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The Sullivan Family Assessment Image 1


Jamie Sullivan Jamie is a 17-year-old Caucasian girl that attends Beaufort High School in North Carolina. She is the daughter of Image 2 Reverend Sullivan. She is raised by her father since her mother died shortly after giving birth to her. Jaimie is portrayed as a simple, plain, cheerful, sweet, nice, quiet, and smart girl. She is not popular at school and does not have much friends. She likes to cook for her dad, volunteer at the orphanage, play the piano, and read the bible. Jamie is a part of the church choir, drama club, and anatomy club. Jamie is in Erikson’s identity versus role confusion stage. She is successful in this stage because she develops a sense of self and makes her own decisions. Jamie decides to live her life to the fullest despite having leukemia. Jamie falls in love and marries Landon, who the opposite of her.

Leukemia

Jamie has been diagnosed with Leukemia and her health has been deteriorating. She has not been responding well to chemotherapy. The movie does not mention if anyone else in her family have Leukemia. Leukemia, disease of the bone marrow and lymphatic system, is one of the most common childhood cancer. Immature WBCs reproduce in the blood-forming tissues of the body by replacing and infiltrating it with dysfunctional leukemic cells. Vascularized organs like the spleen and kidneys are affected dramatically. Leukemic cells can invade the testes, kidneys, prostate, ovaries, GI tract, and lungs. There are two types of leukemia, acute lymphoid leukemia (ALL) and acute nonlymphoid (myelogenous) leukemia (ANLL or AML). Signs and symptoms include pain, anemia, infection from neutropenia, and bleeding due to decreased platelet production. Normal cells are deprived of nutrients for metabolism and the bones become weak over time. (Perry et. al., 2014)


Meet the Sullivans Reverend Hegbert Sullivan (56-year-old) Reverend Hegbert Sullivan, Jamie’s father, is the reverend for Beaufort church. He raised Jamie by himself after his wife died shortly giving birth to Jamie. For many years, Hegert is the only one that knew about Jamie’s illness until Landon came into her life. Hegbert expects Jaimie to focus in school and avoid dating until after graduation. Although Hegert sets rules and expects a lot from Jamie, he only wants the best for Jaimie especially when her health starts deteriorating. Hegbert likes spending time with Jamie by taking her to Church every Sunday. Hegbert is in Erikson’s generativity vs stagnation stage. He is successful because he enjoys his job as a minister and loves taking care of his daughter.

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Landon Carter (17-year-old) Landon is the son of Worth and Cynthia Carter. Landon’s parents are divorced and he lives with his mother. Landon’s father lives in Washington, D.C. and does not appear much in Landon’s life which causes Landon to be rebellious. He is the class president of Beaufort High. Landon is popular and well liked by his peers. He goes to church every Sunday. Landon is in Erikson’s identity versus role confusion stage. He was unsuccessful in this stage until he meets Jamie who influenced him to grow and develop a sense of self.

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Duvall’s Theory Duvall’s theory is based off of a nuclear family. According to Duvall, the Sullivans is in stage 5 (families with adolescents) of the family development model. Jamie is a teenager that is practicing her autonomy. Although peers make up a huge influence and support group, Jamie is able to handle the illness with the support of her father and Landon. She does not care about what others think of her. Rather, she wants to make a positive impact by helping people and living her life to the fullest despite being ill.

culture & religion The Sullivans consist of Jamie and Hegbert. Jamie does not have an relatives. The Sullivans are Christian. Jamie’s culture and religion have shaped her attitude and personality towards people and things. She is optimistic and mature for her age. Jamie is a free spirited, caring, smart, and nice girl. She likes to help those in need and always see the best in Landon. Jamie questions her faith once in a while due to her illness, but believes god has a plan for her. She learns to accept her illness and tries to make the best out of it. Jamie is always seen carrying and reading the bible. She attends church every Sunday and is a part of her church’s choir.

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Strengths ● ● ● ● ● ● ● ● ●

Jaimie finding love Hegburt’s and London’s support Jamie's classmates support towards the end Religion/Church Orphanage Housing Employment Anatomy club Choir

Challenges ● ● ● ● ●

Jamie does not have friends Single parent Limited support system Cost of hospital bills Hegburt doesn’t trust Landon


Communication In the beginning, Jamie and Landon had a hard time communicating with each other due to their differences. Landon is confrontational while Jamie is passive. Jamie is very soft spoken and internalizes her feelings. Jamie hides her illness from Landon because she does not want people to pity or treat her differently. However, Jamie finally builds the courage to tell Landon that she is sick. Landon was upset when Jamie stopped receiving treatment, but he respected Jamie’s decision after listening to her. Jamie learns how to open up and tells Landon about her feelings instead of running away. Landon and Jamie’s communication becomes stronger as their relationship progresses. Landon becomes more mature and understanding the more he spends time with Jamie. Jamie communicates effectively with her father. Hegbert is the closest person to Jamies since she does not have any relatives or friends. Jamie is able to talk to her father about her mother’s death, her illness, and her marriage. He gives Jamie advice about her life. Hegbert is very protective of Jamie and did not want her to date Landon. However, that changes once he sees that Landon is trustworthy. Although Jamie and Hegbert have their different views, they are always respectful towards each other.

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CHronic Illness Framework The Chronic Illness Framework was developed by Rolland to explain how chronic illness influences family functioning. The original framework has been modified and is currently used by nurses to explain how different factors of chronic illness play a role in the family. The framework includes illness types, time phases of the illness, and family functioning. (Kaakinen et al., 2016) Illness Types Jamie has a gradual onset of Leukemia. She received chemotherapy when she was younger, but the cancer came back. Jamie decides to stop treatment because she has not been responding well to it. She wants to let god decide her path. Hegbert adapts his life to the need of Jamie. Hegbert is very supportive and protective of Jamie. He is Jamie's sole caregiver. Jamie becomes weak and thin once treatment is stopped. Jamie eventually has to be placed on bedrest, which is a very difficult time for Landon and Hegbert. Time Phases Jamie was diagnosed with Leukemia during her childhood. Jamie had chemotherapy; however, it did not cure the disease. Jamie is strong and accepts her illness as god’s plan. Jamie decides to make the most of her life while she still can. Jamie and Landon gets married at Hegbert’s church. Jamie is currently in the terminal phase of her illness and decides to stop treatment. It is important for Jamie to receive comfort care and have her wishes respected by her family during this time. Family Functioning In the beginning, Jamie received most of the support from her father until she meets Landon. Jamie did not tell anyone about her illness until the terminal phase. Therefore, it was difficult for the Sullivans to receive support from others. Jamie copes with her illness by doing things she likes such as reading the bible, attending church, helping the orphanage, and playing the piano. Landon and Hegbert adjust their lives according to Jamie’s needs. Landon becomes more mature and understanding as their relationship progresses. Jamie tells Landon that he is an angel sent from god to help her through the tough times.


Interventions & outcomes

1) Besides Landon and Hegbert, no one knows about Jamie’s illness. Jamie deals with the illness herself because she does not want other people to pity her. Outcome: Jamie will join a support group to help her cope with her illness effectively. Jamie will be able to express her feelings and relate to others with Leukemia. Intervention: Provide Jamie with emotional support such as a Christian support group to help her cope with her illness. Spiritual care program decreases anxiety in patient with Leukemia. Nurses who use holistic care approach with a spiritual emphasis of care can promote comfort and reduce suffering (Moeini et al., 2014).

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2) Since Jamie decided to stop receiving treatment, comfort measures at home are very important. Outcome: Jamie will be able to live comfortably at home and continue doing activities she enjoys. Intervention: Allow Jamie to be in control of her care at home. Encourage Jamie do things that she likes such as going to church, listening to music, reading the bible. Help Jamie create a bucket list. Palliative care focuses on maintaining quality of life by preventing and relieving suffering. Patient quality of life can be improved with playing music, attending a place of worship, and having individual preferences respected (Kaakinen et al., 2015). 3) Jamie keeps her feelings and worries about her illness to herself. Jamie does not want others to worry about her for she does not want to be a burden. However, this is not healthy for Jamie to be going through her illness herself. Outcome: Jamie will be able to engage in meaningful conversations with her family. She will be able to talk opening about her illness, fears, and worries to Landon and Hegbert. Intervention: Assess what is holding Jamie back from expressing her feelings. Encourage Jamie to verbalize her worries and feelings instead of internalizing them. Patient’s fears may create a sense of isolation and loneliness. Suffering can be alleviated by inviting and assisting families to come together (Kaakinen et al., 2015).


References Kaakinen, J., Duff-Gedaly, V., Hanson, S. & Coelho, D. (2015). Family health care nursing: Theory, practice and research (5th ed.). F.A. Davis: Philadelphia. Moeini, M., Taleghani, F., Mehrabi, T., & Musarezaie, A. (2014). Effect of a spiritual care program on levels of anxiety in patients with leukemia. Iranian Journal of Nursing and Midwifery Research, 19(1), 88–93. Perry, S. E., Hockenberry, M.J., Lowdermilk, D.L., & Wilson, D. (2014). Maternal child nursing care. St. Louis, MO: Elsevier. Image references [image 1] retrieved from http://www.fanpop.com/clubs/jamie-sullivan/images/20325464/title/jamie-landon-photo [image 2] retrieved from http://www.fanpop.com/clubs/a-walk-to-remember/images/33885214/title/w2r-photo [image 3] retrieved from http://www.tvguide.com/celebrities/peter-coyote/photos/169892/20158/ [image 4] retrieved from https://www.charactour.com/hub/characters/view/Landon-Carter.A-Walk-to-Remember [image 5] retrieved from https://weheartit.com/entry/18822524 [image 6] retrieved from http://hollywoodlife.com/2017/01/25/a-walk-to-remember-reunion-15-years-mandy-moore-shane-west/ [Image 7] retrieved from https://www.buecher.de/shop/tragikomoedie/nur-mit-dir/dvd/products_products/detail/prod_id/20117237/ [image 8] retrieved from https://www.youtube.com/watch?v=C1bPfIkP1JQ

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