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.

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.

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.

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 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.

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 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.