In this editorial, I would like to offer some distinctions between family centered care and family nursing, and declare my belief that family nursing is more than family centered care. I met Colleen McGavin (2013) at a Pre-Forum Deep Dive Session (a.k.a. preconference) in Vancouver called "Patient and Family Centered Care: From Concept to Practice." I was invited to offer a keynote at the preconference sponsored by the British Columbia Quality and Safety Council. Colleen was a member of the panel who responded to my keynote. The audience was not my usual tribe of family nursing scholars and practitioners. Instead they were an interesting mix of front-line health care providers, legislators, administrators, and patient care advocates (like Colleen) who care about "quality" and "safety" and who have diverse ideas about what "patient and family centered care" is and how it could be done better. For more than half a century, a philosophy of care known as patient and family centered care (which had its origins in child health care) has advocated for a seismic shift in health care from patriarchy and paternalism to partnership, dignity and respect, information sharing, participation, and collaboration with patients and families (Johnson, 2000; Kuo et al., 2012; Wells, 2011). These values extend to viewing families as integral members of the health care team and conceptualizing the family as the unit of care (Shields, Pratt, & Hunter, 2006). Patient and family centered care has been endorsed at the highest policy levels in developed countries and privileged in mission statements of most health care systems which has prompted the creation of numerous institutes for patient and family centered care that provide resources and gather data about implementation (Abraham & Moretz, 2012a, 2012b). Yet, concern and some mystery remain about why patient and family centered care has not yet been successfully implemented and why it is still not uncommon to hear patients and families evaluate their relationships with health care providers as uncaring, difficult, and intimidating (Coyne,
Making room for grief: walking backwards and living forwardIn this paper, the authors describe an aspect of a program of research around grief and clinical practice. The first phase of the study involves examination of experiences of grief with attention to troublesome or problematic beliefs that fuel the extent of suffering in the bereaved. The data, obtained from a review of videotaped clinical interviews with families seen in the Family Nursing Unit at the University of Calgary were analyzed according to philosophical hermeneutic tradition. Findings suggest that grief is an experience that is ongoing, that changes in nature over time, but that involves a continuing relationship with the deceased; it is a graceful, periodic, deliberate walk backwards while keeping a sure foot in living forward. Key words: beliefs, bereavement, grief, loss.Making room for grief is not a popular concept. In the past 100 years, attention has been placed on models of practice around grief that involve assisting people to let go of grief and symbolically and emotionally to let go of the lost person. This paradigm and widely accepted model of grief therapy is inherently based on a modernist tradition, and grief research has, until recently, been grounded in quantitative assessment that supports this worldview . A changing perspective of grief as an ongoing experience that is not resolvable, but is imminently livable is emerging in the literature (Attig 1996; Klass, Silverman and Nickman 1996; Moules 1998; Moules and Amundson 1997;Neimeyer 2001Neimeyer , 2003. The bereaved themselves, however, suggest that the general public continue to be influenced by prevailing modernist beliefs. Discourses that suggest that successful recovery from grief involves an absence of feelings of grief and the achievement of relinquished emotional connections with the deceased, continue to create problems that increase suffering in the bereaved. This suffering shows itself in the internalization of beliefs that constrain, confine, and pathologize the experience of grief.In clinical practice with the bereaved, it is apparent that there are commonly held beliefs which contribute to the amount and nature of their suffering in grief. These beliefs are perpetuated through popular literature, culture, and the nature of some therapeutic practices. Yet, experiences of grief contradict these culturally sanctioned theories, and this very contradiction can inadvertently create a sense of failure, incompetence, and even pathology, thereby leading to even more suffering in the lives and relationships of those who find themselves in the universal situation of loss.
This Special Issue about the Illness Beliefs Model (IBM; Wright & Bell, 2009) is a tribute to the power and potential for healing through therapeutic conversations between nurses and families experiencing illness. Although the IBM was first published almost 20 years ago (Wright, Watson, & Bell, 1996), it remains, to the best of our knowledge, the only known model for advanced practice in family nursing. Since 1996, the evidence has continued to accumulate for the value of systemic, family-focused care and the usefulness of relational, family-level interventions (
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