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In: Nursing

Marge is a single parent who dropped out of high school to marry Andrew when she...

Marge is a single parent who dropped out of high school to marry Andrew when she was 17 years old and pregnant. After 6 years of marriage and two children (Stacy, age 5 years, and Monica, age 2 years), Marge divorced Andrew because of his drinking, affairs, and lack of support of her and the children.

Andrew has a job delivering newspapers and spends free time drinking beer with friends. He only sporadically provides monetary support. Marge and the girls live in a small apartment. Because she has only a minimum wage job, Marge relies on food stamps and other types of assistance. Babysitters and rent are major expenses, and Marge continually worries about being able to pay rent. She would like to earn her GED to get a better job, but she lacks the time and resources to make that happen. Andrew sees the girls only occasionally—usually when Marge asks him to keep the girls so she can work extra shifts. He dislikes spending his time babysitting the girls and openly verbalizes his frustration with the “whiny girls.”

Marge’s parents live close by but believe that Marge deserves her situation. They were very against her leaving school to get married, and they consider Andrew a “deadbeat.” They have declined to help Marge financially, citing concerns for their own retirement. They also do not help with babysitting, and they accuse Marge of “spoiling the girls.” Marge has always believed that her parents liked her older brother, Dominic, better. He is married and has three children, who spend a great deal of time with Marge’s and Dominic’s parents. Dominic rarely interacts with Marge because they “don’t have anything in common.”

Recently, after the girls spent time with their father, Marge noticed bruises on the arms and the buttocks of Monica. When she asked the girls what happened, Stacey said, “Daddy got mad when Monica wet her pants and spanked her.” A week later, while at a health clinic getting Stacy immunized for school, Marge shared with the nurse practitioner details of her life and situation: lack of money, lack of support, working too many hours, fear of losing her apartment, and now Andrew hurting Monica. She said she does not know what to do and began crying.


Case Analysis

Marge and Andrew, while married, were in the stage of “families with young children” in the “family life cycle,” whereas their parents are in the stage of “families in later life.” However, since the divorce, Marge and the children form the family unit. Both Marge and Andrew are in the developmental stage of young adults.

The interactions among all the family members are dysfunctional. Marge’s parents appear to favor her brother and his children while giving little support or encouragement to Marge. Exploration of the origins of this situation is necessary before any practical suggestions for resolution of differences can be offered. Family therapy involving Marge, Dominic, and their parents would be ideal but is unlikely to occur.

The nurse practitioner must be cognizant of the laws of the state where he or she practices and must report the alleged abuse. Marge may need to consult with legal aid to change visitation rights for Andrew so that she can keep the children safe. Referral of Marge to a counseling center where she could obtain assistance with planning to obtain a GED, prepare for a higher paying job, and obtain financial assistance would be a short-term solution. Marge must also plan for child care; she might be able to find a day-care center for low-income families for Monica.

This is a family with serious problems with interrelationships. There are many long-term problems with few or no short-term solutions. Counseling individually and as a family is necessary to attain more healthy interactions but may be unlikely to occur. It will take great resolve and work on Marge’s part to achieve her goal of a healthy relationship with her parents and brother.

Question 1:
Bases on the case study what theory of Family Dynamics would best fit this family? Provide rationale and examples from the case study.

Question 2:
What is the law regarding mandatory reporting of suspected child abuse in your state? Are nurses mandated reporters? Members of what other professions are mandated reporters? What constitutes “suspected child abuse?” How would you feel about reporting alleged child abuse in this case?

question is very clear. please if you cant answer then let someone else donit.

Solutions

Expert Solution

Ans.

Family dynamics are the patterns of relating, or interactions, between family members. Each family system and its dynamics are unique, although there are some common patterns. All families have some helpful and some unhelpful dynamics.

The family systems theory is a theory introduced by Dr. Murray Bowen that suggests that individuals cannot be understood in isolation from one another, but rather as a part of their family, as the family is an emotional unit.

Some of the many influences on family dynamics include:

  • nature of the parents' relationship
  • having a particularly soft or strict parent
  • number of children in the family
  • personalities of family members
  • an absent parent
  • the 'mix' of members who are living in the same household
  • level and type of influence from extended family or others
  • a chronically sick or disabled child within the family
  • events which have affected family members, such as an affair, divorce, trauma, death, unemployment, homelessness
  • other issues such as family violence, abuse, alcohol or other drug use, mental health difficulties, other disability
  • family values, culture and ethnicity, including beliefs about gender roles, parenting practices, power or status of family members
  • nature of attachments in family (ie secure, insecure)
  • dynamics of previous generations (parents and grandparents families)
  • broader systems- social, economic, political including poverty.

suspected child abuse or neglect?

State Child Abuse and Neglect Reporting Numbers
Contact your local child protective services office or law enforcement agency.

Childhelp National Child Abuse Hotline(opens in new window)
Call or text 1.800.4.A.CHILD (1.800.422.4453). Professional crisis counselors are available 24 hours a day, 7 days a week, in over 170 languages. All calls are confidential. The hotline offers crisis intervention, information, and referrals to thousands of emergency, social service, and support resources.

National Center for Missing and Exploited Children’s Cyber Tipline(opens in new window)
Report online sexual exploitation of a child or if you suspect that a child has been inappropriately contacted online. Information will be made available to law enforcement in order to conduct an investigation.

Child Welfare Information Gateway is not a hotline for reporting suspected child abuse or neglect, and it is not equipped to accept reports or intervene in personal situations of this nature.

will be sent to child protective services (CPS). When CPS receives a report, the CPS worker reviews the information and determines if an investigation is needed. The CPS worker may talk with the family, the child, or others to help determine what is making the child unsafe. The CPS worker can help parents or other caregivers get services, education, or other assistance.

make a report of child abuse or neglect-

After you make a report, it will be sent to child protective services (CPS). When CPS receives a report, the CPS worker reviews the information and determines if an investigation is needed. The CPS worker may talk with the family, the child, or others to help determine what is making the child unsafe. The CPS worker can help parents or other caregivers get services, education, or other assistance.

Provide a complete, honest account of what you observed that led you to suspect the occurrence of child abuse or neglect. Any reasonable suspicion is sufficient.

What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms
Learn how to identify and report child abuse or neglect and refer children who may have been maltreated. This factsheet provides information on the legal definitions, different types, and signs and symptoms of abuse and neglect.


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