International models of family nursing do not address particular challenges facing UK and Irish nurses, given that the UK and Irish healthcare systems are quite different to those in other countries. Therefore, we set out to develop strategies to promote family nursing within the UK and Ireland. To help shape these strategies, we circulated the validated Families’ Importance in Nursing Care–Nurses’ Attitudes’ (FINC-NA) questionnaire to registered nurses in the UK and Ireland via email, Twitter and Facebook.
The anonymous survey, comprising of 35 questions, took approximately 5 minutes to complete. Data were analysed using descriptive statistics and thematic analysis. We received 735 responses from nurses, midwives and health visitors working with patients and clients across the life course in England, Scotland, Wales, Northern Ireland and the Republic of Ireland. Of those who participated, 93% were female.
Here are some typical quotations from the survey responses:
“Time taken to speak to families, care for them and include them in the care of patients is integral to mental health. They offer valuable information and support for their loved ones, so they need to be included and supported in the carer role. Sometimes it can feel like families are checking I’m doing my job properly – that’s fine by me… if it were my family, I would hope they were doing the same for me!”
“Families and carers are integral to patient care. They often give a vast amount of knowledge about your patient that no one else can provide. The NHS is a disjointed and disconnected service and often the family member is the only one who can pull all of the elements together. They should be listened too and respected – it’s what the patient wants after all.”
“You can be stressed by families and feel watched but it’s about knowing the child and family, understanding their circumstances and building a relationship. Working in the family home is hard – you don’t know the kind of day a family have had and what you are walking into. However, it’s a privilege to support children and young people and their families to be at home enabling them to live their life to full how they wish.”
“Working with children, young people and families and carers is everything I do within my role as a special school nurse. Collaborative care with a multi-disciplinary team from entry into school at 3 years of age until they leave at 19 years.”
“I work in an acute care Emergency Department (ED), an area of the hospital where no family ever plans to visit a loved one, sometimes with space restrictions and time limitations. Families are separated from loved ones to the waiting area, and I feel so bad for patients in the ED to have to wait on a trolley with only one family member present or maybe no one present, due to space issues and health and safety. I feel it further exacerbates stress for the patient, particularly the elderly and vulnerable not to have their family by their side at all times in the process of care… the inclusion of caring family is a fundamental part.”
“Often my work with the learning disability client group involves working with a family/significant other but always I need to be mindful of, and respect the clients capacity and needs/wishes to involve family and/or a significant other. How much I involve family is dependant upon the individual client and circumstance.”
“We take pride in our approach to working with families, often bringing them into the discussions and helping them understand what we are doing a with treatment and why.”
“Family involvement can be extremely important for a patient’s care but as a nurse I have to ensure the patient consents to having their family involved and I check this at every contact with family.”
“Whilst I understand the Family Centred Care concept from being a Health Visitor, I feel I have answered in a best practice way rather than what can necessarily be achieved for all within present constraints.”
“Family members are extremely important in mental health care but unfortunately they are not always included as much as they should be. Staff often find it difficult to work with the issue of confidentiality in a compassionate and sensible manner.”
“Families are paramount in delivering care to a patient and also having been one of those family members being included and kept informed of my family members progress and condition was very important to me.”
“As a neonatal nurse, it is so important to make parents feel included in their babies care and for them to feel they are important. Where possible, parents are encouraged to be part of their babies care and make decisions together.”
“I find families present and ‘assisting’ can almost be a double edge sword. While I encourage it and want them to be there to help, there are times when I feel like I am being checked up on and I find that stressful… sometimes it’s good because it lets them (the families) see that they will not be able to cope at home and that the patient needs to go into long-term care.”
“When caring for young people, I try to listen to their voice first and give them time alone to discuss their medical issues.”
“As a Health Visitor and currently Health Improvement Officer, I see it as crucial to gain family support where possible and provided the client agrees, to engage family involvement in any of our programmers for the benefit of the baby’s brain development and to support the new family.”
“The patient must be comfortable with family involvement in their care and therefore the patient should identify who their “family” is and the level of family involvement they desire. Obviously in intensive therapy unit (ITU) nursing, health interventions are often temporary and specialised and family intervention is more difficult.”
For more information about the survey, please take a look at the presentation delivered at the 14th International Family Nursing Conference:
‘Identifying nurses’ attitudes towards the importance of families across the life-course in the UK and Ireland using the FINC-NA questionnaire’ by Veronica Swallow, presented at the 14th International Family Nursing Conference (August 2019), Washington D.C., United States of America.