The author began her community nursing career as a Health Visitor in a low-income multicultural area of London. In 1976, she took off to Thailand with an English nongovernmental organization (NGO) as part of a four-person medical team to establish health services in a Laotian refugee camp. While she struggled with microbiology and immunology, her training as a health visitor put her far ahead of her medical colleagues in such areas as community health, teaching, and psychology. When the Ministry of Health (MOH) requested a WHO nursing consultant to develop a Primary Health Care (PHC) focused Public Health Nurse training, she immediately got involved. She was determined that urban nurses would never again look down on rural patients and would tailor their preparation for discharge to the conditions to which their patients returned. The community health module was strengthened to better address the issue of rising non-communicable disease rates.

Mental health workers need to be members of the disaster response team from the onset and take mental health services to survivors. A range of psychological and emotional responses to disaster are normal and should not be “pathologized” or “medicalized”. This chapter helps the reader to identify the psychosocial effects likely to occur in various types of disasters, identify the elements of a community impact and resource assessment, and describe the normal reactions of children and adults to disaster. It provides brief description on bioterrorism and toxic exposures, community impact and resource assessment, normal reactions to abnormal events, special needs popluations, and community reactions and responses. The psychosocial impact of a disaster and the resources that will be needed to respond to the disaster can be estimated based on data from past experiences with a variety of natural and man-made disasters.

The management of psychosocial effects begins with a sound plan to mitigate the adverse impact of the disaster on the emotional, cognitive, and behavioral capacity of the individual. Involvement of mental health professionals, such as psychiatric nurse practitioners and clinical nurse specialists, should begin with the development of the community or agency disaster plan. Management of the psychosocial effects of disaster will continue long after the initial impact. Psychological first aid is an evidence-informed approach designed to reduce distress in the immediate aftermath of a disaster and foster adaptive functioning and coping. Major depression and PTSD can be disabling consequences of exposure to disaster among those of any age group, thus, early diagnosis and treatment are critical to the prevention of future disability. There is a growing body of research identifying that effective treatment for PTSD and cognitive behavioral approaches along with exposure therapy are most likely to be beneficial.

While all postpartum complications can result in psychosocial implications, some have more psychosocial impact than physical alterations. This chapter compares the different types of postpartum mood and anxiety disorders (PMADs). It defines nursing interventions that are appropriate for the woman who has experienced a pregnancy loss. The chapter shows strategies to foster maternal-infant attachment in infants who experience a prolonged hospitalization. It also discusses psychological implications associated with traumatic birth. PMADs and mental illness are the most commonly occurring complications related to childbearing. Women with underlying mental illnesses are more at risk for the development of symptoms in the postpartum period and warrant additional assessment and monitoring during the postpartum period. The woman who suffers a pregnancy loss requires the same physiological care as other postpartum women with special attention to her psychological and social needs during this difficult time.

This chapter defines new meaning to nursing’s paradigm that were derived from clinically inducted, empirical experiences, combined with the authors’ philosophical, intellectual, and experiential background. The early work emerged from the authors’ own values, beliefs, and perceptions about personhood, life, health, and healing, and how they manifest clinically and empirically. The authors’ work was guided by the commitment to nursing’s collective caring-healing role and mission in society as attending to and helping to sustain humanity and wholeness as foundation to health and nursing’s purpose for existence. The original work was further shaped by phenomenological psychology and philosophy. The cara-tive factors and general caring language help to release nursing from its political and practice history of medical language dominance and orientation. The carative factors thus serve to help define nursing knowledge, practices, and phenomena as distinct from, but complementary with, curing knowledge and practices associated with modern medicine.

This chapter presents the philosophical and theoretical perspectives of caring, knowing, and story underpinning the study of nursing situations. It describes underpinnings of the caring nature of the discipline and practice of nursing, patterns of knowing in nursing, theories of narrative knowing. The chapter also describes the use of situated stories of professional practice supporting the process of teaching/learning from nursing situations as essential to the study and practice of nursing. Nursing begins with a call for help with a health-related concern. Knowing in nursing is essential to the study and practice of nursing and is foundational to the use of case studies, stories, or nursing situations in nursing education. Prior to the development of nursing theories, the knowledge of nursing was primarily drawn from other related disciplines such as medicine, biology, and psychology combined with traditions of caring.

This chapter assesses patient and partner history that can impact pregnancy care and outcomes. It describes the components of the prenatal history including calculating the due date. The chapter discusses basic components of the physical examination and psychosocial assessment. It defines procedures for obtaining the fetal heart rate. The chapter shows equipment needs for the initial obstetrical examination. It also shows common medications prescribed during routine prenatal care. The medical history should include a detailed assessment of any health or medical issues the woman or partner has had in the past, along with a detailed review of medication use. The physical examination for an antepartum examination begins with obtaining a complete set of vital signs, a head-to-toe assessment, and a pelvic exam. In general, if the nurse notices alterations in vision or hearing, neurological alterations, in a woman’s mental status, additional targeted assessments in these areas would be warranted.

This chapter proposes that Watson’s philosophy/science/theory of human caring, although also developed with individuals in mind, has the potential to be such a framework because of its philosophic congruence with community health nursing. Watson continues her visionary quest to move nursing’s caring-healing practices from the margins to the center of societal health and healing practices. This work strongly reflects the influences of consciousness theory, noetic sciences, quantum physics, transpersonal psychology, Jungian psychology, and feminist theories, among others, that have gained prominence in her work over the past decade. Watson’s humanistic, existential, and metaphysical conceptualization of human beings underpins her view of both the transpersonal caring relationship that is central to her theory and her conceptualization of health-illness. Important to note is that the 10 Carative Factors are based on a knowledge base, clinical competence, and healing intention.

This chapter focuses on the family and its role in maintaining health and well-being. Family-centered nursing is the appropriate nursing system in these instances. The family may be a factor that conditions the therapeutic self-care demand and self-care agency of the family member who is the identified patient; it may be the setting within which dependent care is provided; or it may be the unit of service for which nursing is provided. Much of the knowledge the nurse has regarding family is from the foundational sciences or antecedent bodies of knowledge such as sociology or psychology. The chapter looks at the family as it relates to the proper object of nursing. It helps the learner to describe important elements of Family Systems Theory, identify types of family function, describe nursing in family situations in terms of self-care, and differentiate between family-centered nursing and Family Systems Nursing.

This chapter reveals the experiences of 35 nurses who were deployed for the wars in Iraq and Afghanistan. The nurses describe how “doing nursing” in a war zone changed them personally and expanded their nursing skills, and how reintegration was more difficult than they had anticipated. Some nurses reported a fairly smooth transition with strong support from their families and communities. They wanted people to be patient with them, listen to their stories, and be nonjudgmental. They wanted to be thanked for their service and feel appreciated. On the other hand, nurses who felt a lack of support and connection were devastated. Some nurses struggled in their relationships with family and friends who did not seem to understand that they needed to heal themselves emotionally, psychologically, and spiritually after being deployed. Some nurses reported turmoil in their extended families with the sharing of responsibilities for elderly parents.

Psychiatric-mental health professionals need to have a comprehensive knowledge foundation about mental illness and the theoretical underpinnings associated with it. Definitions of theory, as well as theories of mental health and illness, abound. Variation in these definitions can be influenced by or contingent on a number of factors, including the disciplinary and specialty perspective. This chapter provides an overview of various prominent theories of mental illness. Mental health and psychology are associated with numerous theories, such as grand, middle-range, and micro-level theories. The chapter describes the work of influential theorists, researchers, and practitioners from several disciplines, including but not limited to nursing, medicine, and psychology. It presents theoretical concepts and explanations of the potential etiology of mental illness from within the framework of psychodynamic, behavioral, cognitive, social, humanistic, and biological theory. The chapter includes pertinent definitions, historical background, epidemiological incidence and prevalence rates, and comparative disease burden of mental illness.

Both full-time military service members (MSMs) and part-time Reserve and National Guard component (RC) personnel face multiple transitions related to training, education, deployments, and reintegration to accomplish the Armed Force’s missions. This chapter’s purpose is to provide a better understanding of the complex transitional phases of deployments and/or the reintegration from the military to civilian life. It provides information about the physical, behavioral, and social impacts during the various stages of deployment for the MSM/RC, along with their families/loved ones. The Ecological Model of Veteran Reintegration and its four levels of system factors—individual, interpersonal, community organizations, and societal effects—are used to illustrate the interchanging psychosocial and environmental aspects. The chapter presents specific reintegration challenges of employment, education, and caregiving. Nurses have a pivotal role in screening psychosocial and physical needs, while promoting healthy coping and parenting, to expand the delivery of family-centered care during these transitions.