Note: Faculty instructions will be in italics - Olivet Nazarene …web.olivet.edu/~gparzygn/MSN Syllabi Final/NRSG 613 Fi… · Web viewGuido, G. W. (2006). Legal and ethical issues

NRSG 613 9.2009

NRSG 613: Moral and Ethical Decision Making

Master of Science in Nursing

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Spiritual

Personal Professional

Spiritual Growth Mor

Lead

Professional

Life-Long

Change

Personal

Service

ONU Nurse

NRSG 613 9.2009

CONTRIBUTORS

The following individuals contributed to the completion of this course of study:

Susan Day, MSN, RNAssistant Professor of Nursing

Olivet Nazarene University June 2007

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NRSG 613 9.2009

NRSG 613 MORAL AND ETHICAL DECISION MAKING

Statement of Faith “As an educational enterprise of the Church of the Nazarene, we pursue truth in order to glorify the

God and the Father of our Lord Jesus Christ: praying for the coming of the spirit; remembering the

promise of Scripture and tradition; keeping our hearts faithfully attuned to the voice of God; and

being thoughtfully, acutely, and critically engaged.” 2002-2004 Catalog. Bourbonnais, IL: Olivet

Nazarene University.

COURSE DESCRIPTION/OVERVIEW This course provides the opportunity to study family life experiences and the nurses’ role in moral and ethical decision making. Discussions center on recognizing physiological, moral, ethical, and spiritual variance among cultural norms and health care practices in varied racial and ethnic backgrounds. Students will reflect on their personal values as it relates to moral and ethical decision making, the role to serve as change agents for others and implications to professional, spiritual and personal growth.

COURSE LEARNING OUTCOMES Upon completion of this course, the learner will be able to:

1. Apply an ethical decision-making model to ethical dilemmas. 2. Discuss the ANA Code of Ethics and Standards of Nursing Practice as it relates to

decisions of legal and ethics of caring. 3. Investigate legal and regulatory aspects that influence ethical decision making in

contemporary health care practice. 4. Analyze the impact of cultural, social, and economic issues when providing

ethical care for clients. 5. Explore opportunities to empower the nursing profession and clients as a change

agent addressing contemporary health care issues.

COURSE MATERIALS Required Textbooks:

Burkhardt, M. A., & Nathaniel, A. K. (2008). Ethics & issues in contemporary nursing (3rd ed.). Albany, NY: Thomson Delmar Learning.

Guido, G. W. (2006). Legal and ethical issues in nursing (4th ed.). Upper Saddle River, NJ: Prentice Hall.

O’Brien, M.E. (2008). Spirituality in nursing: Standing on holy ground. (3rd ed.). Sudbury, MA: Jones and Bartlett.

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NRSG 613 9.2009

Courses are presented via blackboard through distance delivery. This format will enable participants to complete work in a flexible manner. Textbooks, articles, and access to blackboard will be made available to the learner. Online assignments will include discussion topics, individual assignments, and projects as outlined in the syllabus.

Special Requirements:Internet AccessMicrosoft Office SoftwareCompletion of the Online Blackboard Training Student Classroom is required.

COURSE ASSIGNMENTS/ASSESSMENTS

The learning outcomes will be fostered and assessed in a variety of ways. As best practice suggests, assessment will be formative and summative and will include the application of acquired course knowledge to real world practice settings. This course will include the following:

WEEKLY DISCUSSION POSTINGSWRITTEN ASSIGNMENTSCUMULATIVE PORTFOLIO

Assignments Points

Discussion Postings 6 @ 5 points 30

Assignment I: Applying an Ethical Decision Making Model

DUE WEEK 3 DAY 7

1 @ 30 points 30

Assignment II: The Change Agent

DUE WEEK 5 DAY 7

1 @ 30 points 30

Assignment III: PowerPoint Presentation

DUE WEEK 6 DAY 7

1 @ 10 points 10

TOTAL COURSE POINTS 100

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NRSG 613 9.2009

WEEKLY WORKSHOP TOPICS

WEEK 1: PROFESSIONAL AND PERSONAL VALUES AS IT RELATES TO ETHICAL THEORIES, PRINCIPLES, ANA “CODE OF ETHICS FOR NURSES”, AND STANDARDS OF PRACTICE

WEEK 2: ETHICAL DILEMMAS AND ETHICAL DECISION MAKING MODELS

WEEK 3: NURSING LEGAL ISSUES AND IMPLICATIONSWEEK 4: CULTURAL, ECONOMIC, AND SPIRITUALCONSIDERATIONS

FOR ETHICAL NURSING PRACTICEWEEK 5: NURSING ISSUES AND PROFESSIONALISMWEEK 6: THE CHANGE AGENT

ATTENDANCE PARTICIPATION

Students are required to participate in class at least three different days each week. Your initial posting is NOT a RESPONSE to classmates. Both the quantity and quality of participation are evaluated. In courses where there are team/group activities, those discussions are NOT counted as part of the discussion postings. In addition to participation, the discussion rubric provides further details on possible points according to quality of posting.

Student Participation Courses are not to be considered independent study courses. Instead courses are considered to be essential shared learning communities. Therefore, it is imperative that students participate with substantive and timely postings to the online discussion board as outlined in the course syllabus. Failure to post the expected frequency and quality will result in grade reduction for the discussion. Students are not allowed to post ahead in any week. If a student posts ahead, faculty will delete the post.

Faculty ParticipationFaculty is expected to facilitate student personal, professional, and spiritual growth through guided responses which provide critical insight, stimulate new ideas, or raise awareness. Faculty is required to be accessible to the student which is demonstrated through visibility and quality feedback on discussions and submitted assignments. It is reasonable for students to expect the faculty will be online at least once per day and to be reasonably accessible to students by providing contact information in their biography link. Students are required to utilize the Olivet email address when communicating. The use of personal email addresses is not allowed. Faculty are to return the student assignments within 7 days of due date. The returned assignment should reflect appropriate comments using the course grading rubric. Further, the student can expect the faculty will provide comments that facilitate personal and professional development in the academic setting. Faculty is expected to respond to questioning and student emails within 48 hours except on holidays and weekends. If the response requires additional time the faculty should communicate this to the student.

Student Attendance

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NRSG 613 9.2009

Students are expected to communicate directly with the course instructor regarding any circumstance that may result in absence of course participation. Course participation is met through discussion postings and submission of assignments by the required due date.

School of Graduate and Continuing Studies – Attendance Policy

One absence (and only one) may be excused without the grade being affected provided make-up work is satisfactory completed:

o The learner must contact the instructor.o The absence must be the result of unavoidable circumstances.o Make-up work is satisfactory completed before the start of the following

workshop.

If the first absence is unexcused, the following scale will be used for grade reduction:o For courses with 7, 8, or 9 workshops/sessions:

1st absence will result in a final course grade no higher than a “B” 2nd absence will result in a final course grade no higher than a “C” 3rd absence will result in a final course grade of “F”

o For courses with 4, 5, or 6 workshops/sessions: 1st absence will result in a final course grade no higher than a “C” 2nd absence will result in a final course grade of “F”)

All subsequent absences (if first absence is excused) will result in an automatic grade reduction.

The number of absences relative to grade reduction will reflect number of workshops in the course (assuming one absence is excused based on the approved criteria listed above):

o For courses with 7, 8, or 9 workshops/sessions: 2nd absence will result in a final course grade no higher than a “B” 3rd absence will result in a final course grade no higher than a “C” 4th absence will result in a final course grade of “F”

o For courses with 4, 5, or 6 workshops/sessions: 2nd absence will result in a final course grade no higher than a “C” 3rd absence will result in a final course grade of “F”

o For courses with 2 or 3 workshops/sessions An alternative cohort must be found so learner can attend the course in

total

Grades will be monitored with final attendance. Grades must reflect absence – no exceptions. If the first absence is not excused or the learner does not complete the necessary make-up

work, the grade will be reduced beginning with the first absence.

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NRSG 613 9.2009

Instructors will address tardiness on an individual basis. Learners are expected to arrive for class on time and remain for the entire four hour period.

Attendance – Online Courses Learners in online courses must post at least one, substantive online message per course

week to be considered in attendance. Failure to log in and post at least once per week will result in an absence. Participation is not the same as attendance. Participation requirements are determined by

the instructor and will be thoroughly explained in the course syllabus.

Absence is defined as not fulfilling any of the above requirements. Due to the nature of some discussions, instructors may not allow students to post in advance or in retrospect to discussions due to absences.

EVALUATION PROCEDURE AND GRADING SYSTEM95 – 100 A92 – 94.9 A-89 – 91.9 B+86 – 88.9 B 83 – 85.9 B-80 – 82.9 C+77 – 79.9 C_____________________________________74 – 76.9 C- Non-passing scores 71 – 73.9 D+68 – 70.9 D65 – 67.9 D-

The student will receive credit for the assignments in the following ways:

ASSIGNMENTSPoints will be given based on the assignment and the Rubric provided. Each week the course guide will provide the student with the required assignment. The grading rubric for the assignment should be utilized by the learner as a guide for formulating written objectives. Faculty will add the grading rubric, their comments, and final points received for each student when returning student assignments. A student with an unexcused absence will receive an automatic 50% grade reduction for any assignment submitted during that week.

DISCUSSIONSParticipation points will be given based on the Discussion Posting Requirements and the Rubric provided. See the link for grading Rubric. To ensure all members of the learning community have sufficient time to respond to discussions, you are expected to adhere to the following guide for discussion posting:

Post your initial activity no later than the third day of each week by 11:59 p.m. Respond to three of your colleagues’ initial postings during each week on three different

days.

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NRSG 613 9.2009

Provide colleagues with reflective thoughts, personal experience, resources, or general thoughts regarding their insight to the activity or topic.

Posting after the required date will result in a grade reduction as stated in the rubric.

Each week the student will respond to the discussion objective as directed. The discussion posting is a large part of learning in an online environment. The grading for discussion activities is outlined in the course grading rubric. Students are required to support their discussions with citations, write using APA format and provide a reference list at the bottom of their posting.

LATE WORK POLICYNo late papers/assignments will be accepted after the date and time stated in the syllabus or otherwise stated by the professor. In extreme circumstances exceptions may be made (i.e. illness). However, this must be agreed upon by the student and professor prior to the due date.

INCOMPLETE GRADESStudents are given an incomplete for a course at the discretion of the instructor and the Associate Director of Nursing. Normally this is granted for a period of no more than one week beyond the end of a course. The student must have 85% of the course work completed. No opportunity is offered to make up any missing discussion postings. Points for discussion activities are provided according to the rubric.

POLICIES ON PLAGIARISMPlagiarism is defined as use of intellectual material produced by another person without acknowledging its course. For example:

Wholesale copying of passages from works of others into an assignment, paper, posting, or thesis without acknowledgement.

Using the views, opinions, or insights of another without acknowledgement. Paraphrasing another person’s characteristic or original phraseology, metaphor, or other

literary device without acknowledgment. Faculty will monitor for evidence of plagiarism. All work must be submitted through the

correct blackboard process to be assessed for evidence of plagiarism. Self-plagiarism is the use of the learner’s work from a previous class and is highly

discouraged. Should the learner’s previous work be used, it must be cited as such.

For further information on Olivet Nazarene University Conduct and Responsibilities see the Catalog at the course link (ONU Bulletin).

Students suspected of plagiarism require faculty to contact the Chair, Director of Nursing Department at ONU directly.

Disability Support ServicesIt is the policy of Olivet Nazarene University to accommodate students with disabilities in accordance with federal and state laws. Any student with a disability who needs accommodation, for example in arranging seating, extended time for examinations, tutors or note-takers, should present faculty teaching courses where accommodation is appropriate a

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NRSG 613 9.2009

Notice of Approval for Accommodation from the Learning Development Center. If you, as a student with a disability, have difficulty accessing any part of the course materials or activities for this class, please notify the instructor immediately. Accommodations for test-taking must be arranged at least 5 business days in advance. All students seeking test accommodations must take their exams in the Learning Development Center. Students may apply for accommodations or services by clicking on the Learning Center Services link on the main page of Blackboard.

COURSE FORMATThe following is an overview of the course format with a description of each area found in the classroom environment. The course consists of 6 weeks. Each week contains activities and assignments that will enhance learners’ understanding of the topic. The activities and the assignments are sequential and therefore it is important the student follow the weekly sequence as outlined through the course.

OVERVIEW WEEK 1

Personal values and morals are formed over time with life experiences and development (Guido, 2006, p. 2). When nurses enter the profession, there is an expectation to uphold legal standards of care and practice as well as ethical codes of practice to provide the best quality of care. Professional resources, such as the American Nurses Association (ANA) Code of Ethics for Nurses (2001), offer nurses a framework to guide ethical decisions and obligations. As we discuss ethical and legal aspects of care, it is important to first assess our own personal values then discuss the integration of values with professional ethics of care and standards of practice. Included in this exploration of personal values is spirituality and caring, an important component to develop the Nurse-Patient relationship (O’Brien, 2004).

RESOURCES WEEK 1

Devotion

READING ASSIGNMENT WEEK 1


Chapter 2 - “Ethical Theory”Chapter 3 - “Ethical Principles”Chapter 4 - “Values Clarification”Chapter 5 - “Developing Values”Appendix A - “American Nurses Association: Code for Nurses with Interpretive Statements”Appendix B - “American Hospital Association: A Patient’s Bill of Rights”

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http://rss.olivet.edu/display_podcast.php?fd_id=2

NRSG 613 9.2009


Chapter 1 - “Ethics”


Chapter 5 - “The Nurse-Patient Relationship: A Sacred Covenant”

WEBSITES WEEK 1

American Journal of Bioethicshttp://www.bioethics.net/beta.php

American Nurses Association Bill of Rights for Registered Nurseshttp://www.nursingworld.org/tan/novdec02/rights.htm

American Nurses Association Code of Ethics for Nurses with Interpretive Statementshttp://nursingworld.org/ethics/ecode.htm

American Nurses Association Code of Ethicshttp://nursingworld.org/ethics/

Canadian Nursing Ethics with International Perspectiveshttp://www.nursingethics.ca/

International Council of Nurses Code of Ethicshttp://www.icn.ch/icncode.pdf

OTHER RESOURCES WEEK 1

JOURNAL ARTICLES

Lindh, I. B., Severinsson, E., Berg, A. (2007). Moral responsibility: A relational way of being. [Electronic version]. Nursing Ethics, 14(2), 129-140.

Mylott, L. (2005). The ethical dimension of the nurse’s role in practice [Electronic version]. Journal of Hospice and Palliative Nursing, 7, 113- 118.

Varcoe, C., Doane, G. D., Rodney, P., Storch. J. L., Mahoney, K., et al. (2004). Ethical practice in nursing: Working in-betweens [Electronic version]. Journal of Advanced Nursing 45(3), 316-325.

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http://www.icn.ch/icncode.pdf

http://www.nursingethics.ca/

http://nursingworld.org/ethics/

http://nursingworld.org/ethics/ecode.htm

http://www.nursingworld.org/tan/novdec02/rights.htm

http://www.bioethics.net/beta.php

NRSG 613 9.2009

Week 1 PowerPoints Lecture - click on folder to view

Burkhardt & Nathaniel (2008)

Chapter 1 - “Social, Philosophical, and Other Historical Forcing Influencing the Development of Nursing” An Overview of the Historical Perspectives of the Development of Nursing

Chapter 2 - “Ethical Theory”A great summary of theories of ethics.

Chapter 3 - “Ethical Principles”Review the Ethical Principle Terms and then reflect on the “Think About It” slides.

Chapter 4 - “Values Clarification”Review the slides and then read the class discussion scenario. Gather a group of classmates and chat in the chat room about the questions that follow the scenario.

Chapter 5 - “Values Development”Review all slides then reflect on slide 16 questions.


Guido (2006)

Chapter 1 - “Ethics”Slides 1-15 discuss ethical theory, principles, and the difference between law and ethics.

DISCUSSION ACTIVITY WEEK 1

In preparation for this posting discussion activity, read the following Case Presentation from Burkhardt & Nathaniel (2002). Consider questions posed as you prepare to present your responses to the discussion board. Tip: Remember APA and citations to support your thoughts.

Reba’s eighty-two-year-old father has been hospitalized with a stroke that has left him severely incapacitated, requiring total care. She has been informed that her father is ready for discharge, and the physician is suggesting that he go to a nursing home. Reba feels that she should take him home with her because her faith says to care for her parents, but the house is small and would need a bathroom added to the first floor. She also has concerns about performing her father‘s care because she works full time and has three small children. She has

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NRSG 613 9.2009

considered quitting her job, but the family needs her income because her husband’s work is seasonal. When visiting her father, she tell the nurse Moira, that she does not know what is best for him, noting that her sister in another state told her it is her duty to care for their father, but her husband says it is too much to take on with all her other family responsibilities. She asks Moira what she should do (p. 89).

1. Reflect on your initial reaction to this scenario. 2. Describe the essential ethical principles in the scenario that are important to

consider. 3. Analyze the scenario. Which values development theory best depicts Reba’s

current time in her life? Make sure to support your answer. 4. Place yourself in Moira’s position. How would you respond to this situation

based on your personal and professional values? Identify your values as you formulate your response.

5. Identify the ethical theory utilized in your response to this scenario. Explain why you chose the ethical theory.

6. Discuss your ethically bound role as a nurse caring for the client in this situation. Support your response with a Tenet(s) from the ANA Code of Ethics.

7. Compare and contrast your initial reaction with your response to the scenario based on the knowledge you have gained regarding ethical theories, principles, and obligations.

8. Post your assignment to the discussion on the board.9. Read all of your colleagues’ postings.

10. Respond to at least three of your colleagues’ initial postings.

* Be sure to support your posting with citations from this week’s readings. Refer to APA Publication Manual to assure your citations in the text and reference list are correct.

ASSIGNMENT WEEK 1

Note: This assignment will be due at the end of Week 3 no later than 11:59 p.m. CST submitted as directed through blackboard features.

“Understanding one’s ethics and values is the first step in understanding the ethics and values of others and in assuring the delivery of appropriate nursing care.” (Guido, 2006, p. 2). This assignment will allow you to take time to assess your personal and professional values while beginning to evaluate how your personal values fit into your professional practice.

Moral Distress is defined as “… the reaction to a situation in which there are moral problems that seem to have clear solutions, yet we are unable to follow our moral beliefs” (Burkhardt & Nathaniel, 2002). Nurses may experience moral distress when faced with restrictions in the work environment. Institutional limitations, financial constraints, and other restrictions may lead to moral distress when the restrictions interfere with the quality of care the client receives. Ethical

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NRSG 613 9.2009

decision making models allow nurses to process situations and develop options, based on all the factors, allowing a decision for the safety of all involved.

Preparation: 1. Complete the reading assignment and journal readings for Weeks 1 & 2. 2. Reflect on your personal values and morals. How do you think your values

developed? 3. Consider how your values influence your professional decision making. 4. Recall a nursing experience when you were faced with an ethical dilemma. 5. Identify the feelings that you experienced during this time. 6. Review the ethical decision models found in Week 2 resources. 7. Choose an ethical decision making model you feel comfortable using. 8. In a 6-9 page paper (including title page and reference page):

a. Briefly summarize a nursing experience when you were faced with an ethical dilemma. For confidentiality reasons, please do not use names.

b. Discuss any feelings or moral distress you experienced during this dilemma.

c. Apply an ethical decision making model to the experience. Provide rationales for each step of the model and support with resources. Make sure to include all the necessary team players as well as any actions you may need to follow up.

d. Explain the nurse-patient relationship as discussed by O’Brien (2004). How do you include your spirituality in the ethical care of clients?

e. Compare and contrast your initial outcome to the conclusion developed when applying the ethical decision making model. Discuss any differences or consistency.

f. Describe your role as an advocate in this situation.

OVERVIEW WEEK 2

Nurses make decisions on a daily basis. Whether confronted with staffing issues or critical end of life issues, it is the nurse’s responsibility to make sure clients have the best outcome for each situation. Nurses must take in to account all factors when faced with ethical dilemmas. These decisions are guided by personal and professional values as well as by legal standards of practice and professional codes of ethics. This week we will discuss ethical decision making models as a means to process ethical dilemmas. Moral Distress, a situation in which nurses are compelled to follow through with standards such as practice standards or institutional policies while faced with conflicting personal moral values and beliefs (Burkhardt & Nathaniel, 2002), is also discussed this week.

RESOURCES WEEK 2

Devotion

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NRSG 613 9.2009



Chapter 6 - “Ethical Decision Making”


Chapter 1 - “Ethics”Chapter 4 - “Standards of Care”Chapter 10 - “Nurse Practice Acts, Licensure, and the Scope of Practice”

WEBSITES WEEK 2

Association of Academic Health Centers: A Framework for Resolving Ethical Dilemmas in Healthcarehttp://learn.gwumc.edu/hscidist/LearningObjects/EthicalDecisionMaking/frameworkexplore.htm

International Association for Hospice and Palliative Carehttp://www.hospicecare.com/Ethics/monthlypiece/eithics2004/pom_oct04.htm

KUMC: MORAL Model for Ethical Decision Making http://classes.kumc.edu/son/nrsg748/EthicalTheories.htm


JOURNAL ARTICLES

Erlen, J. A. (2006). Genetic testing and counseling: Selected ethical issues [Electronic version]. Orthopaedic Nursing, 25(6), 423-426.

Mathes, M. (2004). Ethical decision making and nursing [Electronic version]. MEDSURG Nursing, 13 (6), 492-431.

Zuzelo, P. R. (2007). Exploring the moral distress of registered nurses [Electronic version]. Nursing Ethics, 14(3), 344-359.



Chapter 6 - “Ethical Decision Making”

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http://classes.kumc.edu/son/nrsg748/EthicalTheories.htm

http://www.hospicecare.com/Ethics/monthlypiece/eithics2004/pom_oct04.htm

http://learn.gwumc.edu/hscidist/LearningObjects/EthicalDecisionMaking/frameworkexplore.htm

NRSG 613 9.2009

Review the slides and stop to reflect on the “Think About It” scenarios. What would you do in those situations? How would you process the information to provide the best outcome for your client?


Guido (2006)

Chapter 1 - “Ethics”Slides 1-15 review ethical theory, principles, and the difference between law and ethics. Slides 16-21 discuss the MORAL model of ethical decision making and the value of ethical committees when faced with an ethical decision.

Chapter 4 - “Standards of Care”The presentation outlines the importance of Standards of Care.

Chapter 10 - “Nurse Practice Acts, Licensure, and the Scope of Practice”


In preparation for this week’s discussion activity choose one of the following case scenarios and post your discussion by considering the following:

1. Identify your initial reaction toward your selected scenario.2. Describe the ethical principles and dynamics present in the scenario.3. Apply the MORAL decision making model (as cited by Guido, 2006) to the

selected scenario. Make sure to include all the necessary components of the model and support your statements. Also include any necessary follow up actions.

4. Identify any obstacles you may experience. 5. Compare and contrast your initial reaction to that of the conclusion based on your

application of the MORAL decision making model. 6. Post your discussion for this week.7. Read all of your colleagues’ postings. 8. Respond to at least three of your colleagues’ initial postings.


Sumiko is the home health nurse for Mrs. B. Her patient is an eighty-nine-year-old widow who lives in the home that she and her husband shared until his death five years earlier. She suffers from severe rheumatoid arthritis and has a new colostomy. The colostomy was performed as a last resort for severe ulcerative colitis. Mrs. B. is unable to care for herself because of the advanced state of her arthritis. Her daughter, son-in-law, and two teenage grandchildren moved into her

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NRSG 613 9.2009

home to take care of her daily needs. After many months, the family feels that caring for the elderly woman has become an unbearable burden. They ask Sumiko to help arrange long-term care in a local nursing home. Mrs. B. wants to continue to live in her home (p.33).

Cora is a forty-five-year-old woman who looks years older than her stated age. She has very limited monthly income and no health insurance. Cora smokes two and one-half packs of cigarettes per day. She has severe COPD with constant dyspnea and frequent exacerbations. The nurse who sees her at a local free clinic is interested in at least preventing further problems, and speaks to Cora often about the importance of quitting smoking. The situation becomes very frustrating for all involved when Cora returns repeatedly for increasingly severe problems, having failed to quit smoking. Cora, of course, becomes labeled as noncompliant. During a particularly severe exacerbation, the nurse says to Cora, “You know you are committing suicide by continuing to smoke.” Cora’s reply is, “You don’t understand. I live alone I have no money, no friends, no family, and will never be able to work. I know the damage I’m doing, but smoking is the only pleasure I have in life (Nathaniel, 2000) (p. 44).

Maggie is a nurse employed in the newborn nursery of a small hospital. She is working toward completing her bachelor’s degree and has an important exam at 4:30 p.m. Though she is scheduled to leave work at 3:00 p.m., by 4:00 p.m. the nurse from the next shift has not yet arrived. There is an LPN who is capable of caring for the newborns, but hospital policy requires the presence of an RN in the unit at all times. The supervisor is unable to give her any assistance. All the babies are quiet; she expects the evening shift RN to arrive soon and feels the LPN can handle the nursery for a short time. Maggie is torn between honoring her duty to patients versus leaving to take her exam (p. 160).

ASSIGNMENT WEEK 2

Continue to work on Assignment I - there is no new assignment.

OVERVIEW WEEK 3

Nursing practice is guided not only by ethical codes, but standards of care and practice that provide rules and regulations for the standard of nursing performance. Laws, policies, and procedures also guide the nursing practice within the scope and practice to protect clients, nurses, organizations, and society as a whole. This week legal concepts, the legal system, and liability issues will be explored as they relate to the legal practice of nursing and ethical care of clients.

RESOURCES WEEK 3

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NRSG 613 9.2009

Devotion



Chapter 7 - “Legal Issues”


Chapter 2 - “Legal Concepts and the Judicial Process”Chapter 5 - “Tort Law”Chapter 6 - “Nursing Liability: Defenses” Good Samaritan Law (pp. 118-120)

WEBSITES WEEK 3

http://www.taana.orgThe American Association of Nurse Attorneys

http://news.findlaw.com/FindLaw Legal News and Commentary

http://medi-smart.com/lawtypes.htmMedi-Smart: Types of Laws Affecting Nursing Practice

http://ncsbn.org/National Council of State Boards of Nursing

http://www.hhs.gov/ocr/hipaa/U.S. Department of Health and Human Services Office of Civil Rights-HIPPA

http://www.washlaw.edu/Washburn University School of Law Legal Research on the Web




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http://www.washlaw.edu/

http://www.hhs.gov/ocr/hipaa/

http://ncsbn.org/

http://medi-smart.com/lawtypes.htm

http://news.findlaw.com/

http://www.taana.org/


NRSG 613 9.2009

Chapter 7 - “Legal Issues”Reviews the types of laws and malpractice in nursing practice.


Guido (2006)

Chapter 2 - “Legal Concepts and the Judicial Process”

Chapter 5 - “Tort Law”

Chapter 6 - “Nursing Liability: Defenses” Good Samaritan Law (pp. 118-120)


In preparation for this week’s discussion activity:1. Browse the current news or legal cases that involve a legal and ethical medical concern. 2. Select one case of interest. 3. Discuss your initial reaction to this case. 4. Investigate at least 3 resources relevant to the case. Examples: State Nursing Practice

Acts, Scope and Practice, Institutional Policies and Procedures, and Laws. 5. Briefly summarize the case.6. Identify the type of law and ethical concern you think is relevant to this case. For

example: Quasi-Intentional Tort. 7. Discuss whether the health care provider acted within the boundaries of ethical care,

standards of care and practice, and legal boundaries. Make sure to support your answer. 8. Compare or contrast your initial thoughts about this case to your thought about the case

after you have analyzed your resources for example, standards of practice and legal nursing practices in your state.

9. Post your discussion for this week.10. Read all of your colleagues’ postings. 11. Respond to at least three of your colleagues’ initial postings.


ASSIGNMENT WEEK 3Assignment: Ethical Decision Making is due by Day 7 of this week.

Assignment IINote: This assignment will be due at the end of Week 5 submitted as directed through blackboard features.

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NRSG 613 9.2009

In planning ahead for this assignment you will read the assigned text materials and review the available resources during Week 4 & 5.

1. Investigate nursing issues in your state, institution, or community. 2. Examine the problem.3. In a 6-8 page paper (including title page and reference page)

a. Review your state nurses association, community, or work environment. b. Choose one professional nursing issue raised by the organization, community,

or institution that you have experienced in your nursing career or an issue of interest to you.

Examples (You may choose an issue not on this list):i. Advance Directives

ii. Assisted Suicideiii. Complementary Therapiesiv. Futile Carev. Health Insurance Portability Accountability (HIPPA)

vi. Gender Stereotyping in Nursingvii. Stem Cell Research

viii. Universal Health Careix. Unlicensed Personnel Administering Medications x. Lateral Workplace Violence/Violence against Nurses.

c. Summarize the issue. d. Discuss the pros or cons of the issue and how it affects the practice of nursing. e. Analyze the influence of the issue on your nursing practice and the ethics of

care or legality of health care decisions. f. Explain your role as a leader and advocate striving for change toward legal

and ethical care of clients and improving the profession of nursing.

OVERVIEW WEEK 4

Cultural, economic, social, and spiritual issues are imperative to consider throughout nursing practice. These considerations challenge health care providers, creating conflict of values based on assumptions due to different cultural, social, and spiritual perspectives. When ethical challenges occur, health care providers must explore different perspectives for positive health care outcomes (Burkhardt & Nathaniel, 2002). As you read the assignments for this week, consider cultural, economic, social, or spiritual issues you have experienced in your nursing career and consider the ethical implications.

RESOURCES WEEK 4

Devotion


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NRSG 613 9.2009


Chapter 15 - “Economic Issues” Chapter 16 - “Social Issues”Chapter 18 - “Transcultural and Spiritual Issues”

WEBSITES WEEK 4

http://bioethics.georgetown.edu/Georgetown University: Kennedy Institute of Ethics Library and Information Services

http://www.bc.edu/bc_org/avp/son/ethics/Nursing Ethics at Boston College William F. Connell School of NursingNursing Ethic Links

http://www.nursingworld.org/ojin/ethicol/ethics_4.htmOnline Journals of Issues in Nursing

http://www.culturaldiversity.org/Transcultural Nursing


JOURNAL ARTICLES

Davis, A. J. (1999). Global influence of American nursing: Some ethical issues. Nursing Ethics, 6(2), 118-125.

Hayes, C. (2004). Ethics in end-of-life care [Electronic version]. Journal of Hospice & Palliative Nursing, 6(1), 36-43.

Winslow, G. R., & Winslow, B. W. (2003). Examining the ethics of praying with patients. Holistic Nursing Practice, 17(4), 170-177.



Chapter 15 - “Economic Issues” Review the economical theories and health care cost. Consider the economical problems in your work environment and how the problems influence or do not influence patient care.

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http://www.culturaldiversity.org/

http://www.nursingworld.org/ojin/ethicol/ethics_4.htm

http://www.bc.edu/bc_org/avp/son/ethics/

http://bioethics.georgetown.edu/

NRSG 613 9.2009

Chapter 16 - “Social Issues”Review the slides and then read the class discussion scenario. Gather a group of classmates and chat in the chat room about the questions that follow the scenario.

Chapter 18 - “Transcultural and Spiritual Issues”Review the slides and then read the class discussion scenario. Gather a group of classmates and chat in the chat room about the questions that follow the scenario.


In preparation for the activity:1. Complete the reading and review the resources listed for this week. 2. Peruse the following scenarios.3. Choose one scenario and answer the questions that follow. 4. Identify your initial reaction your selected scenario.5. Describe the issue evident in your selected scenario.6. Discuss how the issue affects health care for the client and the profession of

nursing. 7. Analyze how the issue may influence health as well as health care decisions both

ethically and legally.8. Place yourself in the scenario you have selected. How would you respond to the

situation?9. Explain your role as an advocate. 10. Compare and contrast your initial reaction after analyzing the scenario.11. Post your discussion for this week.12. Read all of your colleagues’ postings. 13. Respond to at least three of your colleagues’ initial postings.


Scenario A: There was a recent court case in which a middle-aged indigent woman, who suffered from insulin-dependent diabetes mellitus, demanded that Medicaid pay for a pancreas transplant. This patient was reported to be uncooperative in her previous diabetic regiment and disliked giving herself insulin injections. Even though Medicaid in that state has a fiscal policy that denies payment for this surgery to all program recipients, the state supreme court ruled that this woman had a right to the surgery because other people with insurance or adequate funds have access to the surgery. The decision was based on the principle of nondiscrimination. (p. 293)

Scenario B: Mr. Chang is a sixty-five-year-old widower with chronic kidney disease. He is supposed to receive dialysis three times a week but frequently misses his appointments due to no transportation or not feeling well. His only hope for a cure is a kidney transplant, which Mr. Chang really wants. Mr. Chang

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NRSG 613 9.2009

is very frail with many health problems. He lives alone is a small garage apartment. The landlord is threatening to evict Mr. Chang because he is behind in his rent payments. Mr. Chang lives on a small pension and Medicare. His prescription costs are excessive.A home health nurse used to transport Mr. Chang to dialysis occasionally, as Mr. Chang lives outside the township limits and is unable to access public transportation services. The clinic, which does not believe Mr. Chang is a candidate for a transplant, has revised their policies regarding home visits due to changes in reimbursement mechanisms. The home health nurse can no longer visit Mr. Chang unless there is a reimbursable need such as a dressing change; and for liability reasons, she can no longer transport Mr. Chang to dialysis (p. 311).

Scenario C: Brenda White is a home health nurse caring for seventy-two-year-old Mrs. Cortez, who is living with her daughter and family while recovering from a stroke. Part of the care involves working with the patient on coordination and strengthening exercises. Brenda has found Mrs. Cortez to be very cooperative and uncomplaining in doing the exercises under her direction, indicating that she would do what was needed to get well. One day Brenda’s supervisor, Maria Lopez, tells her that the agency has received a complaint from Mrs. Cortez’s family that Brenda is being too rough on the patient. Brenda responds that she does not understand this, because Mrs. Cortez has never complained. Brenda further explains that she was trying to have the patient work to her maximum capability and to give her instructions in a clear and direct manner. Ms. Lopez says that in her culture elders are considered very precious and are treated with gentleness and respect. Perhaps the family perceived that Brenda’s direct ways indicated disrespect for their mother, even though the patient did not indicate this (p. 343).

ASSIGNMENT WEEK 4

Continue to work on Assignment II - there is no new assignment.

OVERVIEW WEEK 5

Professional nursing issues are evident in the media, nursing organizations, and medical institutions. Nursing organizations develop position statements, institutions develop policies and procedures, and federal and state lawmakers develop laws such as mandated regulations on nurse to patient ratio. These steps are taken to protect the public’s best issues. As you read the assignments for this week you will notice issues that will be brought forth for discussion that not only affect the contemporary healthcare system, but the ethical and legal challenges for nurses. During your reading, consider these issues in your nursing profession or issues that affect your nursing practice. Reflect on the nurse’s role and responsibility to advocate for policy change at the local level and beyond.

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NRSG 613 9.2009

RESOURCES WEEK 5

Devotion



Chapter 8 - “Professional Issues”Chapter 9 - “Professional Relationship Issues”Chapter 10 - “Practice Issues Related to Technology” Chapter 11 - “Practice Issues Related to Patient Self-Determination”Chapter 12 - “Scholarship Issues”Chapter 13 - “Global Consciousness in the 21st Century”Chapter 14 - “Health Policy Issues” Chapter 17 - “Gender Issues

WEBSITES WEEK 5

http://www.agingwithdignity.orgAging with Dignity

http://www.acog.org/from_home/publications/ethics/ethics060.pdfThe American College of Obstetricians and Gynecologists: Committee of Opinion

http://www.ama-assn.org/ama/pub/category/8390.html American Medical Association

http://4women.gov/violence/index.cfm4 Women: Violence Against Women

http://www.aamn.orgAmerican Assembly for Men in Nursinghttp://nursingworld.org/readroom/position/American Nursing Association Position Statements

http://www.nursingworld.org/rnindex/gov.htmAmerican Nurses Association: Nursing Links to Governmental Resources

http://www.bioethics.od.nih.govBioethics

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http://www.bioethics.od.nih.gov/

http://www.nursingworld.org/rnindex/gov.htm

http://nursingworld.org/readroom/position/

http://www.aamn.org/

http://4women.gov/violence/index.cfm

http://www.ama-assn.org/ama/pub/category/8390.html

http://www.acog.org/from_home/publications/ethics/ethics060.pdf

http://www.agingwithdignity.org/


NRSG 613 9.2009

http://www.cms.hhs.gov/Center for Medicaid and Medicare

http://www.partnershipforcaring.orgChoice in Dying

http://www.eeoc.gov/U.S. Equal Employment Opportunity Commission

http://bioethics.georgetown.edu/Georgetown University: Kennedy Institute of EthicsLibrary and Information Services

http://www.illinoisnurses.com/Illinois Nurses Association

http://www.csg.org/policy/health/default.aspxNational Conference of State Government, Health Policy Issues

www.nighcommunities.orgNightingale Initiative for Global Health

http://www.theworkinggroup.org/niotresources.htmlNot In Our Town: Working Group Against Hate

http://www.bc.edu/bc_org/avp/son/ethics/Nursing Ethics at Boston College William F. Connell School of NursingNursing Ethic Links

http://www.eldis.org/healthsystems/poverty/index.htmPoverty and Health

http://tie.telemed.org/telemed101/policy_links.aspTelemedicine Information Exchange

www.tcn.orgTranscultural Nursing Society

http://depts.washington.edu/bioethx/topics/futil.html University of Washington School of MedicineEthics in Medicinehttp://www.yourdoctorinthefamily.com/grandtheory/section7_9.htm Your Doctor in the Family.Com


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http://www.yourdoctorinthefamily.com/grandtheory/section7_9.htm

http://depts.washington.edu/bioethx/topics/futil.html

http://www.tcn.org/

http://tie.telemed.org/telemed101/policy_links.asp

http://www.eldis.org/healthsystems/poverty/index.htm

http://www.bc.edu/bc_org/avp/son/ethics/

http://www.theworkinggroup.org/niotresources.html

http://www.nighcommunities.org/

http://www.csg.org/policy/health/default.aspx

http://www.illinoisnurses.com/

http://bioethics.georgetown.edu/

http://www.eeoc.gov/

http://www.partnershipforcaring.org/

http://www.cms.hhs.gov/

NRSG 613 9.2009

JOURNAL ARTICLES

Aroskar. M. A., Moldow, D. G., & Good, C. M. (2004). Nurses’ voices: Policy, practice, and ethics [Electronic version]. Nursing Ethics, 11(3), 266-276.




Chapter 8 - “Professional Issues”Chapter 9 - “Professional Relationship Issues”Chapter 10 - “Practice Issues Related to Technology” Chapter 11 - “Practice Issues Related to Patient Self-Determination”Chapter 12 - “Scholarship Issues”Chapter 13 - “Global Consciousness in the 21st Century”Chapter 14 - “Health Policy Issues” Chapter 17 - “Gender Issues”

Review all the PowerPoint presentations and read the class discussion scenarios. Gather a group of classmates; choose one section of interest in particular. Read the class discussion or the slide titled discussion and chat in the chat room about the questions that follow the scenario.


In preparation for the activity:1. Complete the readings assigned for week 5. 2. Select one of the issues discussed in Chapters 9-14, 17 (Burkhardt & Nathaniel, 2008). 3. Summarize a personal experience related to the selected issue. If you do not have

personal experiences to share you may select a Case Presentation from the appropriate chapter or a Class Discussion scenario from the PowerPoint Slides.

4. Discuss the ethical and/or legal issues present in your experience. 5. Research a professional nursing organization (ANA, INA) position on the issue. 6. Assess your reaction to the position statement of the organization. 7. Explain if the position statement is congruent with your values and one or more of the

Tenets of the ANA “Code of Ethics for Nurses” and legal nursing standards of practice. If not, explain why not.

8. Discuss any economic, social, cultural, or spiritual nursing considerations nurses should be cognizant of when challenged with this issue.

9. Analyze your role as an advocate for policy change. 10. Post your discussion for this week.11. Read all of your colleagues’ postings. 12. Respond to at least three of your colleagues’ initial postings.

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NRSG 613 9.2009


ASSIGNMENT WEEK 5Assignment II: Change Agent is due by Day 7 of this week.

Looking ahead

Note: This assignment will be due at the end of Week 6 submitted as directed through blackboard features.

Preparation:

1. Review assignment II submitted earlier in the course.2. In a 10-12 slide PowerPoint presentation (including title page and reference page)

a. Outline your main points of your professional issues.a. Identify your topicb. Summarize the issuec. Outline the pros or cons of the issued. Provide a rationale or key points of your argumente. Discuss your role as an advocate for ethical and legal change

b. Include a title page and reference page

TIP: Refer to APA Publication Manual to assure your citations in the text and reference list are correct. Although this is a power point APA does apply.

OVERVIEW WEEK 6

The ANA “Code of Ethics for Nurses” provides nurses with guidelines to continue the practice of ethical care through the legacy of virtues such as courage, integrity, and accountability (2001; Burkhardt & Nathaniel, 2002, p.361). Consider the Aroskar, Moldow, and Good (2004) article from last week discussing the influence of policy on ethical care of patients and advocacy for policies, informing policymakers to empower nurses ethical care of patients. Empowering nurses to unite with one voice to change the nursing profession gives nurses the opportunity to make ethical and legal decisions in the nursing practice. Moreover, empowering nurses to become comfortable with the decision process creates a ripple effect toward a better health care system and patient outcomes for ethical care such as the O’Brien’s (2008) view of the Nurse-Patient relationship leading to empowered, informed patients.

RESOURCES WEEK 6

Devotion

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NRSG 613 9.2009



Chapter 19 - “Empowerment for Nurses” Chapter 20 - “Enabling Patient Empowerment”

WEBSITES WEEK 6

http://www.nursingadvocacy.org/news/news.htmlThe Center for Nursing Advocacy

http://www.icisf.org/articles/International Critical Incident Stress Foundation, Inc.

http://www.osha.gov/dep/oia/whistleblower/index.htmlOccupational Safety and Health AdministrationOffice of Investigative AssistanceThe Whistleblower Program

http://nursingsociety.org/Sigma Theta Tau

www.tribes.comTribes: A New Way of Learning


JOURNAL ARTICLES

Brown, D., McWilliam, C., Ward-Griffin, C. (2006). Client centered empowering partnering in nursing [Electronic version]. Journal of Advanced Nursing, 53 (2), 160-168.

Daiski, I. (2004). Changing nurses’ dis-empowering relationship [Electronic version]. Journal of Advanced Nursing, 48(1), 43-50.



Chapter 19 - “Empowerment for Nurses” Chapter 20 - “Enabling Patient Empowerment”

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http://www.tribes.com/

http://nursingsociety.org/

http://www.osha.gov/dep/oia/whistleblower/index.html

http://www.icisf.org/articles/

http://www.nursingadvocacy.org/news/news.html

NRSG 613 9.2009

Review all the PowerPoint presentations and read the class discussion scenario. Gather a group of classmates, choose one section in particular. Read the class discussion or the slide titled discussion and chat in the chat room about the questions that follow the scenario.


In preparation for the activity:1. In 5-8 slides, create a rough draft of your PowerPoint Assignment due at the end of this

week. 2. Use the notes page to expand discussion about your outlined points.3. Post your presentation to the discussion board.4. Read all of your colleagues’ postings. 5. Respond to at least three of your colleagues’ initial postings.


ASSIGNMENT WEEK 6

Power point presentation is due at the end of this week.

FINAL COURSE REMINDERS!

CHECK THE PORTFOLIO GUIDELINE FOR ARTIFACTS REQUIRED FOR THIS COURSE.

REMEMBER TO COMPLETE THE ONLINE COURSE ASSESSMENT.

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NRSG 613 9.2009

References

Aroskar. M. A., Moldow, D. G., & Good, C. M. (2004) Nurses’ voices: Policy, practice, and ethics [Electronic version]. Nursing Ethics, 11(3), 266-276.

Brown, D., McWilliam, C., Ward-Griffin, C. (2006). Client centered Empowering partnering in nursing [Electronic version]. Journal of Advanced Nursing, 53 (2), 160-168.


Burkhardt, M. A., & Nathaniel, A. K. (2002). Ethics & issues in contemporary nursing (2nd ed.). Albany, NY: Thomson Delmar Learning.

Daiski, I. (2004). Changing nurses’ dis-empowering relationship [Electronic version]. Journal of Advanced Nursing, 48(1), 43-50.

Davis, A. J. (1999). Global influence of American nursing: Some ethical issues. Nursing Ethics, 6(2), 118-125.

Erlen, J. A. (2006). Genetic testing and counseling: Selected ethical issues [Electronic version]. Orthopaedic Nursing, 25(6), 423-426.



Lindh, I. B., Severinsson, E., Berg, A. (2007). Moral responsibility: A relational way of being [Electronic version]. Nursing Ethics, 14(2), 129-140.

Mathes, M. (2004). Ethical decision making and nursing [Electronic version]. MEDSURG Nursing, 13 (6), 492-431.

Mylott, L. (2005). The ethical dimension of the nurse’s role in practice [Electronic version]. Journal of Hospice and Palliative Nursing, 7, 113-118.


Varcoe, C., Doane, G. D., Rodney, P., Storch. J. L., Mahoney, K., et al. (2004). Ethical practice in nursing: Working in-betweens [Electronic version]. Journal of Advanced Nursing, 45(3), 316-325.

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NRSG 613 9.2009

Winslow, G. R., & Winslow, B. W. (2003). Examining the ethics of praying with patients. Holistic Nursing Practice, 17(4), 170-177.

Zuzelo, P. R. (2007). Exploring the moral distress of registered nurses [Electronic version]. Nursing Ethics, 14(3), 344-359.

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NRSG 613 9.2009

GRADING RUBRICS

ASSIGNMENT I: ETHICAL DECISION MAKING MODELDUE WEEK 3 – DAY 7CONTENT POSSIBLE

POINTSPOINTS RECEIVED

FACULTY COMMENTS

Summarizes Nursing Ethical Dilemma. 3.5

Discusses Moral Distress Experienced.

3

Applies an ethical decision making model to the experience and provides rationales, resources for each step.

11

Discusses the nurse-patient relationship and integration of spirituality in the ethics of nursing care.

4

Reflects on the initial outcome and the analyzed outcome based on utilizing the ethical decision making model.

4

Follows appropriate spelling and grammar. Utilizes at least five appropriate scholarly sources.

2.25

Follows appropriate APA format

2.25

Total Points 30 Received

Support your work with citations from Journal articles, textbook assigned readings, and other scholarly references utilized throughout the course.

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NRSG 613 9.2009

ASSIGNMENT II: THE CHANGE AGENTDUE WEEK 5 – DAY 7CONTENT POSSIBLE


FACULTY COMMENTS

Identifies a professional nursing issue relevant to contemporary nursing.

4

Summarizes the issue. 5

Discusses the pros and cons of the selected issues and provides supported rationales of how the issue affects nursing practice.

8.5

Explains the role of a nurse as change agent.

8


2.25

Follows appropriate APA format.

2.25



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NRSG 613 9.2009

ASSIGNMENT III: POWERPOINT PRESENTATIONDUE WEEK 6 – DAY 7CONTENT POSSIBLE


FACULTY COMMENTS

Identifies the topic . 1

Summarizes the issue.

1.5

Outlines the pros and cons of the issue.

2

Supports above criteria with rationales and resources.

2

Describes their role as an advocate.

2


0.75

Follows appropriate APA format

0.75



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NRSG 613 9.2009

Discussion Requirements and Rubric

Up to 1 point can be deducted for APA and/ or grammar.

5 Points (Exemplary) Discussion postings and responses are responsive to the requirements of the Discussion

instructions and are posted by the due date. Discussion postings and responses significantly contribute to the quality of interaction by

providing rich and relevant examples, applicable research support, discerning ideas, and/or stimulating thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Discussion postings and responses demonstrate an in-depth understanding of concepts and issues presented in the course (e. g., insightful interpretations or analyses, accurate and perceptive parallels, and well-supported opinions), and are well supported, when appropriate, by pertinent research.

Discussion postings and responses provide evidence that the student has read and considered a sampling of colleagues' postings and synthesized key comments and ideas, as applicable.

4 Points (Proficient) Discussion postings and responses are responsive to the requirements of the Discussion

instructions and are posted by the due date. Discussion postings and responses contribute to the quality of interaction by providing

examples, research support when appropriate, ideas, and/or thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Discussion postings and responses demonstrate some depth of understanding of the issues and show that the student has absorbed the general principles and ideas presented in the course, although viewpoints and interpretations are not always thoroughly supported.

Discussion postings and responses provide evidence that the student has considered at least some colleagues' postings and synthesized some key comments and ideas, as applicable.

3 Points (Sufficient) Discussion postings and responses are posted by the due date but are not always

responsive to the requirements of the Discussion instructions. Discussion postings and responses do little to contribute to the quality of interaction or to

stimulate thinking and learning. Discussion postings and responses demonstrate a minimal understanding of concepts

presented, tend to address peripheral issues, and, while generally accurate, display some omissions and/or errors.

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NRSG 613 9.2009

Discussion postings and responses do not provide evidence that the student has considered at least some colleagues' postings or synthesized at least some key comments and ideas, as applicable.

2 or Less Points (Developing) Discussion postings and responses are posted past the late deadline, defined as 11:59 p.m.

on the due date, and/or do not address the requirements of the Discussion instructions. Discussion postings and responses do not contribute to the quality of interaction or

stimulate thinking and learning. Discussion postings and responses do not demonstrate an understanding of the concepts

presented in the course, and/or do not address relevant issues, and/or are inaccurate and contain many omissions and/or errors.

Discussion postings and responses do not provide evidence that the student has read or considered colleagues' postings, as applicable.

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Note: Faculty instructions will be in italics - Olivet Nazarene …web.olivet.edu/~gparzygn/MSN Syllabi Final/NRSG 613 Fi… · Web viewGuido, G. W. (2006). Legal and ethical issues

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