| Course | NR 224 Fundamentals: Skills |
|---|---|
| Week | 5 |
| Paper type | Safety scenario response |
| Length | About 1,130 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 224 Week 5
Safety Scenario Response: A Patient Goes Pale and Buckles Four Steps From the Bathroom, and Why I Lowered Him Instead of Going for Help
Student Name
College of Nursing, Chamberlain University
NR 224: Fundamentals: Skills
Instructor Name
Month Day, Year
Safety Scenario Response: A Patient Goes Pale and Buckles Four Steps From the Bathroom, and Why I Lowered Him Instead of Going for Help
The Hazard
The hazard is a fall with a head injury. The scenario: I am walking Mr. B., 76, to the bathroom at 0700, holding a gait belt, on the second day after he was admitted with a heart failure exacerbation. He was started on a higher dose of furosemide yesterday and slept flat all night. Four steps from the bathroom door, he says, "I feel funny," goes pale, and his knees begin to buckle. Details are composite.
The First Action Is Physical
I lower him to the floor. With both hands on the gait belt, I step in close behind him with my feet apart, one foot slightly forward, and let him slide down against my body and forward leg while I bend my knees, guiding him to sit and then lie on the floor. I keep his head from striking the floor or the door frame by keeping my body between his head and the hard surfaces as he goes down. I do not try to hold him upright. A 90-kilogram man whose legs have given way cannot be held up by one person, and trying to do so is how both the patient and the nurse end up injured.
The obvious alternative is to leave him leaning against the wall and go for help. I rejected it because a person who is losing consciousness will fall whether or not I am there, and the fall I cannot control is the dangerous one. What I can control is the direction and speed of the fall. The call for help comes in the same moment, not instead of the lowering: as I guide him down I call out, loudly, "I need help in room 14," and once he is on the floor I reach for the bathroom's emergency pull cord, which is within arm's reach of the door.
Rank the Rest, and Argue the Ranking
1. Check that he is breathing and responsive. If he is not breathing, the plan becomes a resuscitation, and nothing else on this list matters until help arrives. He is breathing and opens his eyes when I say his name.
2. Keep him lying flat and raise his legs if he is not injured. Lying flat is the fastest treatment for a faint caused by low blood pressure on standing, because it lets blood return to the head. I do not sit him up, and I do not let him try to stand.
3. Check for injury before moving him. I ask whether anything hurts, look at his head, and check whether he can move his arms and legs. He did not strike his head, and he has no pain.
4. Take his vital signs lying on the floor when the second nurse arrives with the monitor: blood pressure 108/64, pulse 88. His pressure before the walk, taken seated with his legs over the side, was 124/72.
5. Get him back to bed with enough people and equipment, a lift device or three staff, not one student and a gait belt.
The order is set by what could kill or injure him soonest: breathing, then brain blood flow, then injury, then the numbers, then the move.
What I Did Not Do
Three things I deliberately did not do are as much a part of the response as what I did. I did not give him anything to drink while he was on the floor, even though he asked for water, because a person who has just nearly fainted may not swallow safely until fully alert, and because his fluid plan for heart failure is set by his provider. I did not try to lift him back to bed with the gait belt alone once the second nurse arrived; two people lifting a 90-kilogram man from the floor without a lift device risk injuring him and themselves. And I did not tell him, to reassure him, that it was "just a little dizzy spell." It may have been, but a near faint in a man with heart failure can also come from a rhythm problem, and the provider needed to hear it described plainly rather than already explained.
He was helped back to bed by three staff at 0720, using the unit's mechanical lift, and a bedside commode was placed for him until the provider reviewed his medicines.
Reporting Has a Name and Words
I report to his nurse, who arrives first, and then to the charge nurse, in the same words: "Mr. B. nearly fainted walking to the bathroom. I eased him down using the belt; he didn't hit his head. He's awake, pressure 108 over 64 lying down, and he says he feels better." His nurse calls the provider. I complete the incident report before the end of the shift, describing what happened and what I did, without judgment about anyone. Lowering a patient to the floor is reported as an event even though no injury occurred, because the pattern of near falls is how a unit learns where falls begin.
Where It Became Possible
The faint did not begin four steps from the bathroom. It became possible earlier, at several points. He had slept flat all night and got up quickly. He was on a higher dose of a diuretic, which lowers circulating volume. And his blood pressure had been taken seated, but never after he stood. A consensus statement defines orthostatic hypotension as a sustained fall in systolic pressure of at least 20 mmHg, or in diastolic pressure of at least 10 mmHg, within three minutes of standing (Freeman et al., 2011). No one had checked his pressure after he stood, so no one knew whether he met that definition before the walk.
The change I would make is small and could have prevented this: before walking a patient who has just had a diuretic increased, let him sit up with his feet down for sixty seconds, then stand at the bedside gripping the walker for sixty more, and take his pressure and ask how he feels before taking a single step. If his pressure dropped by 20 points or he felt dizzy, the walk would wait, and he would use a bedside commode until his provider had been told. It adds two or three minutes to the walk. That is less time than it took to get him off the floor.
References
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., Goldstein, D. S., Hainsworth, R., Hilz, M. J., Jacob, G., Kaufmann, H., Jordan, J., Lipsitz, L. A., Levine, B. D., Low, P. A., . . . van Dijk, J. G. (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research, 21(2), 69-72. https://doi.org/10.1007/s10286-011-0119-5
What the NR 224 Week 5 assignment asks for
The Week 5 assignment presents a patient safety scenario, such as a fall, a fire or an equipment hazard, and asks how you would respond. Expect the instructions to want the hazard identified, actions in priority order with reasons, reporting and prevention. Most sections ask for a few APA pages with at least one scholarly source. The prompt rewards a decision about the first action and an argument for it against the obvious alternative. Ranking should follow what could harm the patient soonest, not the order in which the prompt mentions things. Restraints are rarely the right answer when other measures are available. A strong response ends with how the event could have been prevented.
How this NR 224 Week 5 example is built
The response names the hazard first and sets the scene: Mr. B., 76, day two of a heart failure admission, walking with a gait belt at 0700. The first action is physical, lowering him along the writer's leg, and it is defended against leaving him at the wall. Five ranked actions follow, each with its reason, ending with a mechanical lift and three staff. Readings of 108/64 lying and 124/72 before the walk support orthostatic hypotension, framed with Freeman et al. (2011). A section lists three things not done, such as giving water. The report is written out word for word, and the close names a sixty-second sitting step before walking.
Where the points sit in the NR 224 Week 5 rubric
Scenario responses tend to be graded on hazard identification, prioritization and rationale, appropriate interventions, communication and prevention, plus APA. Prioritization carries the most marks, so the ranking is stated and argued by what could injure him soonest. The first action earns credit because it is physical and defended against the alternative many students choose. Interventions are graded on safety, which is why getting him up uses a lift and three staff. Communication scores when the report names the people told and the words used. Prevention earns its row with a small, specific change tied to the diuretic. The consensus statement on orthostatic hypotension supports the clinical reasoning.
NR 224 Week 5 help from the desk
The most common loss is describing the scene well and never choosing anything. Leaving the patient to fetch help, with no argument that it was safe, is treated by many rubrics as the wrong first move. Listing hazards in the order the prompt mentioned them shows no judgment. Proposing restraints when a low bed and a call light were available costs points. Responses that report to nobody, or end with a paragraph on safety culture that never returns to the room, lose marks too. Calling for help while staying with the patient is acceptable if you say how. Send your scenario as written, and a response can be ranked and argued the same way.
Get a NR 224 Week 5 example written to your instructions
Send the scenario your section published along with the rubric, and a custom NR 224 response is written to that room and returned inside 24 to 48 hours, the first one free. If the prompt carries a required structure, a word limit or a set number of hazards to address, include that too and the example is built to fit it.
More NR 224 papers and pre-licensure samples
- NR 224 Week 1: One Small Safety Action Post
- NR 224 Week 2: C. diff Contact Precautions Write-Up
- NR 224 Week 3: Urinary Catheter Procedure Rationale
- NR 224 Week 4: Vital Signs Write-Up
- NR 224 Week 6: Wound Care Write-up
- NR 224 Week 7: Charting Exercise
- NR 224 Week 8: Skills Reflection
- NR 226 Week 5: Concept Map
- NR 222 Week 5: Shift Worker Sleep Teaching Plan
- NR 228 Week 5: Therapeutic Diet Write-up
- NR 103 Week 5: Nurse Interview Write-Up
NR 224 Week 5 questions, answered
Can I say I would call for help first?
You can, but it needs an argument. Leaving a room to fetch somebody is a choice about what happens in your absence, and a response that makes it without addressing that reads as avoidance. If the room is genuinely safe to leave for a moment, say why it is safe to leave, and then go.
How many hazards should the response cover?
Address what the prompt actually contains, and check whether your section sets a number. Covering everything at one sentence each usually scores worse than dealing properly with the first two and naming the rest, because the ordering is the thing under assessment rather than the count of items found.
Are restraints ever the right answer here?
Rarely, and a first-year response reaching for one before trying anything else tends to lose marks. Lower beds, call lights within reach, a bathroom trip offered before it is needed and closer observation come first in most teaching. If your classroom publishes a policy on this, follow that policy in the example.
Where can I find a free NR 224 Week 5 sample paper?
The full Week 5 safety scenario response, including the controlled lowering, the ranked actions and the report to the charge nurse, is available on this page.
Why does the NR 224 Week 5 response lower the patient instead of getting help?
A patient losing consciousness will fall whether or not the nurse stays, and the fall she cannot control is the dangerous one, so guiding him down protects his head first.