NR 446 Week 8 Delegation Course Reflection Paper Example

Course	NR 446 Collaborative Healthcare
Week	8
Paper type	Course reflection paper
Length	About 1,120 words, 7 pages
Format	APA 7 student paper
School	Chamberlain University
Program	RN-to-BSN
Updated	October 2026

Free sample paper for NR 446 Week 8

The Walk I Handed Off: A Course Reflection on Delegation and One Near Fall

Student Name

College of Nursing, Chamberlain University

NR 446: Collaborative Healthcare

Instructor Name

Month Day, Year

What this page is doingThe title names one incident and the concept it will be measured against, which tells the reader the reflection is about a single decision rather than a review of the course. Student APA 7 format, no running head.

The Walk I Handed Off: A Course Reflection on Delegation and One Near Fall

The Nurse I Was in Week One

At the start of this course I delegated by availability. On a busy day shift on my surgical unit, when a task could be done by a nursing assistant, I handed it to whichever assistant was free, told them what to do in a sentence, and moved on. I thought of delegation as a way to save time, and I measured a good delegation by how quickly the task was done. I did not think about what the assistant needed to know about the patient, only about the task.

I also believed, without saying so, that telling an assistant about a patient's condition was a courtesy rather than part of the task. If the assistant needed to know something, I assumed the chart would tell her, forgetting that assistants on our unit do not usually read the provider notes where the night's events were recorded. The course made me see that belief for what it was.

What this page is doingThe starting point is a concrete habit rather than a mood: delegating by availability and measuring success by speed. That gives the change claimed later a fixed point to sit against.

The Incident

In the third week of the term, I had a patient on the first day after a bowel resection who had been lightheaded the evening before when he first sat on the side of the bed. His blood pressure had dropped from 124 over 76 lying to 98 over 60 sitting, and the night nurse had mentioned it in report. At 1000, physical therapy had not yet seen him, and the surgical team wanted him walking. I asked a nursing assistant who was between rooms to walk him to the end of the hall and back. I said, can you walk bed 14, he's day one post-op, use a gait belt. She did. About twenty steps out of the room he said he felt faint, his knees buckled, and she lowered him to the floor with the gait belt, as she had been trained. He was not hurt. His blood pressure standing was 86 over 52.

At the time, my reasoning felt sound. Walking is within the assistant's competency, she had a gait belt, the patient was stable, and the surgeons wanted him up. When I filled out the event report, I wrote that the patient had an episode of orthostatic hypotension during ambulation. That was true. It was also incomplete, because it left out the fact that I knew about the orthostatic drop and she did not.

What this page is doingThe decision is told as it was actually made, with the reasoning that seemed sound at the time and the exact words used. The admission about the incomplete event report keeps the incident uncleaned, which is what leaves something real to examine.

What the Course Material Showed Me

The five rights of delegation include the right directions and communication, which the national guidelines describe as telling the delegate what to do, what to report and what is specific about this patient (National Council of State Boards of Nursing & American Nurses Association, 2016). I had given her the task and the equipment. I had not given her the one fact that made this walk different from any other walk: that he had dropped his blood pressure sitting up the night before. With that fact, she could have sat him on the side of the bed for a minute first, checked his pressure, walked him a shorter distance with a chair nearby, or told me he was dizzy before he stood. Without it, she was doing a routine task on a patient who was not routine.

The guidelines also say the right circumstances depend on the patient's stability. I had called him stable, and by his vital signs lying in bed he was. But stability depends on the task. A patient who is stable in bed and unstable standing is not stable for a walk, and that judgment was mine to make before I delegated, not something the assistant could have made without the information I held. The course's language gave me a way to see that the gap was not in her skill or in the gait belt, but in what I chose not to say. Tanner (2006) describes clinical judgment as beginning with noticing, which depends on what the nurse already knows about the patient; by keeping the orthostatic drop to myself, I made sure the person standing next to him could not notice what I would have noticed.

What this page is doingThe course concept is brought in to explain the gap, naming what it would have predicted and where the writer's thinking went elsewhere. Delegation language appears attached to a specific handover rather than as a heading, which is how the rubric wants concepts used.

What I Now Do Differently

Since that day I have changed two things, and both are behaviors someone could observe. First, whenever I delegate ambulation or any task on a patient who has had a change in condition in the past 24 hours, I tell the assistant the change and what to report before I ask for the task, using the same order every time: here is what is different about this patient, here is what I need you to do, and tell me right away if you see this. For the patient in bed 14, that would have been: he dropped his pressure sitting up last night; walk him with a chair behind you, sit him on the edge of the bed for a minute first, and get me if he says he feels dizzy. Second, I now walk any patient myself the first time they get up after a documented orthostatic drop, and delegate later walks once I have seen how they tolerate standing.

I have been doing both for about four weeks. The charge nurse has noticed; two assistants have told me they prefer being told the reason for an instruction, because it lets them use their own judgment when something happens that I did not predict. The Interprofessional Education Collaborative (2023) describes shared information as the basis of team decisions, and I had been treating the assistant as someone who performs a task rather than someone who makes decisions while doing it.

What this page is doingForward statements say what will be said, to whom, and at which point in a shift, with the actual words included, and the writer reports four weeks of doing it with feedback from colleagues. That is the difference between a goal and a wish.

What Is Still Unresolved

I still have not settled how much to tell an assistant when time is short. On a day with eight patients and a rapid response in the next room, the one-sentence handoff I used to give is fast, and the three-part version takes perhaps twenty seconds longer each time. I believe the twenty seconds are worth it. But I also notice that on my worst days I slip back to the short version, and I do not yet have a way to catch myself. I also still wonder whether the event report should have said more. I did add a note to my manager afterward, but the report itself still reads as if nobody knew his blood pressure had dropped the night before, and that is not the whole truth of what happened.

What this page is doingThe reflection closes on something that remains difficult rather than total confidence, including an unfinished question about honesty in the event report. Markers read this as maturity, and it keeps the paper from ending on thanks or a summary.

References

Interprofessional Education Collaborative. (2023). IPEC core competencies for interprofessional collaborative practice: Version 3.

National Council of State Boards of Nursing & American Nurses Association. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3

Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211. https://doi.org/10.3928/01484834-20060601-04

The Chamberlain NR 446 Week 8 instructions

The final NR 446 reflection has you reflect on how your collaboration, delegation or leadership changed during the course. The checklist generally covers your starting habits, a specific incident, how course concepts explain it, what you now do differently, evidence that the change is real, what remains unresolved and APA. Describe your starting point as a habit, not a mood. Tell one incident as you actually decided it, including reasoning that seemed sound and anything you would rather leave out. Use course concepts to explain the gap between what you did and what was needed. State changes as behaviors with the words you use. Report how long you have done them and what colleagues noticed. End on what is still hard.

Inside the NR 446 Week 8 example

The first section describes delegating by availability on a busy surgical day shift and treating information about a patient as a courtesy. The incident section describes the third week: a patient who had been lightheaded sitting on the bed edge the evening before, a stable blood pressure lying down, an assistant asked to walk him with a gait belt and a near fall, plus the admission that the event report left out what the nurse knew and the assistant did not. The concepts section applies the guidelines' right directions and right circumstances, noting that stability depends on the task. The changes section gives the script used before delegating to a changed patient and walking patients the first time after a change. Four weeks of practice and feedback follow, then the unresolved question.

NR 446 Week 8 rubric: what full points look like

Reflection rubrics in NR 446 typically weigh a clear starting point, a specific incident, application of course concepts, observable changes, evidence of follow-through, honest discussion of what remains and APA. The incident and its analysis carry the grade, and the paper earns them by telling the decision as made and admitting the incomplete event report. Course concepts are credited because the five rights explain exactly where the reasoning went wrong. The changes score because they include the actual words used. Follow-through earns points through four weeks of practice and comments from the charge nurse and assistants. Ending on time pressure and honesty shows maturity graders value. The guidelines, IPEC and Tanner's model support the reflection.

NR 446 Week 8 help from the desk

The costliest reflection is a course review, paragraphs about readings and discussions that never touch the writer's practice. Another is an incident told with hindsight, so the reasoning at the time disappears. Students also leave out the uncomfortable part, describe changes as intentions rather than behaviors or end with total confidence. Personal moments are expected, with patient details changed. Sources are needed where a concept explains your decision. A reflection that admits an unfinished question reads as more credible than one that resolves everything. If one decision this term changed how you delegate, describe it, and an NR 446 closing reflection can be planned from that decision outward.

Get a NR 446 Week 8 example written to your instructions

Send the reflection prompt and the rubric, plus two or three lines about a moment from your own term if you want the example built on it. We write to your instructions and return the example inside 24 to 48 hours, and the first one is free.

More NR 446 papers and RN-to-BSN samples

NR 446 Week 8 questions, answered

How personal should a reflection be?

Personal about practice, not about private life. The events worth using are decisions you made at work, and the honesty that pays is admitting a call you would now change. Names, employers and identifying detail stay out; a unit described by its specialty carries all the context a marker needs and none of the risk.

Can the example include my own moments?

Send two or three lines about each and it will. Without them the example uses situations typical of the units this course draws from, marked clearly enough that you can tell which parts to swap for what happened on your own unit. Most writers keep the structure, drop in one true incident, and the paper becomes theirs in about twenty minutes.

Does the reflection need sources?

Some sections require them and some do not. Where they are required, the finished example cites the team and leadership material at the point a concept is doing explanatory work, never in a block at the end. Send your prompt and we match the requirement, including any format the classroom template sets.

Where can I find a free NR 446 Week 8 sample paper?

You can read the Week 8 reflection on the walk handed off and the near fall, with the starting habit, the incident, the delegation concepts, the changes, four weeks of practice and three references.

What does the writer now say before delegating in the NR 446 Week 8 reflection?

What is different about the patient, what the assistant needs to do and what to report right away, for example that he dropped his pressure sitting up and should be walked with a chair behind him.