“There are numerous beliefs operating and emerging within every person every day, about every situation, and every person encountered. But not all beliefs matter in daily life; not all beliefs invite an emotional or physiological response. But the beliefs that do matter are our core beliefs… Core beliefs are fundamental to how we approach the world; they are the basic concepts by which we live. …They involve certitude about the issue at hand and are central to our individual lives and relationships” (Wright & Bell, 2009, pp.30-31).
I’ve been thinking about the competencies for generalist practice with families (Wright & Leahey, 2013 describe these skills as conceptual, perceptual, and executive skills). In so doing, I’ve become even more aware that a nurse’s core beliefs about families, nurses, illness, change, and the role of the nurse influence behavior, i.e., what the generalist nurse says and does with families in health care contexts. These ideas have been influenced by years of clinical scholarship and research with families and the practice models I am most familiar with, namely the Calgary Family Assessment and Intervention Models (Wright & Leahey, 2013), the Illness Beliefs Model (Wright & Bell, 2009); and the Trinity Model (Wright, 2005). I have adopted the ideas below about the link between core beliefs and competencies for generalist family nursing practice from my own writing and that of my colleagues, Lorraine Wright, Maureen Leahey, Nancy Moules, and others (see reference list):
Core Belief: Health and illness is a family affair.
- Engage and include family members in therapeutic conversations.
- Use genogram and ecomap.
- Inquire about illness suffering and who is the family is suffering the most.
Core Belief: Family responses to illness and health are interactional and involve family members other than the individual who has a health problem or concern.
- Incorporate useful questions: both linear and interventive questions.
- Think systemically and interactionally: use circular pattern diagram (CPD).
Core Belief: Families have inherent competencies, strengths, and wisdom.
- Work from a strengths not problem based focus.
- Offer commendations.
Core Belief: Opportunities for nurses to make a difference in the illness and health experiences of families occur in everyday practice across everyday contexts.
- Elicit the illness narrative.
- Address family members’ concerns and involve family members in decision making.
Core Belief: All nursing, including family nursing, happens in relationship.
- Harness the impact of the first 3 seconds in building a relationship.
- Take the temperature of the relationship frequently and ask for feedback.
Bell, J. M. (1997). Levels in undergraduate family nursing education [Editorial]. Journal of Family Nursing, 3(3), 227-229. doi:10.1177/107484079700300301
Bell, J. M. (2000). Encouraging nurses and families to think interactionally: Revisiting the usefulness of the circular pattern diagram [Editorial]. Journal of Family Nursing, 6(3), 203-209. doi:10.1177/107484070000600301
Bell, J. M. (2012). Making ideas stick: The 15-Minute Family Interview [Editorial]. Journal of Family Nursing, 18(2), 171-174. doi:10.1177/1074840712443663
Bell, J. M. (2013). Family nursing is more than family centered care [Editorial]. Journal of Family Nursing, 19(4), 411-417. doi:10.1177/1074840713512750
Duncan, B. I., Miller, S., & Hubble, M. (2007). How can being bad make you better? Developing a culture of feedback in your practice. Psychotherapy Networker, 31(6), 36-45, 57.
International Council of Nurses (2002). Nurses always there for you. Caring for families. Information and action tool kit (Part 1). Geneva, Switzerland: Author. Retrieved from: http://www.icn.ch/images/stories/documents/publications/ind/indkit2002_part1.pdf
International Council of Nurses (2002). Nurses always there for you. Caring for families. Tools for action (Part 2). Geneva, Switzerland: Author. Retrieved from: http://www.icn.ch/images/stories/documents/publications/ind/indkit2002_part2.pdf
Moules, N.J., & Johnstone, H. (2010). Commendations, conversations, and life-changing realizations: Teaching and practicing family nursing. Journal of Family Nursing, 16(2), 146-160. doi: 10.1177/1074840710365148
Registered Nurses’ Association of Ontario (2006). Supporting and strengthening families through expected and unexpected events (rev.suppl.). Toronto, Ontario, Canada: Author. Retrieved from: http://rnao.ca/fr/sites/rnao-ca/files/Supporting_and_Strengthening_Families_Through_Expected_and_Unexpected_Life_Events.pdf
Wright, L.M. (2005). Spirituality, suffering, and illness: Ideas for healing. Philadelphia, PA: F.A. Davis.
Wright, L.M., & Bell, J.M. (2009). Beliefs and illness: A model for healing. Calgary, Alberta, Canada: 4th Floor Press
Wright, L. M., & Leahey, M. (2013). Nurses and families: A guide to family assessment and intervention (6th ed.). Philadelphia, PA: F.A. Davis.