rooms/equipment to enable this experiential learning.
The impressive UCQ faculty team consists of Dr Debbie Sheppard LeMoine, professor of the Family Nursing Course; Julie Hoffart, Director, of the Clinical Simulation Center; Roger DeWeerd, clinical simulation and technical specialist; and William Kay, Director of Teaching and Learning Center.
3. Observation/Participation in Actual Family Interviews
The most desirable avenue is to observe and interview actual families experiencing illness with clinical supervision. This was the method my colleague Dr Janice Bell and I offered for 25 years (1982-2007) within the Family Nursing Unit, University of Calgary. Masters and doctorally prepared nursing students left the educational context with confidence and competence to offer family healing. Although very rewarding for both students and faculty, it was incredibly labor intensive to operate a faculty practice clinic within a Faculty of Nursing. Being responsible for both the well being of the families who came to the clinic as well as the skill development of nursing students was both exhilarating and exhausting. For these and other reasons, there have been few faculty practice units that have been implemented within faculties of nursing.
All three approaches require a strong belief by faculty educators and nursing leaders in hospitals/clinics that “illness is a family affair”. Hopefully all of us who are nurse educators can increase our dedication for nursing students to have more opportunities to observe and practice therapeutic conversations with families. Otherwise, involving families in nursing care will only exist as a pipe dream. We owe it to the families who are suffering with serious illness and to nurses who desire to learn how to soften families’ suffering!