Below is a journal from my family visit with the M family. During the visit I identified some problems and planned some ways to help these problems.

I went to the M family home on Fort Campbell to do my family visit. I had her sign the wavier form before I proceeded. My goal was to assess the family in the areas of stress and depression, then make recommendations and educate them. The family consists of a husband (24 years old) and wife (22 years old), their two sons (a two year and a four month old), and a 3 year old German shepherd. The husband is in the military until March of 2012. He is currently scheduled to be deployed overseas in a week. She works at a daycare four days a week. Since the addition of a new baby and upcoming deployment, I chose to use the Holmes and Rahe Stress assessment tool and Beck’s depression scale because she has a familiar history of depression.

            The first tool I used was the Holmes and Rahe stress assessment tool. The results for both spouses fell in the over 300 bracket which indicated a high probability of accident or illness related to their stress level within two years. They need to start focusing on decreasing some of their stress. The second tool I used was the Beck’s depression scale.  The wife has a mother and sister that have been diagnosed with depression. She reported feeling a little down lately, so I chose to assess her. She scored a twenty-three on the Beck’s, which falls in the borderline clinical depression category.

            Based on the results of these two tests, I chose the following two nursing diagnoses.

1)     Ineffective coping related to personal vulnerability as evidenced by fatigue, sleep disturbance, and statements indicating inability to cope.

            2)     Risk of Loneliness related to husband leaving

            I did not determine any macro or micro-environmental risks using the windshield survey. There were plenty of parks and sidewalks to walk/play on. It is a good area and she has friends and support near by.  All the necessary stores are close by. After talking for a couple hours about their thoughts and feelings, I left for the day.

            I came back the following day with my recommendations. One of the problems that was occurring was that she was not coping well with the thoughts of her husband being deployed. She voiced the thoughts of being overwhelmed with now having to take care of two boys, the house, and the dog all by herself. My recommendations included making plans to have family come stay with her, trying the mother’s day out program that is offered just outside of base if she needs a little time without the children, going out with friends at least once a week and leaving the kids at home with a babysitter, sending letters to her husband as much as possible, and having him call and write/e-mail as much as possible. I also recommended taking thirty minutes for herself each day and doing something relaxing such as reading or yoga to help reduce the stress. For the depression, I recommended that she see her family doctor to see if she needs to be on an anti-depressant and to check to see if it is post-partum depression. I explained how all of these things can help manage stress and depression. They both agreed that all the recommendations were good and they would do them.

            I really enjoyed this experience of going into the families’ homes. It helped me work on my communication skills with the clients. It was hard at first to know where to start and how to go about it but I just tried to really listen to their concerns and work on those areas.