Each week, you will be expected to write in your online Journal (in secure site area). Before you can log into your journal, you will need to register and complete your profile. The contents of your journal are private, viewable by only you and your instructor. WEEK 1 Learning Activity 1: Write a paragraph in your online Journal about your own thoughts and feelings about working in the Canadian health care system described in the readings. Quickly jot down some areas of practice that you feel you will need to focus on in order to practice in a safe and confident way in this new evolving system. WEEK 2 Learning Activity 4: Consider the following scenerios using the 12 questions below to approach them, write your analysis in your online Journal : “You have just been hired to work as a public health nurse in a local region. One of your new clients slowly discloses accounts of domestic violence within her family, and you notice bruises on one of her children’s arms during a home visit. What are your responsibilities in this instance within the new regionalized health care system?” “You have reasonable suspicions that one of your community health nurse colleagues is misrepresenting her care, by documenting home visits to continuing care clients without actually making the visits. However, you have no concrete evidence that this is occurring. What are your ethical responsibilities? Twelve Questions to Address Ethical Dilemmas Laura L. Nash posed 12 questions to help managers and professionals address ethical dilemmas. 1. Have you defined the problem accurately? 2. How would you define the problem if you stood on the other side of the fence? 3. How did this situation occur in the first place? 4. To whom and to what do you give your loyalty as a person and as a member of the corporation? 5. What is your intention in making this decision? 6. How does this intention compare with the probable results? 7. Whom could your decision or action injure? 8. Can you discuss the problem with the affected parties before you make your decision? 9. Are you confident that your position will be as valid over a long period of time as it seem now? 10. Could you disclose without qualm your decision or action to your boss, your CEO, the board of directors, your family, society as a whole? 11. What is the symbolic potential of your action if understood? misunderstood? 12. Under what conditions would you allow exceptions to your stand? (Excerpted from: Nash, L. (1981). Ethics Without the Sermon. Harvard Business Review, 59. ). Learning Activity 5: Primary health care addresses the main health problems of a community, providing promotive, preventive, curative and rehabilitative services accordingly. The RNABC supports the idea of community health centres as a core service for providing primary health care. In your Journal, write a one paragraph description of an ideal community health centre for your local community, emphasizing the role of nurses within the centre. WEEK 3 Learning Activity 7: Income inequality is an important health issue because income is one of the primary determinants of health. Without adequate income, people are not able to meet their basic nutrition, clothing, housing, rest, and sleep needs. As well, the day-to-day stress and concerns (hunger, adequate shelter, safe neighbourhood, and so on) take away one’s energy and makes people vulnerable to disease. They also trigger a host of physiological, spiritual, psychosocial, cognitive, and immunological mechanisms that in turn negatively affect an individual’s and family’s health. Poverty as a social condition affects women at a higher rate than men. Over half of single or divorced parents with dependent children are female, and women have a higher rate of disability than men. Thus, women are at a higher risk for poverty than men. Income inequality produces adverse effects on life expectancy, health status, infant mortality rates, birth weight injury rate, homicide among families with low income, and psychosocial, mental and child well-being. In your Journal, describe the income trends and subsequent health threats that are occurring in Canada for the following groups. Consider how nurses can affect policies influencing the health care received by people with compromised income and social status? a) children b) women c) Aboriginal people d) Elderly WEEK 4 Learning Activity 10: In your journal, address this question, “How do the issues of privilege, access and literacy affect the ability of Canadians to reap the benefits of the proposed health information system?” WEEK 5 Learning Activity 13: Consider the work you have done in your nursing education related to portfolios, resumes and any tracking of practice experience. Write down what you have done to date. Share the highlights of this self reflection in your JOURNAL.