The Diaz Family

Leezel Baltazar | NURS 480

The Diaz Family

MEET THE FAMILY Edmundo “Eddie” Diaz is a 32 year old male in the “Intimacy v. Isolation” stage of Erickson’s Stages of Psychosocial Development. He is of Mexican and Swedish ethnicity. While living in Texas, him and his wife Shannon had a son named Christopher who was born with cerebral palsy. Eddie worked as an army medic for multiple tours in Afghanistan, leaving Shannon and Christopher for a few years. After coming back from Afghanistan, Shannon left Eddie and Christopher to care for her mother but never came back. He is currently a passionate firefighter for the Los Angeles Fire Department, creating strong bonds with his fellow first responders, but indifferent with finding a new partner after his wife leaves him.

Shannon Diaz is a 32 year old female in the “Intimacy v. Isolation” stage of Erickson’s Stages of Psychosocial Development. After her husband, Eddie, left for a few years in Afghanistan to pursue being an army medic, she felt abandoned and hurt. She decided to leave Eddie and their son Christopher when he came back from tour to take care of her mother but she was really escaping from the hurt she felt. She also doesn’t look to pursue new, meaningful relationships with people since leaving Eddie and Christopher.

However, Eddie and Shannon remain married.

Christopher Diaz is an 8 year old male in the “Industry v.

Inferiority” stage of Erickson’s Stages of Psychosocial Development. Despite being born with cerebral palsy, Christopher always expels out happiness and laughter with those around him, refusing to let his condition get the best of him. His parents Eddie and Shannon have been separated for a few years but he lives with his dad. When his dad is at work, his great-grandma takes care of him. He enjoys being able to visit his dad and the other firefighters and paramedics at the station because they allow him to play with everything. He especially enjoys the company of his dad’s best friend, Buck, who is also a firefighter for the Los Angeles fire department.

Culture and Religious Traditions

The Diaz family doesn’t actively practice religion but is around Eddie’s grandmother, Helena, who is a practicing Catholic. Grandma Helena constantly prays for the safety of Eddie as he always faces dangers as a firefighter and for the continuing health of Christopher.

Eddie is a busy man being a first responder, but makes sure he makes simple traditions with Christopher. Any morning Eddie and Christopher are able to be together, Eddie ensures he makes waffles with Christopher. Being of a single-parent household, Eddie makes sure their lives revolve around love and patience. Eddie makes sure to give enough time to Christopher and always listens to his concerns. Fortunately, Eddie and Christopher have an amazing support system from the station -- making their lives much more happier.

Duvall Developmental Stage and Life Theory The Diaz family has always been a unique one as Eddie and Shannon stayed married even after years of being separated. In Duvall’s developmental stages of the traditional family, the Diaz family is in the stage of “families with school-age children”. Because Shannon left her husband and son, the expected developmental tasks at this stage were not met as parents. Eddie and his grandmother, Helena, acted as the main guardians of Christopher. They both maintained authority, supported Christopher’s interests and needs, and determined disciplinary actions.

Because of the situation described above, the Diaz family was somewhat in the “separation” phase of divorce -- without the divorce. Because Shannon initially completely cut off communication with Eddie and Christopher, there was no willingness to co-parent. It was not until years later where Shannon decided she wanted to be involved in Christopher’s life again, which Eddie welcomed as he knew Christopher deserved the chance to have a mother again. It was then again when the family transitioned into “families with school age children” where Eddie and Shannon were once again the main guardians. Shannon eventually passes away from a car accident and Eddie and Christopher became a single-parent family again.

Communication

Strengths ●

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When being reunited, Eddie and Shannon are able to be civil for the sake of Christopher.

Eddie and Christopher share a lot of love and understanding despite the absence of Shannon.

Eddie is very involved with the community being a part of the LAFD.

Challenges ●

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Eddie tends to rely on aggression and pain to relieve stress. ○ Eddie has participated in illegal mixed-martial arts (MMA) activities. ○ This can harm him in many ways which can harm Christopher if his dad was injured and unable to care for him.

Shannon is driven by emotion, not logic.

Although Christopher is overall developing well, his condition could also be a stressor for the family.

Verbal ●

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Eddie is not afraid to speak his mind while Shannon always seems to play a “guessing” game and doesn’t express what she’s feeling.

Christopher always lets people know how much they mean to him. He doesn’t hesitate to express his love, despite his condition and speech impairment.

Nonverbal ● When Eddie is stressed, he can become distant and his facial expressions and body language speak for him. ● When Shannon is upset, she can also become distant and cold. ● Christopher always expresses happiness through hugs and drawings. When upset, he wants to be alone.

Family Systems and Illness Model The Family Systems and Illness Model, also known as chronic illness framework, helps promote understanding of how chronic illness affects a family (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2015). This framework helps nurses analyze the multiple factors of an illness and how those factors influence the function of a family.

This model has 3 major elements: Illness Types: onset, course, outcome, degree of incapacitation Time Phases of the Illness: day-to-day adjustments or terminal Family Functioning: demands of managing illness and family strengths and vulnerabilities Christopher’s spastic cerebral palsy isn’t expected to get “worse” over time but symptoms can change in severity and manifestation. The underlying fear in chronic illness is the unknown of what may happen because of it. Although Christopher shows determination to live a normal life, CP can always put him at risk for injury because of the physical limitations. His mother, Shannon, left Christopher and Eddie, without thoughts that Christopher may need all the physical and emotional support in regards to his CP. Because Shannon was left to care for Christopher by herself for a few years, leaving Eddie gave him the same responsibility.

In this situation using the model, the nurse may conclude that the chronic illness present in the Diaz family moreover came as a challenge that was hard to fully take on. Alternatively, the chronic illness might have posed as a “norm” in the sense that Shannon nor Eddie used it as an excuse to stay back from their desires.

Christopher and his Cerebral Palsy Christopher was born with cerebral palsy (CP), a mixture of disorders that affects a person’s ability to move and keep balance and posture (Centers for Disease Control and Prevention, 2019). Cerebral palsy is caused by abnormal brain development or damage to the developing brain that affects the person’s ability to control their muscles.

Furthermore, Christopher has spastic cerebral palsy -having increased muscle tone that makes movements stiff and awkward. CP is the most common motor disability in childhood. Because of his CP, Christopher needs the aid of forearm crutches to ambulate. His speech is slightly impairment and his eyes have strabismus, creating some vision impairment.

NURSING DIAGNOSES, INTERVENTIONS, & OUTCOMES

Problem 1) Impaired physical mobility r/t neuromuscular impairment AEB stiff and awkward movements, need for forearm crutches, vision impairment, and limited range of motion secondary to spastic cerebral palsy.

Intervention: Assess Christopher’s overall developmental status. Assess milestones, degree of dependence on others, and neurological functioning.

Educate the family on keeping Christopher’s surroundings safe.

Rationale: Assessing for low mobility, functional difficulties, cognitive impairments, and multiple comorbidities contribute to both client safety and creation of rehabilitation interventions (Ackley, Ladwig, & Makic, 2017, p. 589).

Outcome: The nurse was able to properly assess Christopher’s physical mobility status and how his condition contributes to his development. Through this, the nurse was able to educate the family on milestones, development, and safety measures needed for Christopher’s well-being.

Problem 2) Risk for injury.

Risk factors: neuromuscular impairment, unsteady gait (lack of balance), need for forearm crutches, and impaired vision.

Intervention: Educate the family on keeping Christopher’s surroundings safe. Ensure his crutches are functioning correctly, remove and recognize hazards in the room that may interfere with walking, assist him when needed, allow him adequate time to perform activities as they may take longer than “normal”.

Rationale: Evidence based studies show that both clients and their families should take a hands-on role in providing client safety (Ackley, Ladwig, & Makic, 2017, p. 536).

Outcome: The family was properly educated on how to keep Christopher’s surroundings safe. They check on his crutches every morning and midday, removed hazards such as loose rugs and exposed wires, and are continuing to assist him in any way needed.

Problem 3) Risk for low self-esteem.

Risk factors: Unable to walk or function like others of that age (comparison), dependence on others for self-care, lack of acceptance from peers, differences in communication.

Intervention: Assess Christopher’s outlook on his condition, coping mechanisms, family coping, mental status, support systems, school and social life.

Rationales: Assessing illness self-concept in a developing treatment plan may prove useful (Ackley, Ladwig, & Makic, 2017, p. 768).

Children and adolescents with chronic illnesses have low levels of self-esteem when compared to their healthy peers; experiences of success and positive peer relations are important sources of self-esteem (Ackley, Ladwig, & Makic, 2017, p. 769).

Outcome: Christopher’s outlook on his condition and life were assessed and concluded he isn’t at risk for low self-esteem at this time. He was educated on the importance of expressing how he feels and to address any concerns. His family was also educated to monitor changes in behavior and were given resources for support groups for Christopher and the family.

References Ackley, B.J., Ladwig, G. B., & Flynn Makic, M. B. (2017). Nursing diagnosis handbook: An evidence based guide to planning care (11th ed). St. Louis, Missouri: Elvisor.

Centers for Disease Control and Prevention. (2019). What is Cerebral Palsy? Retrieved from https://www.cdc.gov/ncbddd/cp/facts.html Fandom. (2019). Christopher Diaz. Retrieved from https://9-1-1.fandom.com/wiki/Christopher_Diaz Fandom. (2019). Edmundo Diaz. Retrieved from https://9-1-1.fandom.com/wiki/Edmundo_Diaz Fandom. (2019). Shannon Diaz. Retrieved from https://9-1-1.fandom.com/wiki/Shannon_Diaz Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & Harmon Hansen, S. M. (2015). Family health Care nursing: Theory, practice and research (5th ed.). Philadelphia, PA : F. A. Davis Company.

Image References [911]. (2019) Retrieved from https://8tracks.com/meatlowf/i-want-you-i-think-buddie [911 Eddie and Christopher Diaz]. (2018). Retrieved from https://www.respectability.org/2018/10/911-cerebral-palsy/ [911 Father and Son]. (n.d.). Retrieved from https://www.pinterest.com/pin/579768152010825732/ [911 Shannon Diaz]. (2019). Retrieved from https://www.distractify.com/p/what-happened-christophers-mom-911 [Christopher Diaz]. (n.d.). Retrieved from https://9-1-1.fandom.com/wiki/Christopher_Diaz [Christopher and Eddie Hug 911]. (n.d.). Retrieved from https://wherever-i-look.com/tv-series/9-1-1-season-2-episode-3-help-is-not-coming-recap-review-with-spoilers [Chronic Illness Framework]. (2015). Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & Harmon Hansen, S. M. (2015).

Family health Care nursing: Theory, practice and research (5th ed.). Philadelphia, PA : F. A. Davis Company.

[Diaz Family 911]. (n.d.). Retrieved from https://gramho.com/explore-hashtag/EddieDiaz [Eddie and Christopher Diaz]. (n.d.). Retrieved from https://telltaletv.com/2019/10/how-9-1-1-could-break-ground-with-disability-representation-and-christopher-dia z/ [Gavin McHugh]. (n.d.). Retrieved from https://saveig.org/iamgavinmchugh/?lang=it [Ryan Guzman]. (2020). Retrieved from https://hollywoodlife.com/pics/9-1-1-show-photos/911-season-2-1/ [Shannon Diaz]. (n.d.). Retrieved from https://9-1-1.fandom.com/wiki/Shannon_Diaz