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In community health nursing, the family will be the considered as a client aside from individual clients in the family. Family Nursing Care Plan is defined as a guide or framework of nursing care designed to provide ways in solving health related problems of the family as a whole. The nursing process is still implemented in making this type of care plan.
It is important to take in mind that Family Nursing Care Plans are unique since it is continuous in nature. A community health nurse must be able to understand that he or she must keep on updating the nursing care plan as the family is a dynamic unit of the community.

Process in making the Family Nursing Care Plan

1. Assessment Phase – Happens on the first and succeeding home visits. Making objective observation can be coupled with subjective statements by each family member.
2. Identification of the Problem/s – Make a list of the problems sited. Prioritization of the needs must be applied.
3. Formulation of Goals and Objectives – Referring on the problems, goals and objectives must be measurable, attainable, realistic and time-oriented.
4. Plot Nursing Interventions – The objectives must be the guidelines in making nursing interventions. Nursing interventions must be rational enough.
5. Evaluate the outcomes – This stage will be the determining stage whether the goals and objectives have been met or not. Nursing interventions can be modified at this stage.

Example of Family Nursing Care Plan

Case: This is a case of S. Family. S. Family is composed of 5 children and both parents were alive. Upon observation the family practices improper hygiene in eating and waste disposal. The 5 children have 2 to 3 years of age gaps, having the youngest child to be 1 year old and the oldest to be 9 years old.
Problem Identified: Improper Hygiene
Date Identified: January 5, 2012 7:00AM
Date Evaluated: January 5, 2012 1:00PM

Problem Cues:
Subjective data: “Dahil sa dami ng anak ko, minsan ang dudungis na nila. Mabuti na lang nandyan ang panganay ko na si Nene, siya yung nagbabantay sa dalawang kapatid niya.”
Objective data: Nene, her nine-year-old daughter cuddles her younger brother Jose who has flu at this time. She manages to feed her other sibling with bare hands without hand washing. The fingernails and toenails of these children were not trimmed properly and filled with dirt. The other two siblings came into the house sweating and their feet were smudged with mud. Jose suddenly wet his shorts and Nene must clean him up. The place wherein he peed was not cleaned but left only. The pillow that was affected by the urine was just placed outside for the sun to dry.
Family Nursing Diagnosis: Inability to provide home environment conducive for health and maintenance secondary to unhygienic practices

Goal of Care: Within 3 hours of nursing interventions, the family will be able to recognize the current home environment and health practices. They must be able to identify healthy practices and be able to practice them habitually. These hygienic measures are as follows: proper hand washing, proper waste disposal and proper house cleaning.

Objectives:
Within 3 hours of nursing interventions, the family will be able to:
1. Recognize the need for proper hand washing before and after meals as well as after using the toilet
2. Enumerate factors that promote in unhygienic practices
3. be knowledgeable in ways on how to maintain hygiene
4. Accept the importance of proper hygiene in the activities of daily living
5. Exhibit the desire to change the current unhygienic practices

Interventions & Rationale:
1. Check if the family is aware of their health practices. This will help the nurse to know the severity of the health problem.
2. Demonstrate the proper hand washing. The nurse must perform the proper hand washing technique so that the family will be able to see the proper technique. A return demonstration will be necessary so that the nurse can assess if the family members can absorb the lesson.
3. Emphasize the importance of proper hygiene in preventing health problems. This step will enable the family members to know the consequences if health practices were not observed in their family.
4. Listen to the concerns of the family regarding the hindrance to practice such hygienic practices. This will be a way of keeping in touch with the family and facilitate them to be able to find concrete ways to achieve the goal of observing hygienic practices.
Tools:
1. Home Visits
2. Diagram of path of infection, steps in correct hand washing
3. Demonstration
4. Hand washing supplies
5. Time and Effort for the family members as well as to the nurse

Evaluation:
After 3 hours of nursing interventions, the goal was met. The parents were able to demonstrate proper hand washing. The siblings who were five years old and above were able to wash their hands with assistance from their parents. Lunch was served and the children filed for a line in washing their hands before and after the meal

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Writing is an integral part of my nursing career. It is my way to reach more people and empower them with the roles of nurses. Currently, I'm working as a nurse in a private hospital specifically in the Emergency Room. Emergency nursing is my forte.