Issues in Nursing and Health Care
Nursing 303A
Course Description
September, 2014
2
TABLE OF CONTENTS
Course Overview .. ...........................................................................................................................................................................................2
Required Texts ................................................................................................................................................................................................2
Course Professor and Contact Information ........................................................................................................................................2
Office Hours ........................................................................................................................................................................................................2
Class Time and Location .............................................................................................................................................................................2
Year Three Student Expectations.............................................................................................................................................................2
Course Goals......................................................................................................................................................................................................3
Course Objectives............................................................................................................................................................................................3
Evaluation ..........................................................................................................................................................................................................4
General Guidelines for Written Assignments ....................................................................................................................................4
Individual/Group Discussions...................................................................................................................................................................4
Suggestions to Guide Reflective Writing...............................................................................................................................................6
Quizzes.................................................................................................................................................................................................................6
Ethical Issues Paper.......................................................................................................................................................................................6
Group Presentation (Ethical Case Study Analysis)...........................................................................................................................7
3
COURSE OVERVIEW
Nursing 303 is a course designed to provide the opportunity to identify and examine issues
important to nursing and to health care from an ethical perspective. This course emphasizes critical thinking
and analysis of these issues. Students will be asked to incorporate knowledge, skills, attitudes and
experiences gained in previous and concurrent courses to explore questions related to the delivery of health
care, current social norms, political situations, the nursing profession, and the health of individuals, families
and communities. The issues addressed may arise in the context of the current changing health care system,
the provincial and national nursing associations, nursing education, nursing practice, or in the context of
nursing as a profession.
The format of the class will focus on active involvement by students in the form of group
presentations, some group activity, and active exchanges with guest speakers and the professor. Based on
the readings and prior knowledge, students will be encouraged to challenge their own ideas as well as those
presented.
Please refer specific policies, codes, and guidelines (Academic Code of Conduct, the Canadian Nurses
Association Code of Ethics) at the School of Nursing and the University to familiarize yourself with them in
order to help promote a respectful learning environment. Professional behaviour will be expected at all times.
REQUIRED TEXTS:
Keatings, M. & Smith,O’N. (2010). Ethical and legal issues in Canadian
nursing.(3rd ed.). Toronto, ON: Elsevier Science Canada.
Picoult, J. (2004). My sister’s keeper. Washington, DC: Atria Books
COURSE PROFESSOR AND CONTACT INFORMATION:
Janis MacLellan-Peters MN, RN
School of Nursing (113)
Telephone: (902) 566-0749
Email: jmaclellanpeters@upei.ca
OFFICE HOURS: Tuesdays: 10:30 - 12:00 (or contact me anytime to arrange an appointment)
CLASS TIME AND LOCATION:
Mondays: 1:30pm – 4:30pm
HSB 106
YEAR THREE STUDENT EXPECTATIONS;
By the end of year three the student is expected to:
3.1
Examine current practice in nursing and health care and use sound arguments
to suggest alternative practices.
3.2
Analyze principles and services of Primary Health Care and integrate these into
practice with individuals, families, and groups.
3.3
Examine health care changes, professional issues, and other issues that may
occur with the implementation of Primary Health Care and discuss
implications for nurses, nursing, and client care.
3.4
Begin to critically evaluate research studies, use research as evidence to guide
practice, and incorporate research findings into scholarly work.
3.5
Begin to act as an advocate for research utilization and communicate relevant
research findings with peers/colleagues.
3.6
Integrate scientific knowledge, critical thinking, and ethical principles in
4
clinical decision making while working with individuals, families, and groups.
3.7
Demonstrate increased competence in providing organized, systematic,
family-centered care in increasingly complex situations with individuals,
families and groups.
3.8
Demonstrate selected roles of the nurse in working with individuals, families
and groups within interdisciplinary teams and in practicing within families and
groups.
3.9
Demonstrate appropriate use of written and verbal communication models
and strategies.
3.10
Demonstrate accountability and responsibility for own learning, and seek
learning experiences to meet own needs.
3.11
Demonstrate enhanced knowledge and skill in collaboration and identify
factors which influence client participation.
3.12
Demonstrate integration of the nursing code of ethics and standards of nursing
practice when providing care to clients.
3.13
Communicate in writing in a clear and scholarly manner using grammatically
correct format.
3.14
Analyze and integrate theory from nursing and other disciplines in practice.
Approved: May 2011
COURSE GOALS
To individually and collectively interpret and synthesize meanings from across subject areas, classroom
learning and real life; experienced within a milieu of open and honest dialogue, shared teacher-learner
leadership, critical thinking and ethical analysis.
COURSE OBJECTIVES
KNOWLEDGE
By the end of N303A the student is expected to:
1.
2.
3.
4.
5.
6.
7.
examine the changes in health care in Canada and discuss the issues that arise for nurses,
nursing, health care, and client health;
identify and analyze questions, challenges, and issues internal to health care generally and
the profession of nursing specifically;
identify, analyze, and discuss economic, social, and physical environmental issues related to
the health of individuals, families and communities;
identify and describe legal issues related to the practice of nursing and health care and
Canadian law at both the provincial and national level;
identify, analyze, and discuss ethical issues and dilemmas facing the practising professional
health care practitioner;
examine and discuss the consumer's role in health care decision making.
acquire enhanced leadership skills through gaining a broader view of nursing and health
care issues.
PROCESS
By the end of this course the student is expected to::
5
1.
2.
3.
4.
5.
recognize the complexity of ethical and legal issues related to nursing and health care
build a sound argument and to support a stance on an issue;
identify and use appropriate resources to research current issues;
identify and use an appropriate format and suitable resources for class presentations;
effectively use a collaborative approach in planning group presentations.
EVALUATION
Assessment
1. Individual/Group in class Critical Thinking
Questions/Group Discussion (not APA)
2. Quizzes
3. Ethical Issue Paper
4. Group Presentation (Ethical Case Study Analysis)
Dates
Weeks 2, 3, 4, 5,
7, 8, 9
October 20th
November 17th
October 29th
November17th or
24th
Total
Percentage
10%
25%
25%
15%
25%
100%
Please note that attendance at all N303A course sessions is required.
Students who must miss time due to illness or emergency need to communicate with the course professor by
telephone or e-mail about the reason for their absence.
It is then at the professor’s discretion whether or not marks will be deducted.
GENERAL GUIDELINES FOR WRITTEN ASSIGNMENTS

APA format is required for all written assignments (except course reading reflections).

All written assignments are to be typed and a printed copy given to course professor on due date.

Assignments must be submitted by 5pm on the due dates, except for in-class assignments (individual
reflections and group work) which must be submitted at the end of each class. Exceptions without
penalty may be made in the following situations: (a) when a student is ill, has reported to the Health
Centre or a family physician, and has requested the Health Centre or family physician to advise the
School of Nursing regarding an extension submission for the assignment; or (b) when a student has
consulted with the professor prior to the submission date and has obtained an extension.

Extensions will not be granted unless there are extenuating circumstances.

Late papers and assignments will be penalized 3% per day (including weekends) for a maximum of 5
days. After that date, late assignments will not be marked; however, a late assignment must be
completed and submitted in order to fulfill course requirements.

Please read the assignment requirements carefully and adhere to the limit of 1600 (to an absolute
maximum of 1700) words (excluding title page, table of contents, & references).
1. INDIVIDUAL/ GROUP DISCUSSIONS
(10% of final grade)
PART A: Individual and Group Discussions
Discussion can be seen as an effort by a group of two or more individuals to share views and engage in
mutual and reciprocal critique (Brookfield & Preskill, 2005 p. 6), and differs from conversation or other forms
of group talk as it is concerned with the development of knowledge, understanding or judgement among those
taking part (Bridges, 1988, p. 17). Discussion serves at least four purposes: (1) to help participants reach a
more critically informed understanding about the topic or topics under consideration, (2) to enhance
participants self-awareness and their capacity for self-critique, (3) to foster an appreciation among
participants for the diversity of opinion that invariably emerges when viewpoints are exchanged openly and
honestly, and (4) to act as a catalyst to help people take informed action in the world.
This course has been framed on the following assumptions as supported by Brookflied and Preskill (2005, p
60):
1. That participating in discussion brings the following benefits:
 it helps students explore a diversity of perspectives
 it increases students’ awareness of and tolerance for ambiguity or complexity
 it helps students recognize and investigate their assumptions
 it encourages attentive, respectful listening
 it develops new appreciation for continuing differences
 it increases intellectual agility
 it helps students become connected to a topic to show respect for students’ voices and
experiences
 it helps students learn the processes and habits of democratic discourse
 it affirms students as co-creators of knowledge
 it develops the capacity for the clear communication of ideas and meaning
 it develops habits of collaborative learning
 it increases breadth and makes students more empathic
 it helps students develop skills of synthesis and integration
 it leads to transformation
2. That students attending will have experiences that they can reflect on and analyze in discussion.
3. That the course will focus on the analysis of the student’s experiences and ideas as much as on the analysis
of academic theories.
4. That a regular activity will be small group discussion of experiences and ideas. Thus attendance,
participation, feeling comfortable in open dialogue with classmates on relevant class topics in a small group
environment, and being prepared to analyze your own and other people’s experience is essential.
Students are expected to thoroughly review all assigned readings when preparing for class. During small group
discussion, students will spend time reviewing and analyzing key concepts, assumptions, and arguments put
forth by the various authors. Active participation in these discussions with high quality contributions is
expected, examples of which include:



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

familiarity with the key arguments, concepts, assumptions etc. from the readings, indicated by the
ability to respond to questions and engage in discussion about specific aspects put forth by the various
authors
questions, concerns, comments that reflect critical and original thinking
identification of contradictory points within and across readings
active participation in organized learning activities
active listening skills and respectful responses (verbal and non-verbal) to others’ views
promotion of a respectful, supportive, and relaxed class atmosphere
To ensure that meaningful and productive discussion groups occur, and that everyone has an equal
chance to participate in the group discussion, ground rules or a code of discussion group conduct will be
developed during the first class. As a group, we will decide what the ‘rules or code of conduct’ will be, and we
will use the aggregated results as a guideline throughout the semester. Consideration of the following
dispositions that are viewed as essential for discussion groups should help in the development of class group
discussion ground rules or code of group discussion conduct. These dispositions are: hospitality, participation,
mindfulness, humility, mutuality, deliberation, appreciation, hope and autonomy (Brookfield and Preskill
2005, p. 8).
SUGGESTIONS TO GUIDE REFLECTIVE WRITING FOR GROUP DISCUSSIONS
Remember the purpose of reflection is to challenge your thinking and expand your learning. The following
questions may help you to reflect on your experiences:










1.
2.
What are your reactions to the experience or information?
What is the significance of the experience or information?
How does new information fit in with that you already know?
How does it relate to your practice, beliefs, and previous experiences?
What questions does the new experience/information raise?
What might you be aware of if the situation recurs?
What action might you have been taken?
What could be done to change the outcome now?
How do you feel about your progress/learning?
What else do you need/want to know?
Used with permission
(Aston et al., May 2006)
Complete all readings and write reflective notes that you can refer to when contributing to your
weekly group discussion.
Each group will then submit a summary of the key points that were highlighted during the discussion
session to the course professor along with each individual’s reflective notes. Someone from each
group will need to take notes. Please choose your own format.
2. Quizzes
Two in-class quizzes are scheduled
 approximately 40 Multiple Choice and 2 Short Answer
 each quiz is valued at 25% of final grade (total 50% final grade)
3. ETHICAL ISSUE PAPER
(15% of final grade)
(Please note: paper must be written according to the formatting guidelines of APA 6th edition).
My Sister’s Keeper is a heart wrenching novel written by Jodi Picoult that contains numerous ethical
and legal dilemmas experienced by an American family. Although fictional, the scenarios could also be
experienced by health care professionals and clients that students will work with during their professional
Registered Nursing career. To delve deeper into ethical issues, students will offer a critical review of one
ethical dilemma from the story.
Students will therefore:
 identify and describe an ethical issue by providing a brief summary
 discuss what made it an ethical issue; use professional documents to support your claim
 identify, discuss, and justify all relevant CNA Code of Ethics (2008) values and responsibility
statements which may be reflected in this issue
 conclude with a list of appropriate actions that you would consider implementing to prevent
adverse effects for one or all family members and the health care professionals
Evaluation:
 The assignment is to be complete in 1600 words (to an absolute maximum of 1700)
(excluding title page, table of contents, & references)
 An introduction and conclusion is required. The paper must be well organized, clear, and adhere
to the guidelines offered above. (5%)
 Brief summary of the case (10%)
 Clear identification of an ethical issue (20%)
 Identification, discussion, and justification of all relevant CNA Codes of Ethics values and
responsibility statements (35%)


List of appropriate actions (20%)
References are current (within the past 5 years) and relevant to points being presented. For this
assignment students are expected to incorporate at least 5 scholarly references, with a minimum
of 3 coming from peer reviewed journal articles. Class notes are not an acceptable reference. APA
(10%)
Please note: All articles from the internet must have full reference information (author, title, volume, number
(if applicable), date retrieved and page numbers), and must be from a respected professional journal. See APA
6th edition for guidelines regarding citation of electronic sources. Incomplete citation of electronic references
obtained from the internet will not be accepted as references.
Value: 15% of final grade
4. GROUP PRESENTATION {Ethical Case Analysis}
Due: 5pm, October 31st
(25% of final grade)
The purpose of the group presentation is to provide students with an opportunity to enhance
research, analytical, and critical thinking skills by in-depth examination of ethical/legal aspects of an issue
important to client health, nursing, or health-care delivery. As a professional nurse or health care practitioner,
it is important to understand current nursing and health-care issues and policy decisions that affect the
profession as well as ourselves as persons. In everyday work environments, nurses encounter various ethical
issues. This assignment will support the development of skills for analyzing ethical issues and help students
articulate relationships between theory and practice.
Guidelines for the Presentation:
Preparation
 provide a printed outline of the title of chosen ethical case, list of presenters, learning objectives, a
brief reading list, and 1 peer reviewed article to course professor one week prior to your
presentation.
 on the day of the presentation, provide a printed copy of the group presentation and any other
significant materials to the course professor prior to class time
Content
Identify an ethical issue in the assigned chapter of the book My Sister’s Keeper by Jodi Picoult, and
present it by using case study format. Synthesize and analyze the case by using one of the following ethical
lens to support your analysis; Bioethical Principalism, Utilitarianism, or Virtue Ethics. The following will guide
you in this assignment. .
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

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Analysis is to include:
A discussion of what you see as the key ethical issues in this case study, identifying what ethical lens
you will use to assist in the analysis.
Justification as to why the group chose this particular lens over the other two. List any assumptions or
presuppositions the lens may have and limitations (if any) if one is to choose this particular lens.
Identification and explanation of the values from the Registered Nursing profession that relate to the
ethical issue.
Using your chosen ethical lens, identification of possible ethical responses (recommendations) to this
situation which address the ethical issue(s) in an effort for resolution or prevention of a similar
situation.
Presentation
All presentations are to be done in a professional manner. You will be evaluated on both the content
and presentation style. The class will be divided into small groups. Students will have 25 minutes to present to
the class on their topic. Ensure all presenters participate equally. Presentations may be made in any format or
combination of formats (ie. a skit, home-made video, role play, or debate, etc). After the formal presentation,
there will be at least 5 minutes for questions. A volunteer from the class will act as time keeper. As this is an
issues course, group presentations should reflect the varied perspectives surrounding the subject. Particular
emphasis should be placed on the legal/ethical analysis of the issue, which support your group’s stance
through ethical theories and principles, values, research laws, etc.
GRADING SCHEME
PREPARATION (5%)
 Reading list relevant to topic.
 Copy of reading list provided to course professor and posted on time.
 Readings are identified by full reference information. (journal, volume, number, year, page numbers)
 Presentation material submitted to instructor on time.
CONTENT
(75%)
 Outline of content and purpose presented
 Topic introduced in a clear, succinct manner
Analysis
 Brief description/summary of the issue. Background of the issue presented. Main facts which highlight
the salient points
 Ethical theories, principles, and values are pertinent in this situation with evidence to support
analysis.
 Justification of lens chosen over others ( 2 others).
 Issue considered in terms of current societal events and forces, changing cultural norms, patterns of
health care delivery, and nursing education and practice where relevant
 Assumptions or presuppositions identified
 Possible ethical responses (recommendations) to this situation which address the ethical issue(s) in
an effort for resolution or prevention of a similar situation.
 Organization and clarity
 Theoretical and clinical perspectives on the issues presented in a logical, organized, yet flexible
manner
 Originality and creativity
 Points are well supported.
 Appropriate use of audiovisual aids (clearly read, ability to hold interest, creative, variety in use)
 Stimulated discussion from the audience
 Summary and conclusion are provided
PRESENTATION DELIVERY (20%)
 Introduction to group members
 Active participation by all group members
 Avoidance of repetition
 Appropriate use of time (incorporation of introduction, content, discussion, summary, conclusion, and
questions).
 Presentation remains focussed
 Questions are answered knowledgeably by group members
TOTAL
100%
=
Dates of Group presentations: November 17th and 24th, 2014
/25
References
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Additional Resources and Websites:
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care. . Retrieved from:
http://www.arnpei.ca/default.asp?id=190&pagesize=1&sfield=content.id&search=240&mn=1.68
Association of Registered Nurses of Prince Edward Island (2013). Why should we evaluate the credibility of
websites: Retrieved from:
http://www.arnpei.ca/images/pdf/web%20sites%20CADTH%20HQC%20Poster%20for%20May%
206-7%20STOON-1.pdf
Canadian Nurses Association. (1999). I see and am silent/I see and speak out: The ethical dilemma of
whistle-blowing. Retrieved from:
http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_see_silent_november_1999_e.pdf
Canadian Nurses Association. (2003). Ethical distress in practice environments. Retrieved from:
http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_ethical_distress_oct_2003_e.pdf
Canadian Nurses Association. (2003). Privacy and health information: Challenges for nurses and for the nursing
profession. Retrieved from:
http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_privacy_health_nov_2003_e.pdf
Canadian Nurses Association. (2006). Ethics in practice for registered nurses: Public health nursing
challenges and ethical practices. Retrieved from:
http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_in_practice_jan_06_e.pdf
Canadian Nurses Association. (2006). Social justice... a means to an end, an end in itself. Ottawa
Canadian Nurses Association. (2010). Working with limited resources: Nurses’ moral constraints. Retrieved
from: http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_limited_resources_sept_2000_e.pdf
Canadian Nurses Association. (2008). Position statement; Providing nursing care at the end of life. Retrieved
from: http://cna-aiic.ca/~/media/cna/page-content/pdf-en/ps96_end_of_life_e.pdf
Canadian Nurses Association. Ethics Reading Resources. Available at:
http://cna-aiic.ca/en/on-the-issues/best-nursing/nursing-ethics/ethics-reading-resources
Canadian Nurses Association. Other Resources available at:
http://cna-aiic.ca/en/on-the-issues/best-nursing/nursing-ethics/other-resources