Each week you will make an entry into your Journal. You are asked to reflect on 3 of the key points for each class. Key points: What did you take away from the module knowledge wise or interesting? Each entry should reflect on your understanding of the topic, your experiences and observations in your work environment or general nursing environment regarding the module topic.
This is a cumulative document. You will save it to your own computer desktop or memory device and update it each week. You may choose to record more than one entry each week, especially if you have an “aha!” moment as a result of your reading, discussions, or experience. You will upload and submit the latest version of your Health Policy & Legal Aspects Reflective Journal to Blackboard by 2359 the Saturday following each class of this course. It is not necessary that your entries be formatted or written in any particular way because it is for your benefit. Your entries will only be reviewed to ensure that you are making sufficient progress and thinking deeply about the requirements in the course.
Rubrics:
Use this rubric to guide your Journal entries.
There will be total of 3 Journal entries. With each journal you are expected to address 3 key points from the class lecture, discussion, and content, discuss how each point applies to your practice as a nurse, and, finally, how will your practice change in the future because of this information.
Journal Rubric for each Module
| Criteria | Target | Unacceptable |
| 1st Key Point
(30 Points)
|
Discuss 1st key point and why it is important or memorable. Connect RN-BSN experiences to key point (career goals, prior nursing practice, a previous RN BSN course, nursing theories or research). Describes how personal practice will be different in the future based on RN-BSN program as a result of the key point addressed.
(30 Points) |
Does not sufficiently record connections or reflections. Fails to connect RN-BSN experiences to goals, prior nursing practice, coursework, theories or research to key areas addressed. Fails to describe how personal practice will be different in the future based on RN-BSN program.
(0 Points) |
| 2nd Key Point
(30 Points)
|
Discuss 2nd key point and why it is important or memorable. Connect RN-BSN experiences to key point (career goals, prior nursing practice, a previous RN BSN course, nursing theories or research). Describes how personal practice will be different in the future based on RN-BSN program as a result of the key point addressed.
(30 Points) |
Does not sufficiently record connections or reflections. Fails to connect RN-BSN experiences to goals, prior nursing practice, coursework, theories or research to key areas addressed. Fails to describe how personal practice will be different in the future based on RN-BSN program.
(0 points)
|
| 3rd Key Point
(30 Points) |
Discuss 3rd key point and why it is important or memorable. Connect RN-BSN experiences to key point (career goals, prior nursing practice, a previous RN BSN course, nursing theories or research). Describes how personal practice will be different in the future based on RN-BSN program as a result of the key point addressed.
(30 Points) |
Does not sufficiently record connections or reflections. Fails to connect RN-BSN experiences to goals, prior nursing practice, coursework, theories or research to key areas addressed. Fails to describe how personal practice will be different in the future based on RN-BSN program.
(0 points)
|
| Spelling & Grammar
(10 points)
|
3 or less spelling & grammar errors in the reflective journal.
(10 Points)
|
Greater than 3 spelling & grammar errors in the reflective journal.
(0 Points) |
Instructions:
Each week, record your experiences, connections to your course goals, and reflections as they relate to the given prompts and/or your course project. You must record one entry each week, but may record more (insert rows as needed). You may find it helpful and rewarding to record one entry at the beginning of the week, think about the prompt during the week, and then record another at the end of the week. For privacy, refer to patients, online colleagues, and/or co-workers with initials instead of names. Remember you must support your key points with cited references.
Save this document to your own computer desktop or storage device after each entry to create a cumulative journal.
| Journal Entries
A separate Journal entry is required for each class by 2359 Saturday of each indicated class. Provide details of your thinking, including insights, challenges, paradigm shifts, and goals. Identify previous course topics, readings, or research that relate to the prompt. |
|
| Journal Entry
|
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| Reflective Journal Example: Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. | |
| Place Key Point in this column: | Reflect on the Key Point (following Journal Rubric) in this column:
YOU MUST ANSWER ALL 3 QUESTIONS ABOUT YOUR KEY POINT IN ORDER TO RECEIVE CREDIT (NO PARTIAL CREDIT). PLEASE COME UP WITH YOUR OWN KEY POINTS FOR EACH MODULE. DELEGATION, SAFE HARBOR & PEER REVIEW ARE JUST EXAMPLES-PLEASE COME UP WITH YOUR OWN KEY POINTS FOR EACH MODULE. |
| Key Point 1:
Example: Delegation
|
Why it is important: at least 3-4 well written sentences using critical thinking
How does it impact my work/nursing practice: at least 3-4 well written sentences using critical thinking How will I change my practice: at least 3-4 well written sentences using critical thinking |
| Key Point 2:
Example: Safe Harbor |
Why it is important: at least 3-4 well written sentences using critical thinking
How does it impact my work/nursing practice: at least 3-4 well written sentences using critical thinking How will I change my practice: at least 3-4 well written sentences using critical thinking |
| Key Point 3:
Example: Peer Review |
Why it is important: at least 3-4 well written sentences using critical thinking
How does it impact my work/nursing practice: at least 3-4 well written sentences using critical thinking How will I change my practice: at least 3-4 well written sentences using critical thinking |
| Reflective Journal Module 2: Legal Overview and Peer Review Process. Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. | |
| Place Key Point in this column: | Reflect on the Key Point (following Journal Rubric) in this column: |
| Key Point 1: Safe Harbor | Why it is important: Safe Harbor is a tool which can be used by nurses within the parameters of their job. It is important to fully understand these parameters so that this tool can be adequately, successfully, and efficiently used.
How does it impact my work/nursing practice: Safe Harbor allows nurses to have a form of recourse should they be presented with unsafe nursing practices. It ensures that the proper guidelines are followed so that patient’s safety is not affected. How will I change my practice: As a nurse, and especially charge nurse, I need to be more aware and well versed of all legalities that protect nurses in instances of unsafe assignments. As a charge nurse, I will can advocate for my nurses with more substantiated knowledge. |
| Key Point 2 Unprofessional nursing conduct. | Why it is important: As a charge nurse, I have encountered nurse staff that conduct themselves in an unprofessional manner. Therefore, I need tools and resources that I can provide to them to prove that they are indeed performing their duties in an unprofessional manner.
How does it impact my work/nursing practice: In my experience, on our unit, we have provide private rooms and semi-private rooms. In this particular case, I have had to address a situation in which a patient in a semi private room requested to make a formal complaint on a nurse aid who mishandled his duties while bathing her roommate who was an altered mental status patient. How will I change my practice: When I need to write up a staff member in these cases, I will be well versed on the Texas Administrative Code Title 22 Part 11 Chapter 217 rule 217.12, which clearly states: “Causing or permitting physical, emotional or verbal abuse or injury or neglect to the client or the public, or failing to report same to the employer, appropriate legal authority and/or licensing board.” Using this tool, I will be able to better help my nurses understand the parameters of the job and why it’s so important to always do the right thing. |
| Key Point 3
Standard of nurse practice. |
Why it is important: To have a standard of nursing practice is important so that regardless of where or when a patient is seen, the level of nursing care stays constant and consistent.
How does it impact my work/nursing practice: On our unit, we have license vocational nurses who work side by side with registered nurses on a cardiac unit. As the charge nurse, I have had to ensure that LVN’s are following their standards of care specific to vocational nurses and the RN’s are resourcing closely with their LVN’s. On a daily basis, I have to ensure the LVN’s are taking patients that are within their scope of practice. Examples are initiating certain cardiac medication drips and admissions of newly admitted stroke patients. “(B) Shall assign specific tasks, activities and functions to unlicensed personnel commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made and shall maintain appropriate supervision of unlicensed personnel.” How will I change my practice: My knowledge of the specific tasks and who is responsible for them is essential to my ability to provide the best leadership, as charge nurse. Understanding what role and to what standard we are being held is also essential for providing the best, safest, and most efficient level of patient care. Standards of Nursing Practice, Title 22, Part 11, Texas Administrative Code, Rule §217.11 (2007).
|
| Reflective Journal Module 3: More Peer-Review Laws and Rules. Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. | ||
| Place Key Point in this column: | Reflect on the Key Point (following Journal Rubric) in this column: | |
| Key Point 1
Reporting minor incidents
|
Why it is important: I feel as if the Texas BON has the minor incident rule to protect the patients not to discipline the nurses. Reporting minor incidents is useful tool to monitor nurses and their progress in the clinical field. I have a lot of new nurses come through my floor. If they make a mistake due to inexperience this law protects their license. These events can be reported and then addressed immediately not only to prevent it happens again but to educate the nurse.
How does it impact my work/nursing practice: My floor is mainly made up of new nurses including new graduate nurses, new nurses to the telemetry field, and nurses from other countries. In my personal opinion, my mentality has always been to simply educate these nurses on how to safely perform tasks that are expected of them. If an error is made and there is a pattern, then reporting the incidents would be the proper way to handle the case of the event. Then it is escalated to a peer review for them to determine if the nurse is a harm to their patients. How will I change my practice: After reading through this module, I have learned that it is my duty to report any incidents that may cause harm to the patients. In the four years that I have been a charge nurse, I never saw myself having to report anyone. We have many so many new nurses that normally the offense is corrected and not made again. But now after learning what reporting a minor incident means, the goal would not be to punish the nurse, but to protect the public from possible harm. If a nurse makes a mistake, then let’s correct that behavior. Reporting minor incidents will only help keep track of the nurse and to help monitor unsafe conduct. |
|
| Key Point 2 incident based peer review | Why it is important: the main goal for incident based peer reviews is to maintain patient safety and the outcomes of the patients. Standards of care are maintained by holding nurses accountable in their own safe practices. But at times we need to hold the hospital and their units accountable for enabling unsafe situations. This is a learning tool for all involved in patient care.
How does it impact my work/nursing practice: We have always been taught that safety of the patient is priority in nursing. A scenario which is often introduced is the adequate staffing dilemma. On my floor if our staffing is not adequate then problems arise that might conflict with nurses being able to practice safely. Lack of the sufficient help such as running with one CNA for a thirty-six bed unit is all too common. This then causes a panic to my nurses which causes inadequately care for the patient and inevitably cause the patient harm. I have seen it over and over again where nurses have to cut corners just to make it through the day. How will I change my practice: Becoming more familiar with what incident based peer reviews are, I will make it a point to report all events presented to me. This might lead to nurses being reported but my intention will not be to get my nurse in trouble but to either hold the hospital accountable should it be their fault or educate the nurse. I have seen that the majority of the time it is not due to their ignorance and lack of education but rather due to what the hospital has pushed on them. My hospital is notorious for pushing nurses to the brink to perform poorly and put patients at risk. |
|
| Key Point 3
Whistleblowing protections |
Why it is important: As nurses we are taught to be patient advocates and how important our role is in the protecting and safety of our patients. But there is a stigma associated with being a “whistleblower,” therefore, many events are not being reported in the healthcare setting. Fortunately, the Texas BON nurse practice act rule217.19 offers whistleblower protections that basically protects nurses who report any situation they believe exposes a patient to harm are then protected from retaliation. It is important that we are protected and supported because our sole purpose is to be an advocate for our patients.
How does it impact my work/nursing practice: Although, there are whistleblower protections in place, where I work there are a lot of new nurses who are not well versed on this law. They are not confident in reporting what is right and what is wrong because they are just trying to make it through the day without making mistakes that are more likely due to their lack of experience. There is one nurse who has been in the field for twenty plus years and is constantly “complaining.” Per my director, she is considered “trouble.” I never follow up whether she actually does any formal reporting. My director doesn’t outright retaliate against her directly but she bad mouths this nurse to other staff members. I see that this in return does affect the newer nurses when wanting to speak up. How will I change my practice: Being one of the veteran nurses, the newer nurses do come to me for advice on how to approach certain situations that they feel aren’t safe for their patients. I have built a rapport with my nurses. I see that they feel comfortable in reporting concerns that affect patient safety. But more often I see that they don’t want to make it a big deal may be due to possible retaliation. If I see that it needs to be escalated I then will bring it up to my director. By in my experience, I have learned how to bring certain situations to light without being labeled a “troublemaker.” For one, I have just recently started our own shared governance council, which I encourage the nurses to come forward to bring to light concerns they may have and make change on our unit. Fortunately, there has not been any major events that need to be escalated to the BON from my end. |
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| Reflective Journal Module 4: Professional Boundaries and Challenges. Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. | ||
| Place Key Point in this column: | Reflect on the Key Point (following Journal Rubric) in this column: | |
| Key Point 1 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
|
| Key Point 2 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
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| Key Point 3 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
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| Reflective Journal Module 5: Malpractice. Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. | ||
| Place Key Point in this column: | Reflect on the Key Point (following Journal Rubric) in this column: | |
| Key Point 1 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
|
| Key Point 2 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
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| Key Point 3 | Why it is important:
How does it impact my work/nursing practice: How will I change my practice: |
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