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The Glass Castle: A Case Study The book, The Glass Castle, by Jeanette Walls gives an intimate look at her family. The Walls family does not fit society’s expectations of normal, functional or healthy behavior. Nurses are particularly interested in assisting families in similar situations. This paper evaluates the Walls family as they interact with each other and their community. Nursing activities which may be of value to the Walls family are proposed and explored. The Walls family consists of six people, Rex, Rose Mary, and their four children, Lori, Jeannette, Brian, and Maureen.

The author of the book, Jeannette, objectively describes her dysfunctional family. She reflects on detrimental circumstances without holding back details. While the mood is troubling and sad, it is also continually hopeful. The book demonstrates the love and adoration children have for their parents in spite of their faults and the personal growth that can be attained through hardship. Alcoholism is an ineffective coping mechanism for Rex Walls. When sober, he captures his children’s imaginations and teaches them to embrace life fearlessly.

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While under the influence, his judgment is greatly impaired and puts his family at risk for injury. During one episode of inebriation, he chases his pregnant wife through the desert in the family car. Another time, he encourages Jeannette to accompany an intoxicated man to his apartment. He completely disregards the family finances by using what little they have to go drinking. He also experiences ineffective coping related to inadequate methods of dealing with stressful situations. This is evidenced by his habit of “skedaddling” or basically fleeing any situation that he is uncomfortable with.

Rose Mary “retreated to her sofa bed and stayed there for days on end, crying and occasionally throwing things at us. She could have been a famous artist by now, she yelled, if she hadn’t had children, and none of us appreciated her sacrifice”, Jeanette accounts. This is a display of altered thought process related to her loss of contact with reality. While both parents demonstrate love for their children, their combined shortfalls leave the entire family at risk for a multitude of problems. They are all at risk for ineffective health maintenance related o a lack of access to medical care. Also, the children are at risk for injury related to a lack of parental supervision and concern. This was obvious when Jeanette was thrown from the car while Rex was simultaneously drinking and driving. Rocks are embedded in her skin and when the car does not stop, she wonders if she has been left. The inability of both parents to hold steady jobs and their failure to sell any items of value left the children trying to provide their own basic needs such as food, heat, and clean water.

This lack of sustenance in the family home leaves all of the Walls at risk for imbalanced nutrition, less than the body requires. A nursing diagnosis that applies to the oldest daughter, Lori, is disturbed sensory perception related to impaired vision. This diagnosis is evidenced by Lori’s struggle to read the eye chart and her teacher sending a note home that she needs glasses. Her mother’s belief is that weak eyes only need exercise to get strong and that glasses just prevent people from learning to see the world on their own.

When the school agrees to pay for Lori’s glasses the world opens up to her and she marvels at being able to see all the details of the world around her. Brian experiences powerlessness related to the molestation by his grandmother. His parents do not believe him. They make him feel the incident is his fault and that the issue is trivial. The family is banished from the grandmother’s house and Brian is left feeling that he is to blame for the lack of shelter. Maureen is not as close to her siblings as they are to each other. She does not depend on them for emotional or physical support.

She looks to others outside of the family to care for her. Because her needs are met from neighbors and friends, she does not struggle for survival as the others do. Her adjustment is impaired, which leads to violence directed at others. Maureen stabs her mother and spends a year incarcerated and institutionalized. Nursing diagnoses for Jeanette include low self esteem and disturbed body image related to negative feedback from peers. At school, the other students make fun of her because she is so skinny. She is called spider-legs, skeleton girl, and pipe cleaner.

She hides in the bathroom during lunch to avoid being teased by the other students. She also tries to fashion her own braces out of wire because she has buckteeth and knows that her family can not afford braces. The Walls family, like many in America, is dysfunctional. The father is an alcoholic and the mother simply does not want to grow up. The Walls children have proven to be survivors and that they can take care of themselves, but that doesn’t mean that they should take care of themselves. One might ask, how can nurses help children such as the Walls?

How can society help the parents? The answer is not simple or easy. The Walls are not receptive to information about health care regarding their maladaptive behaviors. When Jeanette is admitted to the hospital with third degree burns, the nurses suspect that intervention is needed. Hospital staff had an opportunity to help the Walls but they did not take advantage of it. When Rex suspects trouble, he grabs Jeanette and runs out of the hospital with her. The parents created multiple barriers that the nurse would have to break down in order to help the family.

The fleeing nature of the parents would cause difficulty in helping the children in this particular family. A nurse’s responsibility is to care for others even if they are not in agreement with the lifestyle the parents have chosen for their children. Nurses must ultimately respect their clients and be in tune with personal feelings regarding abnormal situations before they strive to help others. Nurses function as advocates, care-takers, educators, and are trained in a variety of communication skills. Trust is gained by listening to clients and creating a non-threatening, non-judgmental atmosphere.

Building a trusting relationship is the way to get close to a family such as the Walls. After establishing a relationship, the nurse can obtain information to understand the needs of the family. This is the first step in developing a plan of care. The nurse is aware of the programs that the community provides to assist families in need. Through these programs, children are eligible for free lunch at school. This provides a daily nutritious meal. Local church service programs offer clothing and shoes as protection from the elements. Government programs, such as Medicaid, provide basic medical and dental care.

The foster care system is also important to be aware of, as it is the nurse’s duty to report the parents if neglect or abuse of children is suspected. Rex and Rose Mary do not want assistance because they believe it is better to care for their children independently. In their minds, it is better than being on welfare. After becoming a trusted confidante, the nurse will educate the parents regarding different programs that provide assistance to families in need. The nurse will explain that without utilization of government funded programs, they cease to exist.

The parents would have to be convinced that they are obligated to use the aid so that it will still be available for others. Rex and Rose Mary must come to the conclusion that accepting help would be in the best interest of the children and it does not undermine their function as parents. Most of the Walls children are now functional adults. Society’s expectation of children in similar situations is a continuation of the cycle of dysfunction. The Glass Castle is an example of how both nature and nurture play a key element in a person’s outcome. Jeanette articulates she is her father’s favorite.

She always knows that he loved her. Her journalism teacher supports her and gives her a chance when no one else will. Without the encouragement of these two key people in her life, her pursuits and accomplishments in life would have been different. Jeanette uses her unconventional childhood as a springboard to happiness. She not only overcomes adversity, but uses it to her advantage. Jeanette develops a perspective of the world that would not have been possible without all of her experiences. Overall, the nursing profession has a lot of offer a family such as this one.

Nurses listen, give chances, and make people feel important. Even if nursing and other professional efforts and attempts fruition can not be seen, they may make a difference somewhere down the road.

References Ackley, B. J. & Ladwig, G. B. (2008). Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care (8th ed. ). St. Louis: Elsevier Mosby. Stuart, G. W. , & Laraia, M. T. (2005). Principles and Practice of Psychiatric Nursing (8th ed. ). St. Louis: Elsevier Mosby. Walls, J. (2005). The Glass Castle. New York: Scribner.

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