| Course | NR 574 Acute Care Practicum I |
|---|---|
| Week | 3 |
| Paper type | Orientation write-up |
| Length | About 1,000 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Acute Care NP (AGACNP) |
| Updated | October 2026 |
Free sample paper for NR 574 Week 3
Orientation Write-Up After Three Days on a Medical Intermediate Care Unit: What It Admits, Who Supervises on Which Day, What I May Do Alone and What Is Still Unarranged
Student Name
College of Nursing, Chamberlain University
NR 574: Acute Care Practicum I
Instructor Name
Month Day, Year
Orientation Write-Up After Three Days on a Medical Intermediate Care Unit: What It Admits, Who Supervises on Which Day, What I May Do Alone and What Is Still Unarranged
What Kind of Unit This Is
Medical intermediate care, 24 beds, inside a community hospital of roughly 300. Nurse-to-patient ratio is one to three. Every bed has continuous cardiac monitoring and pulse oximetry. The unit admits adults who need monitoring or treatment beyond a general ward: noninvasive ventilation, continuous infusions of insulin, heparin, diltiazem or nitroglycerin, gastrointestinal bleeding after endoscopy, diabetic ketoacidosis once the gap has closed, and transfers down from intensive care. In my first three days, about half the patients had a lung or heart failure problem. The unit does not take patients on vasopressors or on invasive ventilation.
Who Is Responsible for Me, Day by Day
Monday to Wednesday, days: my preceptor, the acute care nurse practitioner who covers the unit, 07:00 to 19:00. I am with my preceptor for the whole shift.
Thursday, days: a second acute care nurse practitioner who covers the unit on my preceptor's day off. We met on Wednesday; this colleague has agreed to supervise me on Thursdays and has precepted before.
Friday to Sunday: no practicum hours scheduled.
Nights: no practicum hours. The unit is covered at night by a hospitalist.
The week my preceptor is away: my preceptor has a week of leave in week 5. We agreed that I will spend that week with the Thursday nurse practitioner on Monday and Tuesday and will not attend on Wednesday. Course faculty have been told.
If my preceptor is pulled to the intensive care unit for a rapid response during a shift, I go with them if I am not in the middle of a task, or I stay with the charge nurse and do not see new patients until my preceptor returns.
What I May and May Not Do Unaccompanied
May: review the chart and the overnight events; examine patients and talk with them and their families about their day; write progress notes and admission notes, which my preceptor reviews and cosigns; present on rounds; call consultants with my preceptor's agreement on what to ask.
May not: place or change orders without my preceptor's review and cosignature; perform any procedure without a supervisor in the room; discuss code status or goals of care without my preceptor present; give results of new diagnoses to patients alone; change ventilator or noninvasive ventilation settings without the respiratory therapist and my preceptor agreeing.
The limits were stated by my preceptor on day 1 and match the course handbook. I have recorded both lists because faculty need to see the limits as much as the permissions. The may-not list reads as a set of supervision levels for each activity, which is how entrustment frameworks describe the path to independence (ten Cate, 2013).
The Shape of a Day
07:00: sign-out from the night hospitalist to my preceptor, about 20 minutes, at the workstation.
07:20 to 08:30: pre-rounding; I see my assigned patients and update their problem lists.
08:30 to about 09:45: multidisciplinary rounds in the hallway, with nursing, respiratory therapy, pharmacy and case management.
10:00 to 13:00: orders, calls to consultants, family updates, discharges.
14:00 to 19:00: most admissions arrive, from the ED and from intensive care, in the afternoon and early evening.
17:00: brief check-in with the charge nurse about the night.
Gaps in What I Know After Three Days
I do not yet know how the unit decides when a patient on noninvasive ventilation needs to move to the intensive care unit; my preceptor described it as a judgment made with respiratory therapy, and I have not seen it happen. I do not know whether the vascular access team supervises students, which affects one of my aims. I do not know how family meetings are scheduled or who calls the family. And I have not yet seen an admission from start to finish.
What Is Still to Be Arranged
Electronic record access for note writing: requested on day 1, not yet active; my preceptor is writing my notes into the chart for now. Ultrasound device training: the hospital requires a short course before any use; scheduled for week 2. A meeting with the vascular access team lead: to be arranged by my preceptor this week. Confirmation from course faculty of the leave-week plan: emailed on Wednesday, awaiting reply.
Who to Call About What
Clinical questions during the shift: my preceptor, or the Thursday nurse practitioner on Thursdays. Questions about my schedule or hours: the placement coordinator, by email, answered within two working days. Concerns about supervision or safety: course faculty, by phone, the same day. Access problems with the record or the badge: the unit manager, who has asked me to report them by noon so they can be fixed before the next shift. An injury or exposure on the unit: the charge nurse first, then employee health, then course faculty. I have put these on a card in my badge holder.
Why the Write-Up Is This Plain
Orientation documents that describe a hospital's history, size and awards answer a question nobody asked. What faculty need from week 3 is who is responsible for me on each day, what I may and may not do and what is still missing. A study of nurse practitioner role transition found that a formal orientation was associated with a smoother entry into practice (Barnes, 2015), and a precepting improvement project found that clear expectations at the start helped both preceptors and students (Logan et al., 2015). This write-up is my half of that orientation. The supervision arrangements described here will be checked against what actually happens at the midpoint.
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
Logan, B. L., Kovacs, K. A., & Barry, T. L. (2015). Precepting nurse practitioner students: One medical center's efforts to improve the precepting process. Journal of the American Association of Nurse Practitioners, 27(12), 676-682. https://doi.org/10.1002/2327-6924.12265
ten Cate, O. (2013). Nuts and bolts of entrustable professional activities. Journal of Graduate Medical Education, 5(1), 157-158. https://doi.org/10.4300/JGME-D-12-00380.1
NR 574 Week 3 instructions, in plain terms
The Week 3 assignment asks for a factual write-up of your placement after the first days, usually two or three pages under headings. State what kind of unit it is and what it admits. Say who is responsible for you on each day of the week, and what happens on the days that person is not there, including leave and nights. Record what you may and may not do unaccompanied, since faculty need the limits as much as the permissions. A paragraph on the shape of a day is usually expected. The write-up should name the gaps in your own knowledge, since three days in there will be several, and close on what still has to be arranged. Assessment and opinion do not belong here.
How this NR 574 Week 3 example is built
The sample describes the unit in a short paragraph: beds, staffing, monitoring and the patients it does and does not take. Supervision is set out day by day, including the Thursday nurse practitioner, the week 5 leave plan and what happens during a rapid response. Two lists give what the student may and may not do alone, and a sentence links them to entrustment levels. A timed outline shows the day from sign-out to evening check-in. A section names four things not yet known, from transfer decisions to family meeting scheduling. Another lists who to call for clinical, scheduling, safety and access problems. Open items close it, each with who is arranging it.
Reading the NR 574 Week 3 grading rubric
A write-up that reads like a hospital brochure gives away the most, because founding dates and bed totals answer nothing the assignment asked while supervision gets two lines. Supervision written as a single name costs the next share, since the arrangement that breaks is usually the week that person is away; this sample covers every day, the leave week and rapid response calls. Recording only permissions, and skipping limits, loses the scope criterion. Admitting gaps in knowledge earns honesty credit. Closing on open items with owners satisfies the planning row. Keeping the language factual, without assessment, meets the tone criterion. Naming who to call for each kind of problem also counts toward safety.
NR 574 Week 3 help from the desk
NR 574 Week 3 write-ups most often describe the hospital rather than the arrangement. Another common gap is supervision given as one name, with no plan for days off or leave. Writers list what they are allowed to do and leave out what they are not. Many skip the shape of the day, which faculty use to judge whether the hours make sense. Write-ups that sound fully informed after three days are not believed. Opinions about the unit belong in later journals, not here. If your placement is set up differently, send your schedule and the permissions you were given; a write-up can be laid out from them.
Get a NR 574 Week 3 example written to your instructions
The assignment file, the headings your section requires and a few lines about the unit, the supervision and the hours are enough to work from. A custom NR 574 Week 3 orientation write-up is returned inside 24-48h, the first one free, arranged under your headings, with the particulars of your own site left for you to enter.
More NR 574 papers and AGACNP samples
- NR 574 Week 1: First Practicum Week Discussion Post
- NR 574 Week 2: Practicum Learning Objectives
- 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 3: Simulation Debrief Timeline
- NR 567 Week 3: Nicardipine Titration Plan
- NR 572 Week 3: Working Differential Brief
- NR 569 Week 3: Differential Narrowing Memo
NR 574 Week 3 questions, answered
Can the site be named?
Most sections prefer not, and a finished write-up works without it. What carries the marks is the kind of unit, its admission profile and the supervision arrangement, none of which need a name. Where faculty do ask for the site, that line gets added by the writer rather than sitting in any example, along with the unit and the dates.
It is only week three and the write-up feels thin.
Thin is accurate at week three and faculty know it. The document that marks badly is not the short one, it is the one hiding what is not yet known behind general description. A page of precise arrangements plus a dated list of unsettled questions beats three pages of atmosphere every time.
How does this differ from the setting description in a later course?
A later practicum describes a setting the writer already understands and can evaluate. This one is written from inside the first week, when everything is second hand, so it reports what was said and by whom instead of judging whether the placement is any good. The judging assignment arrives in week eight.
Where can I find a free NR 574 Week 3 sample paper?
The full orientation write-up for the intermediate care unit, with day-by-day supervision and the lists of permissions and limits, is published on this page.
Why does the NR 574 Week 3 write-up cover the preceptor's leave week?
Supervision usually breaks when the named preceptor is away, so the write-up records exactly who supervises and what changes during that week.