| Course | NR 574 Acute Care Practicum I |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 580 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Acute Care NP (AGACNP) |
| Updated | October 2026 |
Free sample paper for NR 574 Week 1
Week 1 Discussion: Initial Post
Saying the Plan Out Loud Before the Preceptor Does: What I Expect to Be Hardest on a Step-Down Unit's Morning Rounds, Stated So It Can Be Proved Wrong
Initial Post
My position is that the hardest part of this first acute care practicum will not be knowing what to do for a patient. It will be saying it first, out loud, on rounds, before my preceptor has spoken.
I am placed on the medical intermediate care unit of a community hospital, 24 beds. I spent an orientation morning there on Friday. At 08:30 the team stands in the hallway outside the first room: the acute care nurse practitioner who will be my preceptor, a hospitalist, the charge nurse, a respiratory therapist, a pharmacist and a case manager. Each patient gets about five minutes. The person presenting gives a one-line summary, the overnight events, the numbers that changed and a plan, and the plan is the part everyone is waiting for. When clerkship directors in internal medicine were surveyed, most put a plan focused on the main problems near the top of what a case presentation must contain (Green et al., 2009), and the hallway on Friday behaved as if it agreed. On Friday the preceptor presented twelve patients in a little over an hour. On two of them the respiratory therapist disagreed with the plan for the breathing machine, and the plan changed in the hallway in under a minute.
In our simulation lab last term, a presentation had a clock but no audience with its own opinions. The faculty member listened to the whole thing before commenting. On the unit, the plan is challenged as it is spoken, by people who know more about one piece of it than the presenter does. A classroom version can teach the order of a presentation; it cannot teach what it feels like to propose weaning a patient off bilevel ventilation while the respiratory therapist is shaking their head.
What I expect will be hard is this: by week 4, I think I will still be waiting to hear the preceptor's plan before giving mine, even when I have one. That is a prediction that could turn out to be wrong. If by week 4 I am presenting my own plan first on most patients, I will say so in a later post. A study of new nurse practitioners found that a formal orientation was the factor that best predicted an easier move into the role (Barnes, 2015), which makes me think the habits of the first weeks matter more than I would have guessed.
Reply to Brianna
Brianna, your placement is a cardiac surgery step-down, and you said the hardest part will be chest tube management. I wonder whether the harder part might be the handoff from the surgical team each morning, since you described the surgeons rounding at 06:00 before you arrive. If the plan for the chest tubes is made before you are there, how will you get a chance to make it yourself?
Reply to Jason
Jason, you predicted that night admissions would be the hardest part of your hospitalist placement. That is a prediction someone could test, which I liked. Could you make it sharper? For example, how many night admissions do you expect to write up by week 4, and what would tell you that you were doing them well, beyond the number?
References
Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. Journal for Nurse Practitioners, 11(2), 178-183. https://doi.org/10.1016/j.nurpra.2014.11.004
Green, E. H., Durning, S. J., DeCherrie, L., Fagan, M. J., Sharpe, B., & Hershman, W. (2009). Expectations for oral case presentations for clinical clerks: Opinions of internal medicine clerkship directors. Journal of General Internal Medicine, 24(3), 370-373. https://doi.org/10.1007/s11606-008-0900-x
NR 574 Week 1 instructions, in plain terms
In week 1 the prompt wants a stance on what your unit will demand of you, written before you know it well. Expect three or four paragraphs and a reference or two. Open with a position rather than a definition of acute care. The middle should describe one concrete thing that happens on your unit, closely, followed by the reason a classroom version of it would be thinner. Then say what you expect will be hard, in terms that could later turn out to be wrong, so the coming weeks can test it. Most sections ask for two shorter replies, each aimed at a specific feature of the classmate's service rather than at acute care in general.
How this NR 574 Week 1 example is built
The sample opens with its position in one sentence: the hard part will be saying the plan first. It then describes an orientation morning on a 24-bed intermediate care unit, the team in the hallway, the pace of twelve patients in about an hour and two plans changed by the respiratory therapist in under a minute. A paragraph contrasts this with simulation, where the faculty listened to the end before commenting. The prediction follows, tied to week 4, with a sentence on how the writer will report if it proves wrong, and a study of new nurse practitioners supports the point about early habits. The replies ask one classmate about surgical rounding at 06:00 and another to put a number on a prediction.
Reading the NR 574 Week 1 grading rubric
The grader's first deduction goes to a post that defines acute care in general terms. That paragraph could have come from any course in the sequence, and graders reward the post that could only have come from this writer and this unit. A promise with no test attached, such as growing in confidence, is the next loss, since nothing in eight weeks could confirm it; this sample names a week and a behavior. The concrete event described closely earns the middle rows. A source that supports the claim adds evidence credit. Replies earn points when they go at a feature of the classmate's placement, and lose them when they restate agreement at length, because every classmate is on a different unit.
Common NR 574 Week 1 mistakes, and how to avoid them
Students often answer this NR 574 Week 1 prompt with a definition of acute care and the competencies of the role, which a grader reading forty posts will skip. Another common slip is a vague promise to become more confident or more efficient. Some posts describe the hospital instead of one event on the unit. Others choose a difficulty so general that it could not be wrong. Replies that praise a classmate's enthusiasm earn little. Pick one moment from your orientation, describe it as it happened and predict something about it you could later check. If your unit differs, send what you saw on your first day, and a sample post built on it can follow the same shape.
Get a NR 574 Week 1 example written to your instructions
Send the discussion instructions and whatever your classroom publishes about post length and replies, and a custom NR 574 Week 1 post is written to them and returned inside 24-48h, the first one free. If the rubric names a required number of sources, include it, since that changes how the middle paragraph is built.
More NR 574 papers and AGACNP samples
- NR 574 Week 2: Learning Objective Set
- NR 574 Week 3: Orientation Write-up
- NR 574 Week 4: Weekly Practicum Journal
- NR 574 Week 5: Midpoint Self-appraisal
- NR 574 Week 6: Exposure Gap Memo
- NR 574 Week 7: Rounds Presentation Outline
- NR 574 Week 8: End of Rotation Summary
- NR 573 Week 1: Procedure Note Line Discussion Post
- NR 567 Week 1: Status Epilepticus Route Discussion
- NR 572 Week 1: Calcium Timing Discussion Post
- NR 569 Week 1: Fever and Back Pain Discussion Post
NR 574 Week 1 questions, answered
Can a week one post talk about a placement that has not started?
It has to, because none of them have started. A finished post writes in the conditional: what the writer expects a service to supply, why coursework cannot supply it, and what would count as being wrong. Anything written as though shifts had already been worked reads false to faculty who know the term calendar.
My section wants two replies. What makes one count?
A question the other writer is uniquely able to answer. Everybody in the section is on a different unit, so asking what their team does with an admission arriving during walking rounds produces information that could not come from a textbook. Agreement plus a citation fills space and is marked as space.
Is this post different from the discussion in the courses before it?
Materially, yes. The three courses ahead of this one argue about patients, and those arguments settle on published work anybody can look up. Here the subject is the writer's own position on a service, which no source covers, so the post is judged on precision and on whether the claim stays falsifiable rather than on how much was cited.
Where can I find a free NR 574 Week 1 sample paper?
The full post predicting the difficulty of offering a plan first on step-down rounds, with replies to Brianna and Jason, is on this page.
What prediction does the NR 574 Week 1 post make?
That by week 4 the writer will still be waiting for the preceptor's plan before giving their own, a claim the term can confirm or disprove.