Nurs 480 Jen Lindley of Dawson's Creek Heart Failure

JenniferLindley

OF DAWSON'S CREEK

Jennifer (Jen) Lindley, born in New York, was the only daughter of Theodore Lindley and Helen Ryan. She was sent to Capeside to live with her maternal grandfather (Gramps) and grandmother Evelyn (Grams) Ryan and after pursuing risky behaviors including substance abuse, underaged drinking & underaged intercourse as a result of discovering her father having an affair with a minor. Gramps soon dies from complications of a stroke.

Jen becomes part of the core group of friends including Joey, Dawson, and Pacey. A few years later, Jen and Jack McPhee develop a strong 'soulmate' type friendship when Jack is sent from his home after telling his father he is gay. Jack is welcomed into Jen and Grams' home.

Multiple events occur throughout her high school years that lead Jen back into her risky behaviors. Throughout it all, Grams and Jack, along with her other friends are her strong support system.

When her heart failure becomes too advanced, the group rallies to support her one last time as she says goodbye. Jack requests Jen's permission to adopt Amy Lindley, Jen's baby and promises to love her as his own.

Heart Failure AND THE

CARDIOPULMONARY

The human heart has 4 chambers, a right atrium, a right ventricle, a left atrium, and a left ventricle and acts like a pump Blood is simultaneously pulled and pumped in multiple directions and through multiple vessels with each cardiac cycle. It is pulled into the right atrium, proceeds to be pumped through tricuspid valve into the right ventricle. Next, it is pushed through the pulmonic valve into the pulmonary artery where it is delivered deoxygenated but returns through the pulmonary veins to the left atrium. From the left atrium blood is pumped through the mitral valve into the left ventricle. Next it is pushed through the aortic valve into the aorta and proceeds to deliver blood to the rest of the body. (Jarvis, 2020) With the complexity of this pump, and its many involved actions, dysfunction in any area leads to failure in other areas

SYSTEM

Heart failure is "defined as the inability of the ventricle to eject adequate cardiac output " (Norris, 2019) Jen Lindley was diagnosed with left ventricular heart failure. As we recall, blood is pushed and pulled simultaneously. If the pump is unable to pump blood of the left ventricle, as is present with left ventricular heart failure, it backs up all the way to the pulmonary circulatory system. Excess blood in the pulmonary circulation, excess pressure is placed on these vessels and it begins to osmotically seep into the interstitium of the pulmonary tissues called pulmonary edema (Norris, 2019)

Jen Lindley decompensates rapidly with her end stage/ advanced heart failure becoming unresponsive toher current medicinal regimen which is common in "left ventricular systolic dysfunction associated with a low output state " (Norris, 2019) As her pulmonary congestion worsens, the oxygen supply to vital organs decreases causing her ultimate death.

Bronfenbrenner's

BIOECOLOGICAL SYSTEMS THEORY

Bronfenbrenner's Bioecological Systems Theory is appropriate for this as model illustrates the interrelationship between humans and their environment and how it changes with time. It "describes the interactions and influences on the family from systems at different levels of engagement" including the microsystem, the macrosystem which includes the mesosystem and exosystem, and finally the chronosystem. (Kaakinen et al., 2018)

I. The microsystem is the setting that revolves around the individual. For Jen Lindley, her microsystem currently includes the hospital with her healthcare team members where she will ultimately pass away. It includes her home where she lives with Grams and Amy.In Jen's life, her closest friends, most importantly Jack McPhee, whom she considers family would be part of her microsystem.

II. A macrosystem incorporates the mesosystem and the exosystem and "together they are the 'blueprints' for the ecology of human and family development." (Kaakinen et al., 2018) The aspects of this system provide the underlying culture and in Dawson's Creek, this would include small town life, East Coast lifestyle, late 1990's culture. This would include Jen's atheism and aversion to Gram's conservative values.

A. Jen's mesosystem includes the relationships between the components of her microsystem; how Grams and Amy relate; Grams' and Jack's relationship; Jack's relationship as godfather to Amy; how Grams and the hospital and healthcare team interact; Jack, Pacey, Joey and Dawson's relationships.

B. An Exosystem is a "system of social structures in which the individual does not reside, but is nonetheless influenced and impinged on by the activities in this system." (Roux et al., 2021) Politics of the town of Capeside, issues affecting Jack's employment, the local High School, Jack's relationship with his boyfriend, Doug, issues at Gram's church, the difficulty that Joey is having with her boyfriend, or the issues that Dawson is having with his job as a director all could be considered part of Jen's exosystem.

III. Chronosystems involve the time period during which the individual lives. Dawson's Creek evolved over the course of 20 years during Jen's life beginning in the 1990's. Her chronosystem would take into account all the events that have shaped her into the woman she is today.

Evelyn "Grams" Ryan

Since the passing of her husband, Grams has been the matriarch of her family. She also was Jen's caregiver throughout her life and continues to be now that Jen is ill Grams is in late adulthood, the 8th stage of human development as expressed by Erickson. During this stage in her life, Grams is reminiscing about her life with the ultimate goal of satisfaction rather than regret.

Jen went through a difficult 5th stage and grappled with her identity. Now that she has a child, Amy, she expressed how much it changed her. She was working towards love in the 6th satge: young adulthood but became ill and is having a difficult tme coming to terms with her impending death She and Jack are 'soulmates' in the sense that each hold part of the others' and have long been in a platonic but committed relationship.

As a toddler, Amy is in Erickson's 2nd stage and is ultimately attempting to gain self control. Now thatAmy has been adpoted by Jack and Doug, it will be their job to provide the opportunities for her to gain autonomy and learn cause and effect of her actions

J e of development and is learning to be in a committed relationship with his partner, Doug and learning love Jack was supported by Jen and Grams when he was struggleing with his sexual identity and went through his adolescence with minimal discomfort. Doug has only recently been able to be open about his sexual identity and is now on his was to achieving love as well

RET I RED RN, CONSERVAT I VE CH RI ST I AN, DX BREAST CANCER 25, LEFT VENTRICULAR HEART FAILURE (HF)

PLAT O NI C S O ULM AT E

Jennifer Lindley

Amy Lindley Jack McPhee

Elements

OF A FAMILY

Grams' devotion to her was a point of contention between Jen and her. Jen is an atheist , much to Grams' dismay. In Jen's final video recording to Amy, she expresses hope that Amy will find God.

religion

functioned

Gramps and Grams were a nuclear dyad before Jen came to live with them transitioning the family into a nuclear family. After Gramps' passing, Grams and Jen became a single parent family. Even after Jack moved in and became a member of the family, Grams has always as the caregiver and single parent. While Jen and Jack had some form of socialization before, it was Grams (their family) who truly helped both learn their function within society. By having positive relationships among each other, Grams, Jen and Jack fulfilled the affective function of family. They are able to "maintain a consistent level of involvement with one another, yet at the same time not become too involved in esch other's lives." (Kaakinen et al., 2018)

Grams and Jen did not always have good verbal communication. Jen would be vocal about her thoughts on Grams' religion. They have better communication now. Jen has always had a difficult time expressing herself to others and this continued until she could no longer hide her HF. When she does communicate, she is clear and effective. As communication is the way that "families find ways to adapt to changes" it would have been better had she been open with Jack and the rest of her close friends about her diagnosis. (Kaakinen et al, 2018) Being open would have prevented some of the issues that the rest of the family will inevitably face after Jen's passing.

Interventions

AND THEIR OUTCOMES

R I S K FOR I MPAI R E D AT T ACH ME NT

Jack, Doug and Amy have a risk for impaired attachment after Amy is adopted by Jack McPhee and Doug Whitter It may be difficult for Amy to adjust to life without her mother, Jen. An important intervention for impaired attachment is to promote trust building by encouraging Amy to express her feelings and will allow for open communication. The primary outcome would be that Amy, Jack and Doug develop a healthy attachment to one another as a new family unit and secondarily that Amy will have healthy growth and development as measured by her healthcare team. (West Olatunji, Wolfgang, & Frazier, 2019)

RISK FOR CAREGIVER ROLE STRAIN

While Jack and Doug may love and include Amy as their own child, strain will occur due to the new situation and emotional stress over this new role. It will be important for Jack and Doug to take time for themselves and allow Grams or one of the other friends to babysit Amy for a short time. This will allow Jack and Doug to take the time they need to "relax and reenergize...to assume care responsibilities " (Wayne, 2022) The outcome will be that Jack and Doug maintain emotional and physical capabilities of caring for Amy.

PARENTAL ROLE CONFLICT

Grams has been Jen caregiver for 15+ years as well as Amys' since her birth After Jen's passing and Amy's adoption into Jack and Doug's family, Grams will likely experience parental role confusion as she transitions out of the caregiver role and into supportive great grandmother role. Interventions to assist Grams should be provided by a licensed professional therapist. In addition, Jack and Doug can support Grams by including her in conversations about Amy The interventions will be deemed successful when Grams' no longer feels confusion regarding her new role as verbalized by her.

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