NURSING 456 (1.5 UNITS) NURSING WITHIN COMMUNITIES AND HEALTH SYSTEMS

UNIVERSITY OF VICTORIA SCHOOL OF NURSING NURSING 456 (1.5 UNITS) NURSING WITHIN COMMUNITIES AND HEALTH SYSTEMS SEPTEMBER - DECEMBER 2014 COURSE SYLLABUS INSTRUCTORS: Maureen Ryan, RN, BN, MN, PhD (A01) Assistant Teaching Professor CLASS TIME: Fridays 11:30am 2:20pm ROOM: DSB C124 OFFICE NUMBER: A462 PHONE: (250) 472-5434 EMAIL: mmryan@uvic.ca Tracy Shenton, RN, BSN (A02) CLASS TIME: Fridays 11:30am 2:20pm ROOM: DSB C114 OFFICE NUMBER: PHONE: (250) 472-0535 EMAIL: tshenton@uvic.ca

Carolyn Hammond, RN, MN (A03) CLASS TIME: Fridays 11:30am 2:20pm ROOM: CLE C214 OFFICE NUMBER: A414 PHONE: (250) 721-6334 EMAIL: chammond@uvic.ca Deborah Thoun, RN, BN, MN, PhD (A04) Associate Professor CLASS TIME: Fridays 11:30am 2:20pm ROOM: CLE B215 OFFICE NUMBER: A434 PHONE: (250) 472-4609 EMAIL: thoun@uvic.ca Natalie Frandsen, RN, MN (A05) CLASS TIME: Fridays 11:30am 2:20pm ROOM: HHB 120 OFFICE NUMBER: PHONE: (604) 274-7343 EMAIL: nroehrig@uvic.ca Margaret Scaia, RN, BScN, MN, PhD (A06) Assistant Teaching Professor CLASS TIME: Fridays 8:30am 11:20am ROOM: DSB C114 OFFICE NUMBER: A442 PHONE: (250) 721-7963 EMAIL: mrscaia@uvic.ca

Margaret Eastman, RN, BSN, MN, CAE (A07) CLASS TIME: Fridays 8:30am 11:20am ROOM: CLE C214 OFFICE NUMBER: PHONE: (250) 478-9286 EMAIL: meastman@uvic.ca Marg Lachmuth, RN, BSN, MN (A08) CLASS TIME: Fridays 8:30am 11:20am ROOM: CLE B415 OFFICE NUMBER: PHONE: (250) 478-4702 EMAIL: mlachmuth@uvic.ca Maureen Hobbs, RN, BSN, MN (A09) CLASS TIME: Fridays 8:30am 11:20am ROOM: CLE C316 OFFICE NUMBER: PHONE: (250) 478-6658 EMAIL: maureenh@uvic.ca The University of Victoria is committed to promoting, providing and protecting a positive, supportive and safe learning and working environment for all its members.

COURSE DESCRIPTION - CALENDAR Apply nursing knowledge, skills, judgements, and attributes where people intersect with communities, organizations and health systems. Students analyze and utilize evidence-informed data to: influence change; promote interprofessional collaboration to enhance continuity, address challenges and deliver safe, ethical, quality health care, foster social justice, empowerment, and culturally competent practice, and provide leadership. COURSE LEARNING OUTCOMES Increase your familiarity with RN entry-to-practice competencies and professional nursing standards through reflection and planned learning to articulate and enact the registered nurse role; Critically analyze, apply and evaluate evidence-informed data in your practice; Draw on conceptualizations of power, advocacy, leadership, delegation, and risk in promoting safe, ethical, and quality practice within communities, organizations and health systems; and Discuss how local health-related situations, events, and issues may link to nursing in other parts of the health authority, province, nation and/or world. COURSE GOALS and PROCESS Your practice experiences with a specific client population, agency leader, or citizen group will be supported by praxis seminars. You will critique nursing practice and health system experiences through sharing information with your peers in various practicum settings. Praxis, the dynamic interplay between theory and practice, can be advanced through active participation in practicum activities and seminars, critical reflection and evaluation of practice, simulation, and scholarly writing. You will be expected to move beyond observation to active engagement in the work of the agency, group, or community where you are placed. You will be working in settings that may, or may not, have health/health care as the primary mandate, but value the health/healing and system perspectives that you bring to the practicum experience. You will design an evolving learning plan with your field guide and your instructor based on nursing competencies and standards of practice, course concepts, mandates of the practicum agency, and your individual learning needs. Your individualized learning plan will outline learning goals and strategies/commitments for your participation during the practice experience, and guide your reflection and evaluation of practice. RESOURCES: Unless otherwise instructed, the School of Nursing requires written assignments to adhere to the format in the APA Publication Manual*: Publication Manual of the American Psychological Association, 6th ed. Washington, DC: American Psychological Association, 2010. Canadian Nurses Association. (2008). CNA code of ethics for Registered Nurses. Retrieved from http://buydownload.cna-aiic.ca/shopexd.asp?id=4 College of Registered Nurses of British Columbia. (2014). Competencies in the context of entrylevel Registered Nurse practice in British Columbia. Retrieved from http://crnbc.ca/registration/lists/registrationresources/375competenciesentrylevelrn.pdf College of Registered Nurses of British Columbia. (2013). Professional standards for Registered Nurses

and Nurse Practitioners. Retrieved from http://crnbc.ca/standards/lists/standardresources/128professionalstandards.pdf CONCEPTS Students are expected to integrate previous learning and practice experiences as well as incorporate learning gained from the Term Seven courses as they cultivate their sense of who and how they are as a nurse working with different populations. Concepts, sub-concepts, and topics for consideration/integration into praxis include, but are not limited to, the following: CLIENT Who is your client? What are the various conceptualizations of client that are key to your practice? How are clients, staff and students conceptualized in your practicum environment? What assumptions underpin your view of client? Group, community, population, society CONTEXT What context informs your personal perspective and that of your client and staff? How do you understand the notion of context? What informs your understanding of context? Historical, socio-cultural, political, economic, global factors and perspectives Philosophical and ethical worldviews Promoting social justice and equity HEALTH AND HEALING What does health mean to the population you are working with? What are the various ways in which health is conceptualized in nursing? What theories inform your understanding of health and healing? What values and beliefs do you hold about health and healing? How do you see nursing contributing to the health of communities and the functioning of safe, ethical and quality health systems? Health promotion and primary health care Community development through capacity building, empowerment and transformation Providing and promoting safe, quality care INQUIRY What theories and frameworks inform your practice? What practice methodologies guide your practice? Who determines what qualifies as evidence? What supports and challenges exist and how are these managed? Teaching and learning Using conceptual frameworks to guide practice Evidence-informed practice Participating in knowledge translation Integrating informatics competencies NURSE/NURSING What is nursing? What are some of the roles you can take up as a nurse? How do you take up professional nursing roles and responsibilities in practice? To whom/for what are you responsible? Accountable? Professional accountability and transitioning to graduate role Nursing knowledge and ways of knowing Clinical reasoning and judgment Reflective practice Change Advocacy

RELATIONAL PRACTICE What theories inform the notion of relational practice? Or, how is practice conceptualized within various nursing theories? What assumptions, values and beliefs are evident or suppressed in your practicum agency? Cultural safety Diversity Relational lenses and competence Delegation of duties Leadership Power/power relations and critical social theory Risk management and risk discourse Intersectionality Interprofessional practice ATTENDANCE AND COURSE LOAD Please review the UVic Calendar note regarding "attendance in classes." You are expected to attend all lectures, classes, workshops, practice experiences and seminars associated with your program. Please notify your instructor immediately if you are unable to attend classes for any reason. For longer term absences please also notify the student advisor. It is the student s responsibility to ascertain the consequences of non-attendance. The expectations for attendance, and possible consequences for non-attendance in courses are provided in this course outline, which is typically distributed by instructors and discussed on the first day of class. STUDENT PROGRESS AND INFORMATION SHARING Within the University of Victoria School of Nursing we are committed to open, transparent processes of evaluation. This means that we encourage students to be proactive in approaching their instructors about past progress and challenges as each new course starts. Faculty and staff at the School of Nursing work as a team to maximize learning opportunities and enhance the quality of instruction. Evaluative feedback about current and past student progress is shared by course instructors with other faculty or staff in the School of Nursing as needed in order to promote student success in all courses (University of Victoria Calendar). STUDENT EVALUATION This is a COMPLETE/FAIL course. You are required to successfully meet ALL of the following expectations to receive a COMPLETE grade. Further details about each expectation are below. It is expected that students will adhere to professional standards of practice and codes of conduct during this course. Failure to complete all course requirements will result in course failure. 1. Completing required practicum hours (78 hours); 2. Attending and participating in seven (7) three hour required praxis seminars (21 hours); 3. Developing a learning plan-practice evaluation using CRNBC Professional Standards for Registered Nurses; 4. Arranging and participating in site visits to discuss learning with your field guide and instructor 5. Completing verbal and/or written student self-evaluations at mid-term and a written selfevaluation at term end; 6. Completing a reflective practice narrative; and 7. Planning and co-facilitating a student-led seminar. DEADLINES, EXTENSIONS AND DEFERRED GRADES

You are responsible for ensuring your individual course requirements are met, for both theory and practice courses. You are expected to comply with deadlines for assignments as stated by your instructor. Extensions of deadlines for assignments are granted at the discretion of your instructor in consultation with you. If you are unable to meet a deadline, you must consult directly with your instructor prior to the deadline to determine whether or not an extension should, or might, be granted at least 48 hours prior to deadline. Additional work will be assigned upon failure to meet deadlines. Individual instructors will determine this work. Please refer to this course outline for specific course requirements regarding deadlines and terms of extensions, especially in regard to late penalties. If there are any questions regarding late penalties, please consult with your instructor immediately. Attention to details about deadlines, terms of extensions and communication with instructors in both theory and practice courses is considered to be an essential component of your professional responsibility and accountability. In certain cases where your progress in a course is interrupted due to illness, accident or family affliction, a deferred grade or academic concession may be considered. You must notify your instructor and the student advisor if you require a deferral or academic concession prior to the end of the course in order to facilitate the necessary paperwork. In the case of a deferral, the University requires supporting documentation of the situation (e.g. medical certificate). For written assignments, the School of Nursing requires that students adhere to the format outlined by the American Psychological Association (American Psychological Association, 2009) Policy on Academic Integrity: You are expected to adhere to the policy on academic integrity in the University of Victoria Calendar. The online version of the Calendar is found at: http://web.uvic.ca/calendar2014-09/ Search the online calendar for Policy on Academic Integrity. NOTE: The Calendar may be revised or changed at any time and it is your responsibility to be familiar with the most current version of the Academic Calendar. If you are in doubt about violations of academic integrity covered by this policy you should consult with your instructor. What if an assignment, project, or learning activity involves gathering information from or about your clients or other individuals? Is this research? When engaged in course work, whether an assignment, learning activity or part of your practice experience, you may decide or be asked to gather information from or about clients, family members, classmates, or others. You must decide whether or not this activity involves research and the need for approval through the University Research Office s Human Subjects Ethics Review process. To help you decide, a document, GUIDELINES FOR ETHICAL REVIEW OF COURSE-BASED RESEARCH INVOLVING HUMAN PARTICIPANTS is available from the UVic Office of Research Services website using this link: www.research.uvic.ca/forms/hrec/guidlines%20coursebased%20research.doc Overall, there is no expectation for BSN graduates to be able to initiate and independently engage in research. If involved in research it would be with support and in collaboration with experienced researchers. If you are contemplating engaging in research or have any questions about this, please ask your instructor who may consult with the course coordinator.

Completing required practicum hours (78 hours): You are expected to participate in a minimum of 78 hours of practice. This translates into approximately 6 hours per week for 13 weeks. The hours of practice are considered to be flexible to accommodate the different operating hours of programs and maximize the opportunity to take advantage of learning opportunities. The details must be negotiated with the agency and the instructor and included in the learning plan. A log of practice hours must be kept and included with the submission of mid-term and final practice self-evaluations. A practice log usually includes the date, the hours, overview of activities, and overview of what was learned as a result of the activities. The field guide must be aware of your weekly practice hours each week. 1. Attending and participating in seven (7) three-hour required praxis seminars (21 hours) You are required to attend and participate in all praxis seminars to: Illustrate engagement in praxis the focus of the seminars is discussion, reflection and analysis of how course content is integral and/or related to your nursing practice in this course. Provide your instructor with essential information for evaluating your learning, practice and performance. Enact leadership qualities in seminar as part of your learning. At the beginning of the term your praxis seminar group will establish an agenda for how you plan to meet the praxis seminar requirement throughout the term. The seminar schedule will be congruent with university and course expectations and agreed to by your group at the beginning of the term. If you are unable to attend a seminar due to illness or some other urgent matter, your instructor should be notified in advance and alternate activities will be arranged to ensure seminar requirements can be met. 2. Developing a learning plan-practice evaluation using CRNBC Professional Standards for Registered Nurses Your learning plan is an evolving agreement that may change over time as the context and the conditions within your practice setting change. You will have an opportunity to discuss the development of your learning plan with your instructor and in praxis seminars. The CRNBC Professional Standards for Registered Nurses will provide the primary frame for your plan and evaluation to further familiarize you with standards for the transition from student to new graduate RN role. The plan will outline your involvement in your practice setting in relation to the mandate of the agency. As much as possible, stratify your goals, strategies and activities targeted to micro (personal or client), meso (program), or macro (organization, community, region, etc.) levels of engagement -based on discussion with your instructor, agency field guide, and student peers. The learning plan should reflect professional knowledge and capabilities commensurate with fourth year level student nurse work. INITIAL SEMINAR: discuss how you will begin to explore the learning opportunities available in your agency given the course concepts and outcomes. Bring information on the agency available to the public (e.g., from the agency website, newspaper, pamphlet, etc.). How are clients, health/illness, professional roles, practice guidelines and working together for client-based care conceptualized or understood in your practicum setting? INITIAL PRACTICUM VISIT: discuss with your field guide ideas for learning related to the course concepts and outcomes, and possible strategies given the agency mandate and what is happening in your practicum during the term. Your initial visit to the agency should focus on what might be accomplished during your practice time over the entire term, recognizing that some

learning goals, strategies or opportunities may need a negotiated change. What are people excited or concerned about in their work? How might a student help further the work of the agency? What evidence is collected regarding the populations served or the staff who work in the agency? How is this evidence utilized? INITIAL DRAFT LEARNING PLAN: initial draft learning plan is a mutually negotiated agreement between you and your field guide as to what you are going to explore in the practice setting. Your instructor plays an active role in helping you lay the foundation for a solid learning experience. An initial draft of your evolving learning plan is to be handed in by the end of Week 2 to obtain feedback from your instructor before finalizing the agreement with your community group/agency. Your learning plan will be revisited a minimum of two times with your instructor and field guide, usually at mid-term evaluation and during your final evaluation. What stands out as key learning opportunities regarding nursing leadership and professional practice, power relations and advocacy, how people manage their health, and how clients and staff to learn navigate health and other systems? 3. Site Visit with Instructor and Field Guide (1-2): A meeting of the instructor, field guide and student(s) is required early in the term as possible to discuss course requirements, learning outcomes, and a possible work plan over the term. The student is responsible to organize and schedule this meeting. A visit later in the term is a leadership opportunity for the student to review learning. Additional meetings may be scheduled as necessary. 4. Completing verbal and/or written student self-evaluations You are expected to observe and critically reflect on, your practice throughout the term using the CRNBC Professional Standards for Registered Nurses. You are responsible for organizing all meeting and evaluation times with your instructor and field guide. An in-person mid-term conference with your instructor is held to discuss your progress in the course and your goals for the second half of the practicum. A written or verbal report for this meeting is determined by your instructor. An in-person final evaluation is held with your instructor (may include your field guide). In a written self-evaluation, submitted by the end of the last week of term or as negotiated with your instructor, you evaluate your progress against your learning goals, practice strategies, and feedback from your field guide and. Your instructor provides a written evaluation of your learning and practice based on all required activities listed in this syllabus, while enacting professional nursing standards of practice. To facilitate judgements about progress, the instructor gathers information during your participation in seminars; submission and revision of your learning plan; evidence of practicum activities related to learning goals, student self-evaluations; feedback from your field guide, and your practice narrative/alternate activity. Your written final self-evaluation and the instructor s final evaluation are placed on your permanent school file. It is the student s responsibility to ensure that the instructor has sufficient data on which to base a judgement about a student s COMPLETE/FAIL status. 5. Completing reflective practice narrative or alternate activity Students are to submit one practice narrative. The submission date can be negotiated with your instructor depending on pace of learning in your practicum. A reflective practice narrative (RPN) is a written document submitted about a specific aspect of your practice and submitted to your instructor as partial evidence of your practice progress and your ability to reflect-on-practice (Schon, 1983). The purpose of the RPN is to go beyond a description of your practice or practice goals and include: Evidence of deeper critical thinking (beyond description to analysis and synthesis of various

perspectives), in particular in relation to integrating the various understandings of concepts are integral to this course; Evidence of your developing competence in enacting the standards of nursing practice; and Evidence of applying theory to practice (e.g., principles of community development or leadership; nursing theory), and/or evidence- informed practice. Your RPN/alternate activity will be written clearly and succinctly with correct grammar, punctuation and spelling and should include at least 4 references. When you cite references please use correct referencing format (APA Publication Manual, 6 th edition, 2010)* including a title page and reference list. The assignment should be limited to 5 pages double-spaced in 12 point New Roman font with 1 margins on all four sides. In some cases it may be necessary for you and your instructor to co-construct other guidelines for a RPN, if needed, based on your individual learning needs. Your instructor may adapt this requirement and develop alternate activities depending on your individual learning needs and discussions of the group as a whole. 6. Planning and co-facilitating a student-led seminar At the beginning of the term your praxis seminar group will establish an agenda for how you plan to meet the praxis seminar requirements throughout the term. In addition to individual participation, you are required to co-lead one seminar with your peers in a group of 3-4. The topics for the seminars will be determined collectively by the seminar group in consultation with your instructor. Topics will be related to the concepts of focus for this course. The purpose of this element is to provide an opportunity for you to develop competency in the areas of leadership, facilitation, transformative teaching and learning, knowledge translation, and evaluation. You are required to: As a group, develop a one-page detailed seminar plan, including learning objectives, activities, and roles of team members. Please send to your instructor one week before your seminar; As a group prepare a one-page resource sheet for your peers (including key references, helpful web links, YouTube talks, etc.) and bring to your seminar; Conduct the seminar collectively and collaboratively; and Provide your instructor with an individual brief self-reflection on the experience of developing and co-facilitating a seminar. Your self-reflection will be written clearly and succinctly with correct grammar, punctuation and spelling. Cite references with correct referencing format (APA Publication Manual, 6 th edition, 2010)* including a title page and reference list. The reflection should be limited to 3 pages double-spaced in 12 point New Roman font with 1 margins on all four sides. It is due one week following your student-led seminar. CRITERIA FOR GRADING University regulations can be found in the University Calendar at the following web site: http://web.uvic.ca/calendar2014-09/facs/unin/uare/grad.html. A final grade represents the sum total of the marks for the assignments.

* References must be cited according to the latest edition of the Publication Manual of the American Psychological Association, called APA referencing for short (American Psychological Association, 2010). References Schön D. (1983) The Reflective Practitioner. Basic Books, New York.