Reflective Journal Week 7 Topic: Philosophies and Theories for Advanced Nursing Practice Course objective: 1. Examine organizational theories utilized in the nursing discipline. 2. Explore possible applications of organizational theories in nursing practice, research, and theory development. Discussion Question: 7 DQ 1 How can the DNP-prepared nurse apply the concepts of a complex adaptive system to individual patient care? Provide examples. Complex Adaptive Systems  The science and theory of complex adaptive systems, also known as complexity science, has emerged as an alternative to existing paradigms. Complex adaptive systems demonstrate identifiable characteristics: embeddedness, self-organization, non-linearity, unpredictability, and others. These systems exhibit emergent behavior that arises from simple rules and interconnections among diverse elements with porous boundaries, as they interact with and respond to the environment. The health system and the profession of nursing can be viewed as complex adaptive systems, and when done so, new insight can be gained. While several authors have stated they believe nursing is indeed a complex adaptive system, a visual model has not yet been advanced. Health care organizations are complex adaptive systems where things that happen are unique, dynamic, and unpredictable; they also have diverse agents including providers, patients, and other stakeholders that serve as a source of creativity and problem-solving solutions but can also create communication difficulties (McDanial, Lanham, & Anderson, 2009). The Meikirch model uses five components that spontaneously arrange themselves with interactions; these interacting components include life’s demands, biologically given potential, personally acquired potential, social determinants, and environmental determinants.  An example of how the adaptive process works in looking at how life itself is an evolutionary process starting from conception and ending at death with the demands of life, social, and environment constantly evolving with numerous adaptive processes that occur as different complex interactions happen in an individual’s life.  Complex adaptive systems (CAS) comprise five major components, and as a rule, they are labelled from “a” to “e”. The first component (a) represents the demands of life that people seek to address sufficiently. They respond to these needs by using their (b) biologically given potential and (c) personally acquired potential. These two kinds of potentials are significantly dependent on the (d) environmental and (e) social health determinants. These components are coupled with interactions that link various healthcare agents to the components (Bircher & Hahn, 2016). Therefore, DNP-prepared nurses can effectively apply the CAS to individual patient care. DNP nurses can apply the CAS approach in problem solving by recognizing an organization’s networks and complexities and the relationships between the components of the sys ...

1. Reflective Journal Week 7
Topic: Philosophies and Theories for Advanced Nursing
Practice
Course objective:
1. Examine organizational theories utilized in the nursing
discipline.
2. Explore possible applications of organizational theories in
nursing practice, research, and theory development.
Discussion Question: 7 DQ 1
How can the DNP-prepared nurse apply the concepts of a
complex adaptive system to individual patient care? Provide
examples.
Complex Adaptive Systems
The science and theory of complex adaptive systems, also
known as complexity science, has emerged as an alternative to
existing paradigms. Complex adaptive systems demonstrate
identifiable characteristics: embeddedness, self-organization,
non-linearity, unpredictability, and others. These systems
exhibit emergent behavior that arises from simple rules and
interconnections among diverse elements with porous
boundaries, as they interact with and respond to the
environment. The health system and the profession of nursing
can be viewed as complex adaptive systems, and when done so,
new insight can be gained. While several authors have stated
they believe nursing is indeed a complex adaptive system, a
visual model has not yet been advanced.
Health care organizations are complex adaptive systems where
things that happen are unique, dynamic, and unpredictable; they
also have diverse agents including providers, patients, and other
stakeholders that serve as a source of creativity and problem-
solving solutions but can also create communication difficulties
(McDanial, Lanham, & Anderson, 2009). The Meikirch model
uses five components that spontaneously arrange themselves
with interactions; these interacting components include life’s

2. demands, biologically given potential, personally acquired
potential, social determinants, and environmental determinants.
An example of how the adaptive process works in looking at
how life itself is an evolutionary process starting from
conception and ending at death with the demands of life, social,
and environment constantly evolving with numerous adaptive
processes that occur as different complex interactions happen in
an individual’s life.
Complex adaptive systems (CAS) comprise five major
components, and as a rule, they are labelled from “a” to “e”.
The first component (a) represents the demands of life that
people seek to address sufficiently. They respond to these needs
by using their (b) biologically given potential and (c) personally
acquired potential. These two kinds of potentials are
significantly dependent on the (d) environmental and (e) social
health determinants. These components are coupled with
interactions that link various healthcare agents to the
components (Bircher & Hahn, 2016). Therefore, DNP-prepared
nurses can effectively apply the CAS to individual patient care.
DNP nurses can apply the CAS approach in problem solving by
recognizing an organization’s networks and complexities and
the relationships between the components of the system
(Ghazzawi, Kuziemsky, & O’Sullivan, 2016). For example, they
can apply the CAS in the general assessment of patient health
while assessing all the important aspects of health. As such, the
patients can effectively assess their lives and how their lifestyle
impacts their current health condition (Bircher & Hahn, 2016).
In addition, DNP-prepared nurses are able to relate the
components and interactions within the healthcare system;
therefore, they can help patients to understand their health,
social and environmental situation better. Finally, the patients
are provided more opportunities to understand the possible
avenues they can use to achieve better healthcare by themselves
(Bircher & Hahn, 2016).
DNP nurses are prepared to support the development and
revision of healthcare policies. Therefore, they develop and

3. evaluate patient-care models, and contribute to the assessment
of cost effectiveness of patient care (Edwards, Coddington,
Erler, & Kirkpatrick, 2018). This role is greatly supported
through CAS. For instance, nurses get more opportunities to
make informed decisions, as they understand the organizational
behaviour at different levels in the healthcare setting (Ghazzawi
et al., 2016). As such, nurses can identify the gaps in healthcare
quality and strive to address them so as to improve patient care
at different levels. In general, DNP nurses are well prepared to
address healthcare issues by applying the CAS model.
Discussion Question: 7 DQ 2
Research change theories in scholarly literature and on the
Internet. Develop a scenario and describe application of a
change theory from the perspective of an advanced practice
nurse leader.
Kurt Lewin propositioned a change theory that is highly
applicable to the nursing field. A dvanced practice registered
nurses (APRNs) are tasked with extensive obligations in
healthcare delivery under the guidance of their nurse leaders.
Lewin’s theory involves instances where change is managed by
APRNs’ leaders in a process of ‘unfreezing,’ ‘moving/shifting,’
and, finally, ‘refreezing’ certain abstractions, intellections, and
concepts. Lewin’s theory is contingent on the manifestation of
leading and resistance forces that reverberate around the
healthcare arenas.
The healthcare industry has been implementing considerable
changes in the practice and techniques of patient care. Brown et
al. (2017) acknowledge that technological advancements have
led to the use of sophisticated machinery and gadgetry in
patient recognition, identification, and diagnosis. With these
implementations being significantly proliferated internationally,
nurse leaders have had devastating consequences of anxiety,
apprehension, and trepidation because of the shifts in paradigm
and the challenges they encounter in promoting such advances
to the nurses in their fraternity. Reliance on Lewin’s theory by

4. nurses and medical staff can palatably use the stages of
‘unfreezing,’ ‘moving,’ and ‘refreezing’ in countering the
skepticism of change by accepting it.
The most endearing changes in the nursing field are the use of
patient recognition bar-coded bands worn by patients for
facilitating bar-coded medical administration. By unfreezing the
conventional roster procedure that was susceptible to err in
medication, APRNs’ leaders have the role of encouraging nurses
to accept the new procedure of medical administration.
Resistance by many nurses who are unfamiliar with the new
technology has to be enforced by the nursing leaders. Stringent
conformance to the new rules has to be enforced by compulsory
training, and obligatory utilization of the scanning/bar-code
medical administration. Burnes and Cooke (2013) theorize that
changes in technology and procedures in professional domains
need not be voluntary. Nurse leaders are encouraged to compel
adherence to newer technology where its accorded to be the
efficient method of delivering healthcare.
Lewin’s theory is a tool that is well suited for nursing leaders to
introduce prevailing technological changes to a nursing
environment burdened with procrastination of the
implementation of technology in enhancing medical safety. By
unfreezing the conventional practices susceptible to errors,
nursing leaders are given the prerogative of inducing the
learning of the new technologies in their staff. Eventually, when
such technologies have been implemented and wholesomely
accepted, nurse leaders can refreeze the new paradigm to a new
normal.
HIS 311 Notable Minority in History Essay and Power Point
Presentation
Exemplary

5. Accomplished
Developing
Beginning
Dimension 1 - Formatting
Flawless formatting and pagination. Essay is double spaced with
1 inch margins. Essay has a title page, running head title and
subtitles (where appropriate). In-text citations are included and
correctly formatted. . At least 5 scholarly-historical sources
were used and listed in and listed in APA/MLA format. Essay is
between 2-4 pages (excluding title page).
Few issues with formatting and pagination. Few issues with title
and subtitles. Few issues with in-text citations. Includes most
references used in APA format and in alphabetical order. Essay
is between 2-4 pages (excluding title page).
Multiple formatting and pagination issues. Inappropriate use of
in-text citations. Includes references used but with APA
formatting problems and not in alphabetical order. Essay is at
least 2 pages in length (excluding title page).
Missing multiple components in formatting and pagination.
Lacks title and subtitles where needed. In-text citations are
either non-existent or not in APA format. Reference page is
either missing components or not in alphabetical order. Essay is
not 2 pages or more in length.
Standards
USA- WASC Core Competency Standards
Core Competency: WASC Core Competency 01 – Written
Communication
CA- California Baptist University OPS Degree Program Student
Outcomes
Standard: University Student Outcomes
Indicator: USO2GM – Respect diverse religious, cultural,
philosophical, and aesthetic experiences and perspectives.
Indicator: USO3AP – Use critical thinking skills to demonstrate
literacy: listening, speaking, writing, reading, viewing, and

6. visual representing.
Standard: Bachelor of Arts in Liberal Studies Student Outcomes
Indicator: BALS02 - Effectively convey ideas and concepts in
an organized and inspiring fashion through oral and written
mediums.
Dimension 2 - Organization
Essay is well organized contains subtitles when introducing new
ideas. A logical, fair and coherent argument is presented. The
essay is written in an objective and analytical way, with
appropriate use of illustrations and evidence to substantiate the
claims.
Essay contains titles and subtitles. The essay is written in a
fairly objective and analytical manner. An argument is
presented but not easy to distinguish. Illustrations and evidence
provided are relevant to topic but not to the argument presented.
Essay has a title and main topic but not subtopics. The essay is
not an objective essay and lacks analysis. An argument is
developing but it is not coherent. Illustrations and evidence are
present but are not connected to the topic or argument.
The title, the main topic and subtopics are unclear. The essay is
not objective and lacks analysis. An argument was not made for
the historical figure. Illustrations and evidence are unclear and
loosing related to the topic.
Standards
USA- WASC Core Competency Standards
Core Competency: WASC Core Competency 04 – Information
Literacy
CA- California Baptist University OPS Degree Program Student
Outcomes
Standard: University Student Outcomes
Indicator: USO3AP – Use critical thinking skills to demonstrate
literacy: listening, speaking, writing, reading, viewing, and
visual representing.
Standard: Bachelor of Arts in Liberal Studies Student Outcomes

7. Indicator: BALS01 - Communicate unique and alternative
perspectives that appeal to a variety of senses and thought
processes.
Indicator: BALS02 - Effectively convey ideas and concepts in
an organized and inspiring fashion through oral and written
mediums.
Dimension 3 - Grammar
Flawless spelling, grammar and use of punctuation. Writing
clear and concise.
Few issues with spelling, grammar and use of punctuation.
Writing mostly clear and concise.
Multiple issues with spelling, grammar and use of punctuation.
Writing is partially clear and concise.
Spelling, grammar and use of punctuation not at college level.
Writing is not clear nor concise.
Standards
USA- WASC Core Competency Standards
Core Competency: WASC Core Competency 01 – Written
Communication
CA- California Baptist University OPS Degree Program Student
Outcomes
Standard: University Student Outcomes
Indicator: USO3AP – Use critical thinking skills to demonstrate
literacy: listening, speaking, writing, reading, viewing, and
visual representing.
Standard: Bachelor of Arts in Liberal Studies Student Outcomes
Indicator: BALS02 - Effectively convey ideas and concepts in
an organized and inspiring fashion through oral and written
mediums.
Dimension 4 - Content
Biographical information proves an understanding of chosen

8. historical figure and time period. Essay includes evidence of
scholarly- historical research. Student clearly addressed all the
assignment’s content requirements. Student presents a clear
argument in favor of the minority historical figure and clearly
provides evidence in support of the argument.
Biographical information reflects an understanding of either the
historical figure or time period, but not both. Essay includes
evidence of some scholarly-historical research. Evidence of
some scholarly research but includes some non-academic
sources. Addressed most of the assignment’s content
requirements. Student introduced an argument in favor of the
minority historical figure but did not provide clear evidence in
support of the argument.
Biographical information at times misses historical details.
Evidence of research but not scholarly research. Few scholarly
historical sources beyond the textbook used. Sources cited are
non-academic resources. Student addressed only some of the
assignment’s content requirements. Student’s argument was not
clearly articulated and the supporting evidence was vague.
Biographical information failed to maintain historical accuracy.
Sources used for content are non-academic. Textbook was the
main source for information. Student did not address most of
the assignment’s content requirements. Student failed to make
an argument for the historical figure chosen and the supporting
evidence as not relevant.
Standards
USA- WASC Core Competency Standards
Core Competency: WASC Core Competency 05 - Critical
Thinking
CA- California Baptist University OPS Degree Program Student
Outcomes
Standard: University Student Outcomes
Indicator: USO2GM – Respect diverse religious, cultural,
philosophical, and aesthetic experiences and perspectives.
Indicator: USO3AP – Use critical thinking skills to demonstrate
literacy: listening, speaking, writing, reading, viewing, and

9. visual representing.
Standard: Bachelor of Arts in Liberal Studies Student Outcomes
Indicator: BALS01 - Communicate unique and alternative
perspectives that appeal to a variety of senses and thought
processes.
Indicator: BALS02 - Effectively convey ideas and concepts in
an organized and inspiring fashion through oral and written
mediums.
Indicator: BALS06 - Frame situations to provide constructive
solutions.
Dimension 5 - Presentation
Presentation was excellent. The notable was introduced, the
time period and historical context and relevance was explained.
A brief biography of the notable was given. The presenter
persuasively stated why this Minority is important and should
be further studied in History classes. Examples of
accomplishments, significant contributions to history were
given. The presentation was a narrated (via PowerPoint, Video
recording or other media). It was distributed online or given in
class. The illustrations,graphics and wording were clear,
relevant and engaging.
Presentation was good. The notable was introduced and the time
period mentioned.The historical context and relevance of the
person's life was mentioned but needed more.Presenter
mentioned why this person was important and should be studied
further. Gave some examples of accomplishments and
contributions to history.The presentation was good but not
narrated (if online). It was not provided to the professor but not
the rest of the class. The illustrations,graphics and wording
were clear and relevant.
Presentation needed more developing.The notable was
introduced but the time period in which he/she lived was not
clear. Historical context and relevance needed to be further
developed in order to be fully understood. Presenter mentioned

10. why this person was important and should be studied further.
Gave some examples of accomplishments but did not tell us why
they were significant. The presentation was not narrated and
slides needed to be properly titled. It was turned into the
professor but it was not delivered in class or distributed to the
class via blackboard. The illustrations,graphics and wording
needed to be more clear and relevant.
Presentation was not up to college standards. The historical
time period in which the notable lived was not clear. It was not
clear what context of history he/she lived in and the relevancy
of the period was not explained. A brief biography was
given.Presenter mentioned why this person was important and
should be studied further. Did not provide relevant examples of
accomplishments or contributions to history. The presentation
was not narrated and slides no clearly titled. It was turned into
the professor (late). It did not get presented to the class or it did
not get distributed to the class via blackboard. The
illustrations,graphics and wording were not clear or relevant.
Standards
USA- WASC Core Competency Standards
Core Competency: WASC Core Competency 02 – Oral
Communication
CA- California Baptist University OPS Degree Program Student
Outcomes
Standard: University Student Outcomes
Indicator: USO2GM – Respect diverse religious, cultural,
philosophical, and aesthetic experiences and perspectives.
Indicator: USO3AP – Use critical thinking skills to demonstrate
literacy: listening, speaking, writing, reading, viewing, and
visual representing.
Standard: Bachelor of Arts in Liberal Studies Student Outcomes
Indicator: BALS01 - Communicate unique and alternative
perspectives that appeal to a variety of senses and thought
processes.

11. Indicator: BALS02 - Effectively convey ideas and concepts in
an organized and inspiring fashion through oral and written
mediums.
Indicator: BALS06 - Frame situations to provide constructive
solutions.