Public Health Nurse Assessment of Family in Crisis


Returning home after experiencing the casualties of war is a dramatically strenuous endeavor for veterans. As numerous soldiers undergo post-deployment issues and family-related matters, such consequences as sleep disturbances, moodiness, and PTSD can arise. To properly battle the negative ramifications and allow service members to successfully adapt to the novel surroundings, it is essential to conduct supplementary assistance procedures. This work will discuss the challenges faced by the family of a soldier, Mike, and will evaluate health nursing strategies to provide necessary assistance to the individuals from the perspective of the Neuman model.

Case Study

The case described revolves around the family of Mike, a veteran undergoing active military duty. Mike is a service member who has recently returned from 8 months of deployment in Afghanistan. Other family members are Joan, the soldier’s wife for eight years, and two children, Kayla and Conrad. The veteran experiences several difficulties connected to civil life adaptation, namely anger issues, nightmares, sleep disturbances, and instances of flashbacks. Given the family complications and frequent manifestations of violent behavior, Mike’s employer is unsure whether he should be kept as an employee.

Central Core

The evaluation of a traditional family is crucial in identifying immediate health care needs for suitable nursing interventions. In the scenario presented, a nuclear family is in a situation requiring nursing professionals’ support and the implementation of strategies that will aid the individuals in resolving the conflicts. According to the Neuman model, the family can be viewed as one structure comprised of several variables that contribute to the stability of the system and allow it to prosper in the current environment (Ahmadi & Sadeghi, 2017). Physiological, psychological, sociocultural, developmental, and spiritual factors are crucial parts of the central core. The family does not exist as an entity separate from an environment; alternatively, it is an element of its surroundings and is constantly influenced by internal and external attributes. Such components as lines of defense, lines of resistance, stressors, strengths, and weaknesses consistently affect the central core and might hinder the health characteristics of the structure. From this perspective, Mike’s family is encountering severe difficulties and demonstrates disrupted communication patterns, which could be amended by the utilization of the Neuman model.

Lines of Resistance

Located around the central core, the lines of resistance constitute a part of the lines of defense responsible for preventing stressful and negative responses to the outside stressors. While supporting and protecting the basic structure from adverse influences, the lines of resistance are imperative for maintaining a healthy life (Ahmadi & Sadeghi, 2017). However, given the lack of coping methods evident in family behaviors, it is possible that necessary knowledge is not available for the individuals. The overall situation is unprecedented for the affected people, rendering them unable to use previously learned mechanisms to confront the complications.

As mentioned above, Mike has suffered a great deal of distress and is likely suffering from PTSD. Within the formerly deployed military, PTSD is relatively common as they are typically at a higher risk of developing this disorder due to the presence of significantly more stress-inducing conditions (Fried et al., 2018). In Mike’s case, nightmares, flashbacks, and physiological and psychological reactivity indicate the presence of PTSD. It is possible to assume that the veteran’s lines of resistance were overwhelmed by the severity of distress caused during deployment, prompting him to use anger as a method of overcoming the painful experience (Reisman, 2016). However, this mechanism does not allow for the establishment of successful communication patterns within the family, and newer, more effective strategies should be introduced.

Additionally, the wife and children might be suffering from anxiety since Joan has reported children are afraid of Mike’s constant anger outbursts. The public health nurse should assess the family for non-verbal cues and body language to detect any potential violence in the family. Although Joan reports that Mike has not been violent, it is the nurse’s responsibility to assess the wife and children for indicators of abuse and substantial emotional stress.

Cultural Values and Religious Beliefs

Given the difficulties that were created after Mike’s deployment, internal family communication has not been effective. As a family unit, the individuals should facilitate a process of consistent interaction, which is impossible under the current circumstances (Bostwick & Johnson, 2018). Considering the cultural values and their impact on the family is an essential part of accomplishing an improvement in family relationships. Examining the moral principles exhibited by the family and accepted as shared beliefs could enhance communication practices. For instance, if the common values are weak or nonexistent, it is possible to suggest principles that will adhere to the necessity to maintain a healthy family environment, potentially advancing Mike’s rehabilitation process.

Another vital concern is connected to religious beliefs, which should also be assessed to properly evaluate the family culture. Given the influence of religion on people’s everyday life, the family’s attitudes towards religion and faith should be ascertained. The differences between religious views might severely hinder the establishment of effective communication and should be addressed by the nursing personnel (Bostwick & Johnson, 2018). Maintaining similar attitudes or slightly altering negative perspectives towards faith might positively affect the family.


Ahmadi, Z., & Sadeghi, T. (2017). Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal – Experimental, Translational and Clinical, 3(3). Web.

Bostwick, E. N., & Johnson, A. J. (2018). Family secrets: The roles of family communication patterns and conflict styles between parents and young adult children. Communication Reports, 31(2), 91–102. Web.

Fried, E. I., Eidhof, M. B., Palic, S., Constantini, G., Huisman-van Dijk, H. M., Bockting, C. L. H.,

Engelhard, I., Armour, C., Nielsen, A. B. S., Karstoft, K.-I. (2018). Replicability and generalizability of posttraumatic stress disorder (PTSD) networks: A cross-cultural multisite study of PTSD symptoms in four trauma patient samples. Clinical Psychological Science, 6(3), 335-351. Web.

Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10), 623–634.

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