| Course | NR 579 Palliative Care in Adult-Gerontology Across the Spectrum |
|---|---|
| Week | 8 |
| Paper type | Narrative reflection |
| Length | About 980 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Primary Care NP (AGPCNP) |
| Updated | October 2026 |
Free sample paper for NR 579 Week 8
Narrative Reflection: The Typed Question "Am I Dying?" That I Answered With "Let's Focus on Today," and the Visit the Next Morning When I Stayed in the Room
Student Name
College of Nursing, Chamberlain University
NR 579: Palliative Care in Adult-Gerontology Across the Spectrum
Instructor Name
Month Day, Year
Narrative Reflection: The Typed Question "Am I Dying?" That I Answered With "Let's Focus on Today," and the Visit the Next Morning When I Stayed in the Room
The Question
It was the third time I had seen the patient, a 66-year-old retired chemistry teacher with ALS. The spouse had gone to the parking garage to move the car. My preceptor was in the next room. The patient typed on the tablet, slowly, with one finger, and turned the screen toward me: "Am I dying?"
I read it. I said, "Let's focus on today. How's the shoulder?"
The patient looked at me for a second, typed "fine," and turned the screen away.
What I Was Doing
I knew the answer. The patient's breathing strength was 38% and falling, swallowing was failing, and the patient had already said no to a tracheostomy. The honest answer was yes, sooner than anyone wanted, probably within a year. I kept quiet because I did not want the words to come from me, a student on my own, with my preceptor out of the room. I told myself it was not my place. That was partly true; it was also the easiest thing to say.
What I did not consider was that the patient had chosen that moment, with nobody else in the room, on purpose. The question had been typed slowly. Someone who types with one finger does not ask by accident.
What I Did Afterward
In the car, I told my preceptor. My preceptor did not tell me what I should have said. My preceptor asked what I thought the patient wanted from the question. I said, probably, to be told the truth by someone who would not cry. My preceptor said, "Then you know what to do tomorrow."
The next morning I went back with my preceptor, who let me lead. I said: "Yesterday you asked me if you were dying, and I changed the subject. I'm sorry. Do you still want to talk about it?" The patient typed "yes." I said that the disease was getting worse, that the breathing muscles were weakening, and that I thought the time left was probably months rather than years, though nobody could be sure. Then I stopped talking.
The patient typed for a long time. The screen said: "Thank you. Nobody would say it. Now I can tell the kids."
What the Patient Did With the Answer
The spouse told me two weeks later that the patient had written letters to each grandchild that weekend, typing them over three days, and had asked the spouse to keep them for the grandchildren's eighteenth birthdays. I had not known that was what the patient wanted the answer for. I would not have found out if I had left the subject changed.
The Turn
The turn was small. It was the decision to go back and to sit down instead of standing by the door. A guide to difficult conversations in serious illness describes the value of responding to emotion and allowing silence after hard news (Back et al., 2005), which I had read and had not done. Reading about it had not been enough; I needed to have failed at it once.
What My Preceptor Did Not Do
My preceptor did not take over the next morning, did not script what I should say and did not tell me afterward that I had done well. My preceptor sat at the end of the bed and said nothing for the whole conversation. I understood later that this was the point: the patient's question had been asked to me, and the answer needed to come from me.
Why I Almost Did Not Write About This
I considered writing this reflection about a family meeting that went well, where I had a clear role and did it. That would have been easier to grade and easier to read. It would also have taught me nothing I did not already know about my own habits. The question that hurt is the one worth writing about, because it showed me something I was doing without noticing it. The encounter I chose is the one I still think about on the drive home, which seemed like the better test of whether anything changed.
What I Do Now
When a patient asks a direct question about dying, I ask first what they already understand, then answer honestly in plain words, then stop and wait. If I am not the right person to answer, I say so and tell the patient who will, and when, rather than changing the subject. I have done this twice since, once well and once clumsily. The clumsy one was a family member's question in a hallway, when I answered before asking what they already knew and said more than they wanted to hear. The difference between the two was the first question, not the answer. Asking what someone already knows tells me how much to say and where to start. Skipping it means guessing, and I guessed wrong. Charon (2001) describes attention to the patient's story as part of clinical skill, not separate from it, and the question typed with one finger was the patient's story arriving at the moment the patient chose.
What I Still Avoid
I still look for the doorway when a family member starts to cry. The structure of serious illness conversations, which puts responding to emotion before decisions (Bernacki & Block, 2014), is the part of the method I find hardest. I have noticed it and not yet changed it.
References
Back, A. L., Arnold, R. M., Baile, W. F., Tulsky, J. A., & Fryer-Edwards, K. (2005). Approaching difficult communication tasks in oncology. CA: A Cancer Journal for Clinicians, 55(3), 164-177. https://doi.org/10.3322/canjclin.55.3.164
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
Charon, R. (2001). Narrative medicine: A model for empathy, reflection, profession, and trust. JAMA, 286(15), 1897-1902. https://doi.org/10.1001/jama.286.15.1897
What the NR 579 Week 8 assignment asks for
The Week 8 piece reads as short nonfiction with a clinical spine underneath it. One encounter carries the whole thing, chosen because it went imperfectly rather than because it went well. Your own avoidance belongs on the page: the question dodged, the euphemism used, the conversation handed to someone more senior. Then the turn, which is usually small and specific, such as a single sentence or a decision to stay in a room. Most rubrics reward a change shown in action rather than a claim of growth, and an honest note of what has not changed. Sources, if used, should support the turn rather than decorate it.
Inside the NR 579 Week 8 example
The piece opens with the patient typing the question while the spouse and preceptor are out of the room, and the writer's deflection in the exact words used. A section explains why the writer deflected and what the timing of the question meant. The preceptor's one question in the car follows, then the return visit the next morning, with the words used and the patient's typed reply. A section records the letters the patient wrote to grandchildren. The turn is named as going back and sitting in silence, with a source on difficult conversations. Sections cover the preceptor's silence, why this encounter was chosen, current practice and what is still avoided.
NR 579 Week 8 rubric: what full points look like
The reflection that stays general loses most, because the insight row has nothing to fasten onto; this one carries a single encounter. Growth asserted without evidence comes next, and here the change is an action, going back and staying seated, shown in two later conversations. Pieces that avoid the writer's own failure read as safe and are graded as safe; this one quotes the writer's deflection. A turn that is too large to be believable loses credit, while a small, specific one earns it. Admitting what still has not changed completes the honesty criterion. A changed action, visible in a later conversation, is what turns the reflection into evidence.
NR 579 Week 8 help: mistakes that cost points
The most common NR 579 Week 8 problem is a summary of the whole term with no single encounter. Another is a reflection about an interaction that went well, which teaches little. Many pieces describe feeling more confident without showing any changed action. Some hide the writer's own avoidance behind the patient's story. Patient details that could identify someone must be left out. If your term held a different encounter, send what happened and what you said; a reflection can be built around the moment you would handle differently. Pick the encounter you still think about, quote what you said, and describe one small change you can show in a later conversation. Leave out anything that could identify the patient.
Get a NR 579 Week 8 example written to your instructions
Send your prompts, the rubric and whatever length the section allows, and a custom Week 8 reflection written to them arrives in 24-48h, first one free. Your clinical hours, the log recording them and any evaluation a preceptor completes are records of your own practice, and this desk never produces those. The written piece built around a classroom encounter is what we draft.
More NR 579 papers and AGPCNP samples
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NR 579 Week 8 questions, answered
Is a patient I met on placement allowed in this piece?
Write about the encounter, never about the person. Alter the details that identify, keep the ones carrying the clinical point, and check your section's rules first, because some prohibit placement material outright and want a classroom case instead. The reflection is graded on your reasoning and your change, not on how remarkable the patient was.
Does it need references?
Usually yes, though fewer than an analytical paper. Two or three current sources placed where they did work are the standard shape. A reflection with no scholarly support at all often loses against a rubric row nobody reads until afterward, and one carrying a dozen sources has generally stopped being a reflection.
Where is the line on personal detail?
A disclosure earns its place when it explains a clinical behavior, and not otherwise. A writer's own family loss can belong here if it accounts for something they avoided at work. Detail included for its own sake does not, and markers tend to read it as standing in for analysis. Keep the focus on practice and the piece stays professional.
Where can I find a free NR 579 Week 8 sample paper?
The full narrative reflection on the typed question and the return visit the next morning is published on this page.
What is the turn in the NR 579 Week 8 reflection?
Going back the next morning, acknowledging the deflection, answering honestly in plain words and then staying seated in silence while the patient typed.