| Course | NURS 6227 Current Issues in Health Policy |
|---|---|
| Week | Week 11 |
| Paper type | Reflection |
| Length | About 540 words, 4 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | October 2026 |
Free sample paper for NURS 6227 Week 11
Reflection: How a Classmate's Rural Hospital Changed My Position on Nurse Ratios
Student Name
College of Nursing, Walden University
NURS 6227: Current Issues in Health Policy
Instructor Name
Month Day, Year
Reflection: How a Classmate's Rural Hospital Changed My Position on Nurse Ratios
Where I Started
In the first draft of my Week 2 issue analysis, I wrote: "The state should require minimum nurse-to-patient ratios on all inpatient units, without exceptions, starting next year." I believed the evidence on staffing and outcomes was strong enough that any delay or exception meant accepting avoidable harm. The phrase "without exceptions" was deliberate. I thought exceptions were how hospitals escaped rules.
The Disorienting Moment
In a mid-term discussion thread, a classmate who works at a small rural hospital replied to my post. Her hospital has one medical unit. It has been trying to hire two registered nurses for more than a year, and the nearest nursing school is two hours away. Under my proposal, she wrote, her hospital would have to close half its medical beds or the unit itself, and the patients would go to a hospital ninety minutes away, if there were beds there. She was not arguing against ratios. She was telling me what my version would do to her county.
Mezirow (1991) described transformative learning as beginning with a disorienting dilemma, an experience that does not fit one's existing frame of reference, followed by critical reflection on the assumptions underneath that frame. Her reply was that dilemma for me. The assumption it exposed was one I had not noticed holding: that every hospital could hire its way to compliance if it were made to. For hospitals in the city where I work, that may be true. For hers, it was not.
How the Revision Shows in the Documents
The change is visible in the term's work. My Week 3 appraisal split its conclusion: strong evidence that staffing matters, weaker evidence that a fixed statutory ratio is the best instrument, a distinction I would not have drawn in Week 2. Reading about the mandate state's labor market, where the hospital nursing workforce did not grow overall after the law and some hospitals shut their doors (Munnich, 2014), made the rural concern concrete. My Week 4 position paper limited the ratio to adult medical-surgical units, phased it in over three years and added a waiver for critical access hospitals. The phasing drew on the argument of Lindblom (1959) for moving in limited steps that generate information for the next decision, which I would once have dismissed as timidity.
Where I Stand Now
I support a phased statutory ratio for adult medical-surgical units, with a time-limited rural waiver and investment in rural nurse supply. The one finding that would move me again: if, during the phase-in, rural hospitals using the waiver still close medical units at the end of it, I would support replacing the ratio in those regions with a funded staffing subsidy rather than a legal floor.
Holding Positions on Open Questions
The revision taught me something about how to hold a position on a question that is still open. I had treated certainty as a sign of commitment. What I learned is that a position can be firm about its purpose, safer staffing for patients, while staying revisable about its means, and that naming in advance what would change my mind makes the position stronger, not weaker.
References
Lindblom, C. E. (1959). The science of "muddling through." Public Administration Review, 19(2), 79-88. https://doi.org/10.2307/973677
Mezirow, J. (1991). Transformative dimensions of adult learning. Jossey-Bass.
Munnich, E. L. (2014). The labor market effects of California's minimum nurse staffing law. Health Economics, 23(8), 935-950. https://doi.org/10.1002/hec.2966
The Walden NURS 6227 Week 11 instructions
In the last NURS 6227 week, students trace how one of their own positions developed. You show where you started, what challenged you, how your work changed and where you stand now. Faculty credit visible revision, and claims of growth without a before and after disappoint. Cite course sources in APA 7. Mezirow describes learning that begins with a disorienting dilemma and leads to a changed frame. If your position did not change, show how it was tested and refined. Quoting earlier assignments is the clearest way to show revision. A clear arc follows the start, the moment, the documents and where you stand.
Inside the NURS 6227 Week 11 example
A first-person piece of four pages. The opening states the original position from the Week 2 issue analysis, ratios on all inpatient units with no exceptions, quoted from the author's own text. A second section describes the disorienting moment: a classmate's reply in a mid-term thread, describing a rural hospital where a staffing floor could mean closing the only medical unit in the county. Mezirow's theory frames what followed, critical reflection on an assumption the author had not noticed holding, that every hospital could hire its way to compliance. A third section traces the revision through the documents: the appraisal's split conclusion, the position paper's phase-in, the waiver. A fourth states the current position and the one finding that would move it again. A closing paragraph considers what the revision taught about holding positions on open questions.
Where the marks sit in the NURS 6227 Week 11 rubric
A reflection on a revised position earns its credit through evidence of revision, and the version that disappoints claims growth without showing a before and after. Most rubrics weigh depth of reflection, which here means naming the assumption that changed, not just the conclusion. The theory is scored for use: a framework mentioned once and then dropped contributes little, while a disorienting dilemma identified and followed through the documents contributes most. Quoting the original position persuades because it cannot be revised after the fact. Credit is often given for stating the current position with its remaining conditions, which shows the author still holds a position rather than retreating to neutrality. Professional register persists in first person. A reflection ending on the conclusion that the issue is too complex to decide has undone the course's central demand.
Common NURS 6227 Week 11 mistakes, and how to avoid them
Final reflections lose credit when they claim change without showing it. Quote the earlier draft. Another common gap is skipping the trigger. Name the moment that challenged you. Writers also treat the new position as final. Say what could still change it. Avoid praising the classmate without explaining the argument. State what they showed you. Use first person. A side by side of the two claims, the first draft and the revised one, makes the change plain. Close with how you will hold positions on open questions.
Get a NURS 6227 Week 11 example written to your instructions
Forward the Week 11 prompt and rubric, with your earliest statement of the position if you still have it. A NURS 6227 reflection traces the revision through a named theory and arrives in 24 to 48 hours, and nothing is owed on a first. Its author, her rural classmate and both positions are composites belonging to the sample.
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NURS 6227 Week 11 questions, answered
What is Mezirow's transformative learning theory?
Jack Mezirow described adult learning in which a disorienting dilemma, an experience an existing assumption cannot explain, prompts critical reflection on that assumption and a revised perspective. The example uses the theory to locate the author's change in one specific moment, a classmate describing a rural hospital, and to name the assumption it exposed. Another reflective model can replace it where your section names one.
What if the author's position did not change?
Then the reflection examines why it held. A position tested against the strongest opposing argument and kept for stated reasons is a legitimate outcome. The example happens to narrow its position, but the same structure works with a position confirmed: name the challenge, show the reasoning, state the current view. Your honesty about which occurred matters more than the direction of change.
Should the reflection quote earlier assignments?
Where the rubric allows it, yes. Quoting the author's own earlier position fixes the starting point and makes the revision verifiable. The example quotes one sentence from Week 2 and dates each later change to an assignment. Paraphrasing the earlier view tends to soften it, which makes the change look smaller or larger than it was and weakens the evidence your reflection rests on.
Where can I find a free NURS 6227 Week 11 sample paper?
The rural hospital reflection is shown here with where the writer started, the disorienting moment, the revision in the documents and where they stand now.
What changed the writer's position in NURS 6227 Week 11?
A classmate's account of a rural hospital that could not hire enough nurses, which led to a phased plan with a rural waiver.