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San Diego State University School of Nursing
NURS 608 Syllabus
Nursing in the Healthcare System
Spring 2014
Faculty:
Willa Fields, DNSc, RN, FHIMSS
H: 858-756-5642
C: 619-925-0450
Email: willa.fields@sbcglobal.net
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COURSE SYLLABUS
COURSE:
NURS 608 – Nursing in the Healthcare System
CREDIT:
3 Semester Units
PLACEMENT:
Spring Semester
FACULTY:
Willa Fields, DNSc, RN, FHIMSS
PREREQUISITES: None
LOCATION:
Hardy Tower 183
Thursdays, 7:00 to 9:40 PM
COURSE DESCRIPTION
Examination of current and evolving health care issues and policies. Analysis of ethical,
political, and social forces underlying delivery of health care. Focus on role of
professional nursing.
COURSE OVERVIEW
The course examines the role of the professional nurse in today’s society. The focus is on
the specific concepts, theories, and issues that confront the nurse in the dynamic health
care system. Emphasis is on the right and responsibility of the professional nurse to be
informed about and an active participant in the development of nursing and the health
care system.
COURSE OUTCOMES
Upon completion of the course, the student will be able to:
1.
2.
3.
4.
5.
6.
7.
Utilize concepts and theories from nursing and other disciplines in the analysis
of issues in nursing and health care systems.
Describe the development and structure of the health care delivery system in
the US.
Analyze and critique current models for organizing nursing care delivery
across health care settings.
Analyze the implications for nursing of the changing role of women in
society.
Analyze principles of ethical decision-making in nursing practice and health
care.
Examine the activities of professional nursing organizations.
Analyze social, economic, cultural and political factors in contemporary
society that affect the practice of nursing, the delivery of health care, and the
formation of healthcare policy.
3
8.
9.
10.
Synthesize knowledge of power and the political decision-making processes as
they relate to nursing and healthcare policy and reality.
Using theories of leadership, problem solving, and decision-making, identify
strategies for achieving changes in nursing and health care.
Analyze current roles and contemporary issues in advanced practice nursing.
TEACHING METHODS
This is a discussion/seminar course. Students are expected to come to class prepared to
discuss the topic of the day. Spirited debate, based on facts, is both expected and desired.
Some class sessions will be on-line. During these sessions there will be readings and
exercises for you to complete.
REQUIRED TEXTBOOKS


American Psychological Association. (2010). Publication Manual of the
American Psychological Association (6th ed.) Washington, DC: Author.
o APA Publication Manual Online tutorials:
http://www.apastyle.org/learn/index.aspx
Mason,D.J., Leavitt, J.K., & Chaffee, M.W. (2012). Policy & Politics in Nursing
and Health Care. 6th Ed. St.Louis: Saunders.
REQUIRED HARDWARE AND SOFTWARE






Access to a Windows or Macintosh multimedia computer. Preferably one that
meets the SDSU minimum computing standards (see http://wwwrohan.sdsu.edu/~mwssls/nws.html) In addition, the following will be needed to
support course participation:
E-mail system
Microsoft Word, version 7.01 or higher, as your word processing software
High-speed connection to the Internet
Computer headset
Blackboard Student Support: http://wwwrohan.sdsu.edu/dept/its/blackboard/student/
 Netiquette: http://wwwrohan.sdsu.edu/dept/its/blackboard/student/gettingstarted/netiquette.html
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STUDENT DISABILITY SERVICES
If you are a student with a disability and believe you will need accommodations for this
class, it is your responsibility to contact Student Disability Services at (619) 594-6473.
To avoid any delay in the receipt of your accommodations, you should contact Student
Disability Services as soon as possible. Please note that accommodations are not
retroactive, and that I cannot provide accommodations based upon disability until I have
received an accommodation letter from Student Disability Services. Your cooperation is
appreciated.
PLAGIARISM
Students are responsible for abiding by the University policy on plagiarism, written
below and found at http://arweb.sdsu.edu/es/catalog/2013-14/Graduate/060070_University%20Policies.pdf. Papers with plagiarized content will have the grade
reduced by 25 points. I also strongly encourage you to take the paraphrasing and
plagiarism tutorials on the SDSU library website:
http://library.sdsu.edu/guides/sub2.php?id=336&pg=354.
Plagiarism
Plagiarism is defined as the act of incorporating ideas, words, or specific
substance of another, whether purchased, borrowed, or otherwise obtained, and
submitting same to the university as one's own work to fulfill academic
requirements without giving credit to the appropriate source. Plagiarism shall
include but not be limited to (a) submitting work, either in part or in whole,
completed by another; (b) omitting footnotes for ideas, statements, facts, or
conclusions that belong to another; (c) omitting quotation marks when quoting
directly from another, whether it be a paragraph, sentence, or part thereof; (d)
close and lengthy paraphrasing of the writings of another; (e) submitting another
person's artistic works, such as musical compositions, photographs, paintings,
drawings, or sculptures; and (f) submitting as one's own work papers purchased
from research companies.
Disciplinary Action
Cheating and plagiarism in connection with an academic program at the
university may warrant two separate and distinct courses of disciplinary action
that may be applied concurrently in response to a violation of this policy: (a)
academic sanctions, such as grade modifications; and (b) punitive sanctions, such
as probation, suspension, or expulsion.
Academic sanctions are concerned with the student's grades and are the
responsibility of the instructor involved. Punitive sanctions are concerned with the
student's records and status on campus and shall be the responsibility of the
university president or designated representative. The Coordinator of Judiciary
Procedures shall be the president's representative in matters of student discipline.
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COURSE REQUIREMENTS AND GRADE DETERMINATION
For successful completion of NURS 608, students are required to complete the course
requirements listed below. Grade determination and due dates are specified. For late
written assignments, the grade will be dropped a half letter grade for each day late unless
prior faculty approval for an extension has been obtained. All assignments are to be on
different topics.
REQUIREMENT
PERCENT OF GRADE
DUE DATE
Current Events
5% (pass/fail)
Student sign up
Outside Session
5% (pass/fail)
No later than 5/8
Policy Letter
5% (pass/fail)
No later than 5/8
Comment on Federal Rule
5% (pass/fail)
No later than 5/8
Paper
60%
No later than 5/8
Editorial
5% (pass/fail)
No later than 5/8
World Cafe
5% (pass/fail)
5/8
Presentation
10%
Student sign up
GRADING SCALE
A
AB+
B
B-
=
=
=
=
=
100-93
92-90
89-87
86-83
82-80
C+
C
CD+
D
F
=
=
=
=
=
=
79-77
76-73
72-70
69-67
66-63
62 or less
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FACULTY APPOINTMENTS AND COMMUNICATION
Dr. Willa Fields can be contacted by phone or e-mail listed below. All meetings are by
appointment and can be scheduled directly with the professor. Students are encouraged
to use e-mail for scheduling appointments and communicating with the professor
between regularly scheduled class meetings.
Office Hours:
By appointment
Phone numbers:
Home/Office: 858-756-5642
Mobile: 619-925-0450
E-mail address:
willa.fields@sbcglobal.net
This course may require students to participate in field trips, research or studies that
include course work that will be performed off-campus. Participation in such activities
may result in accidents or personal injury. Students participating in the event are aware of
these risks, and agree to hold harmless San Diego State University, the State of
California, the Trustees of the California State University and Colleges and its officers,
employees and agents against all claims, demands, suits, judgments, expenses and costs
of any kind on account of their participation in the activities.
Students using their own vehicles to transport other students to such activities should
have current automobile insurance.
Web Sites of Interest:
 California Healthcare Foundation: http://www.chcf.org/
 Commonwealth Fund: http://www.commonwealthfund.org/
 Health Care Reform: http://www.healthcare.gov/
 Kaiser Family Foundation: http://www.kff.org/
 Pew Charitable Trusts: http://www.pewtrusts.org/
 Robert Wood Johnson Foundation: http://www.rwjf.org/
 Portal for Federal rulemaking: www.regulations.gov
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WEEKLY SCHEDULE
DATE
TOPIC/CLASS ACTIVITIES
Introductions
ASSIGNMENT (to be completed prior to
class session)
Bring to class:
 Personal goals and priorities for N608
Course Overview
Identify personal goals and priorities
for N608
Ethical Theories for Biomedical
Decision Making
1/23
Current Events
Historical Perspective on Nursing
The Future of Nursing Report
How Government Works
2/6
ANA Code of Ethics:
http://nursingworld.org/MainMenuCategori
es/EthicsStandards/CodeofEthicsforNurses.
aspx
Policy, Politics, and Nursing
Finding Government Documents in
the SDSU Library
Guest Speaker: Marilyn Hall,
School of Nursing Librarian,
1/30
Mason, Leavitt, & Chafee
 Unit 1
Guest Speaker: David Roberts, San
Diego County Board of Supervisor
Current Events
Student Presentations
Epstein, E.G., Delgado, S., (Sept 30, 2010)
"Understanding and Addressing Moral
Distress" OJIN: The Online Journal of
Issues in Nursing Vol. 15, No. 3,
Manuscript 1.
doi:10.3912/OJIN.Vol15No03Man01
Available at:
http://www.nursingworld.org/MainMenuCa
tegories/EthicsStandards/Courage-andDistress/Understanding-MoralDistress.html
Mason, Leavitt, & Chafee
 Unit 1 continued
Political exercise
The Future of Nursing IOM Report
 http://www.iom.edu/Reports/2010/TheFuture-of-Nursing-Leading-ChangeAdvancing-Health.aspx
Mason, Leavitt, & Chafee
 Unit 5
Bring peer review forms to class.
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DATE
TOPIC/CLASS ACTIVITIES
Current Events
2/13
ASSIGNMENT (to be completed prior to
class session)
Mason, Leavitt, & Chafee
 Unit 6
State Boards of Nursing
Bring peer review forms to class.
Professional Nursing Organizations
Student Presentations
Current Events
2/20
2/27
Advanced Practice Nursing/Nursing
Education
Bring peer review forms to class.
Student Presentations
Attend a Center for Ethics forum,
webinar, or some other forum during
the semester on an issue related to
course content.
Submit a brief summary of presentation,
what you gained from the experience, and
how the session related to the course
content.
Current Events
3/6
Status of Healthcare/Health
Disparities in the USA
Student Presentations
Health Insurance in the United States:
Affordable Care Act/Covered
California
3/13
Mason, Leavitt, & Chafee
 Unit 7
Becca Karpinski, Planned Parenthood
of the Pacific Southwest
Student Presentations
Current Events
Email summary to
willa.fields@sbcglobal.net.
Mason, Leavitt, & Chafee
 Unit 2
Bring peer review forms to class.
Mason, Leavitt, & Chafee
 Unit 2 continued
Take ACA quiz: http://kff.org/quiz/healthreform-quiz/
Review video: http://kff.org/healthreform/video/youtoons-obamacare-video/
Bring peer review forms to class.
Mason, Leavitt, & Chafee
 Unit 2 continued
ICD-9/ICD-10
3/20
Bring peer review forms to class.
Medicare
Prescription Drugs
Student Presentations
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DATE
TOPIC/CLASS ACTIVITIES
Research and Politics
ASSIGNMENT (to be completed prior to
class session)
Mason, Leavitt, & Chafee
 Unit 3
3/27
online
Bring peer review forms to class.
4/3: Spring Break
Current Events
4/10
Mason, Leavitt, & Chafee
 Unit 2 continued
International Health Systems
Bring peer review forms to class.
Student Presentations
Current Events
4/17
Mason, Leavitt, & Chafee
 Unit 4
Nursing Workforce Issues
Bring peer review forms to class.
Student Presentations
Current Events
4/24
Mason, Leavitt, & Chafee
 Unit 4 continued
Nursing Unions
Bring peer review forms to class.
Student Presentations
Current Events
Bring peer review forms to class.
5/1
Nurse-Physician Relationships
Student Presentations
Health Policy: The World Café
5/8
Review course materials.
Bring snacks to share with class.
Paper and Editorial due by 7:00 PM.
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Current Events Oral Report
Purpose:
The purpose of the current events report is to facilitate the student’s application of course
content to what is being reported in the news (print, radio, TV, or internet based).
Requirements:
The student is expected to summarize and critique a current event related to the week’s
course content. Critique to include source, summary of issue, impact on health and health
care, and ethical considerations.
Preparation:
Review news related to weekly class content.
Grade: 5%
Pass/Fail. Evaluation will be based on the student’s ability to analyze, synthesize, apply,
and critique discussed concepts.
Paper
Purpose:
The purpose of the paper is to facilitate the student’s ability to analyze, synthesize, apply,
critique, and answer ethical questions and current issues in nursing and health care with
professional experience and literature based evidence and thought.
Requirements:
Choose a nursing/health care issue that you consider important. In approximately ten
pages, introduce the topic, state your purpose and position, describe the ethical system
upon which your position rests, and provide a reasoned, logical argument for your
position that also addresses opposing opinions. Provide evidence to support your position
from the professional literature. Your purpose is to persuade others to your point of view
using fact, logic, and ethical decision making. Follow guidelines in the APA Publication
Manual.
The paper must be submitted by email to the instructor on or before the due date.
Grade: 60%
The paper will be evaluated on the clarity of writing, presentation of the overall concept
to be discussed, organization of the content into topical sub-headings, and incorporation
of evidence-based literature addressing the problem/issue. Evidence of critical thinking
and analysis is expected. Correct spelling, punctuation, sentence/paragraph construction,
and APA style are expected. See grading rubric for specific point allocation.
Late papers will be accepted, but the overall grade of the paper will be dropped five
points for each day late.
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Editorial
Purpose:
The purpose of the Editorial is to facilitate the student’s ability to analyze, synthesize,
apply, and critique an opposing view to a current issue in nursing and health care.
Requirements:
In two double spaced pages or less, on the topic written about in your paper, write a
persuasive editorial arguing the opposite point of view. Include the editorial at the end of
your paper, after the references and on a new page
The editorial must be submitted by email to the instructor on or before the due date.
Grade: 5%
Pass/Fail. The editorial will be evaluated on the clarity and persuasiveness of writing.
Evidence of critical thinking and analysis is expected, as well as your own interpretation,
inferences and rationale about the issue. Correct spelling, punctuation, and
sentence/paragraph construction are expected. Since this assignment is an editorial, you
do not need to use APA style.
Late assignments will not be accepted. Students not submitting a letter by the due date
will receive no credit for the assignment.
Policy Letter
Purpose:
The purpose of the Policy Letter is to facilitate the student’s ability to analyze,
synthesize, apply, and critique a specific health care policy at the local, state, or federal
level.
Requirements:
Identify a health care policy/bill/issue currently progressing through the state or federal
government. Write a persuasive letter to an elected official on your position which may
include encouraging the passage or defeat of the policy/bill. Include evidence to support
your position which may include economic, ethical, and societal implications of the
policy/bill. Include any changes you recommend to the policy/bill and your rationale.
You are encouraged to use references beyond the professional literature such as the
Congressional Record or Congressional Committee Testimony.
A copy of your letter and an email receipt from the elected official must be emailed to the
instructor on or before the due date.
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Grade: 5%
Pass/Fail. The letter will be evaluated on the clarity and persuasiveness of writing.
Evidence of critical thinking and analysis is expected, as well as your own interpretation,
inferences and rationale about the policy/bill.
You are strongly encouraged to complete the assignments throughout the semester.
Summaries are due no later than 7:00 PM on the last class.
Late assignments will not be accepted. Students not submitting a letter by the due date
will receive no credit for the assignment.
Comment on Federal Rule
Purpose:
The purpose of requiring students to comment on a Federal Rule is to facilitate the
student’s ability to analyze, synthesize, apply, and critique a specific health care policy at
the federal level.
Requirements:
In a group of no more than three students, identify a Federal Rule open for public
comment at www.Regulations.gov, identify a rule of interest that is open for public
comment, and submit your well thought out comments.
Email the instructor a copy of your submission, with group member names, no later than
the last day of class.
Grade: 5%
Pass/Fail. The submission will be evaluated on the clarity and persuasiveness of writing.
Evidence of critical thinking and analysis is expected, as well as your own interpretation,
inferences and rationale about the Federal Rule.
You are strongly encouraged to complete the assignments throughout the semester.
Summaries are due no later than 7:00 PM on the last class.
Late assignments will not be accepted. Students not submitting a letter by the due date
will receive no credit for the assignment.
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Class Presentation
Purpose:
The purpose of the student presentation is to facilitate the student’s speaking ability to
analyze, synthesize, apply, and critique a specific aspect of the course content.
Requirements:
In no more than 15 minutes, utilizing PowerPoint slides, students will present on an
assigned topic related to health policy, nursing, and the health care system.
Grade: 10%
Letter Grade. Evaluation will be based on instructor and peer ratings of the presentation.
Peers will use the Peer Evaluation Form. A half letter grade will be deducted for going
over the time limit.
You are strongly encouraged to complete the assignments throughout the semester.
Summaries are due no later than 7:00 PM on the last class.
Outside Session
Purpose:
The purpose of attending an outside session is to expose the student to the broad range of
public policy and health care issues available beyond NURS 608.
Requirements:
Attend at least 2.5 hours of a professional conference, webinar, governmental hearing, or
other online education on a topic related to public policy and health care issues. Email a
brief summary of the presentation, length of session, what you gained from the
experience, and how the session related to the course content to
willa.fields@sbcglobal.net.
Grade: 5%
Pass/Fail. Evaluation will be based on completeness of summary information. Grading
will be pass/fail.
You are strongly encouraged to complete the assignments throughout the semester.
Summaries are due no later than 7:00 PM on the last class.
Late assignments will not be accepted. Students not submitting a letter by the due date
will receive no credit for the assignment.
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N608 Paper
Grading Rubric –
Student:
Description
Pts
APA
Citations written correctly per APA Manual
5
References listed correctly per APA Manual
5
Paper formatted per APA Manual
5
Content
Introduction
5
Clear, concise purpose statement
5
Well developed, referenced, body of paper
20
Ethical discussion
5
Pro/Con discussion
5
Clear, concise conclusion
5
Paper logically developed
10
Clear writing style, use of good grammar and punctuation
10
Synthesis of material
10
Content grounded in current evidence
10
TOTAL POSSIBLE POINTS:
100
Your
Score
15
Peer Evaluation Form
Class Presentations
Presenter: ______________________
Date: _______________
Presentation Title: _____________________________________________
Please complete the following information about your classmate’s presentation. This
information will be used to provide positive feedback and areas for growth for executive
level presentations.
Thank You.
Needs
Improvement
Please rate the presentation in the
following areas.
1
2
Excellent
3
Innovative ideas
Logically and clearly developed
Synthesized classroom and evidencedbased materials
Included relevant and current references
Professional and articulate presentation
PowerPoint slides enhanced material
Answered questions well
Please comment on what you particularly liked about the presentation?
What areas could the presenter improve upon?
4
5
NA