| Course | NR 575 Acute Care Practicum II |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 570 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 575 Week 1
Week 1 Discussion: Initial Post
One Change Carried Into the Second Rotation: Leaving Silence After Bad News in a Family Meeting, Traced to Last Term's Closing Summary and Tested in Week 8
Initial Post
The change I am bringing into this second practicum is narrow: in every family meeting I lead, after I give difficult information, I will stop talking and wait for the family before I offer any options.
Its source is my closing summary from last term. In it, I recorded the one area I still judged weak: the seconds after hard news in a family meeting, when relatives need room to react. My preceptor's written comment on the only meeting I led said the same thing in fewer words: offer a pause before moving to options.
The occasion was week 7 of last term, on a medical intermediate care unit. A daughter and son had come to talk about their father, who had severe COPD and had been on bilevel ventilation for a week. I told them that their father's lungs were unlikely to recover enough for him to come off the machine at night, and that a breathing tube might be needed if he worsened. The daughter looked down. I did not wait. Within about five seconds I said, "So there are three options we could think about," and listed them. The son asked a question about the first option; the daughter did not speak again for the rest of the meeting. Afterward my preceptor asked what the daughter had been thinking when she looked down. I could not answer; I had not given her the chance to say.
A review of communication about serious illness describes asking what the patient or family understands, sharing information and then responding to emotion before moving to decisions (Bernacki & Block, 2014). My error was skipping the response to emotion, and I skipped it because I was filling the silence.
The request this turns into: I have asked my new preceptor, in the medical intensive care unit, to let me lead two family meetings this term, the first by week 4, and to write one comment on each about what I did after giving the hardest piece of information. A comment tied to a stated objective is more useful than general praise, because both of us will know what is being watched (Ende, 1983).
The test, for week 8: both written comments say that I paused and asked the family what they were thinking before raising any option. If either comment says otherwise, the change has not happened yet.
Reply to Natalie
Natalie, your change was to present fewer patients on rounds but more thoroughly, sourced to your midpoint appraisal. I like that it has a parent document. I wonder about the test. How would a reader in week 8 tell "more thoroughly" from "longer"? Could you name one thing that would appear in a thorough presentation and not in a long one, so the test can be checked?
Reply to Derek
Derek, you said your change was to be more independent with admissions. Where did that come from in last term's file? If your closing summary already marked admissions as met, the change might belong to a different item. If it came from a comment by your preceptor, quoting that comment would make the source clear and give the change a parent.
References
Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994-2003. https://doi.org/10.1001/jamainternmed.2014.5271
Ende, J. (1983). Feedback in clinical medical education. JAMA, 250(6), 777-781. https://doi.org/10.1001/jama.1983.03340060055026
What the NR 575 Week 1 assignment asks for
The first discussion in the second practicum asks you to name one change you are carrying over from the first, and to show where it came from. Expect about a screen of text that reads as a claim rather than a warm-up. Open with the change, then name its source: an aim from last term, a line in the midpoint appraisal or a sentence in the closing summary. Give one occasion in enough detail for a classmate to see where it went wrong. Then state the request the change turns into, addressed to a real person and attached to a week. End on a test, one line saying how a reader in week 8 could tell whether the change happened. Replies should ask classmates for a source or a sharper test.
How the NR 575 Week 1 example is put together
The sample opens with the change in one sentence, then names its source in last term's summary and the preceptor's written comment. The occasion is a meeting with a son and daughter about their father on bilevel ventilation: the daughter looked down, the writer moved to three options within seconds and the daughter did not speak again. A review of serious illness communication explains the skipped step of responding to emotion. The request asks the new intensive care preceptor for two meetings and a written comment on each, the first by week 4. The test names what both comments must say. One reply asks how thoroughness differs from length; the other asks where a classmate's change came from.
Reading the NR 575 Week 1 grading rubric
This post is marked on the join between two terms, so the largest loss is a feeling where an item belongs, such as more confident or better prepared, with nothing on file behind it. A change with no source document costs nearly as much, because it skips the assignment; this sample names two documents. A change nobody could confirm by week 8 loses a row of its own, and the test here is two written comments. The occasion described in detail earns the evidence row. Replies that reword a classmate's post earn little; replies that ask for a source or a test, as these do, earn the reply points.
NR 575 Week 1 help from the desk
Students in NR 575 Week 1 often write about feeling more ready for the second rotation, which nothing in the file can support. Another common slip is a change with no parent document, offered as a fresh goal. Some posts name a change and a source but no test, so week 8 has nothing to check. Others describe the occasion so briefly that a classmate cannot see what went wrong. Replies that simply agree add nothing. Start from a sentence in last term's documents and build the post from it. If your first practicum produced a different change, send the line it came from; a post can be shaped around it with a request and a test.
Get a NR 575 Week 1 example written to your instructions
Send the discussion instructions your section posted, along with whatever survives from your first rotation, and a custom NR 575 Week 1 post is written to those rows and returned inside 24-48h, the first one free. Tell the desk which aim you want it built on and the example will argue from that one.
More NR 575 papers and AGACNP samples
- NR 575 Week 2: Objective Revision Memo
- NR 575 Week 3: Continuity Case Narrative
- NR 575 Week 4: Competency Evidence Map
- NR 575 Week 5: Practice Readiness Appraisal
- NR 575 Week 6: Transition to Practice Plan
- NR 575 Week 7: Cumulative Portfolio Entry
- NR 575 Week 8: Practicum Closing Memo
- NR 567 Week 1: Status Epilepticus Route Discussion
- NR 574 Week 1: First Practicum Week Discussion Post
- NR 569 Week 1: Fever and Back Pain Discussion Post
- NR 573 Week 1: Procedure Note Line Discussion Post
NR 575 Week 1 questions, answered
Can I keep the objectives I wrote last term?
One can certainly carry over, but the post has to say so deliberately and give the reason it survived. An aim that simply turns up again, with nothing said about it, reads as an oversight and not as a decision, and faculty holding both terms see it straight away. The stronger move names the aim, states that it stands, and says what the first rotation showed that keeps it standing.
My first practicum went well. What is there to change?
Then the post argues for depth instead of repair. A rotation that went well still leaves something untouched: a presentation you never gave, a decision you always watched somebody else make, a conversation you were never the one to have. Naming one of those counts as a change and marks the same as fixing a weakness, provided the source is named.
How long is the opening post meant to be?
Shorter than people expect. Most sections keep it well short of an essay and mark it on whether the join between the two terms is visible rather than on volume. A worked example shows where the words go: one sentence for the change, two for the occasion behind it, one for the request, and one for the check a reader could run at term end.
Where can I find a free NR 575 Week 1 sample paper?
The full post on carrying a family meeting change into the second practicum, with replies to Natalie and Derek, is on this page.
What test does the NR 575 Week 1 post set for week 8?
Two written comments from the preceptor, one on each family meeting, both saying the writer paused and asked what the family was thinking before raising any option.