| Course | NR 662 Advanced Nursing Role Synthesis |
|---|---|
| Week | 3 |
| Paper type | Role boundary analysis |
| Length | About 1,100 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NR 662 Week 3
Role Boundary Analysis: Twelve Transition Activities Across the Heart Failure Transitions Nurse, the RN Case Manager and the Clinical Pharmacist, With the Contested Cells Explained
Student Name
College of Nursing, Chamberlain University
NR 662: Advanced Nursing Role Synthesis
Instructor Name
Month Day, Year
Role Boundary Analysis: Twelve Transition Activities Across the Heart Failure Transitions Nurse, the RN Case Manager and the Clinical Pharmacist, With the Contested Cells Explained
The Positions
The heart failure transitions nurse, as described in the role brief. The RN case manager on the cardiac units. The inpatient clinical pharmacist covering those units. These two were chosen because they are the positions whose work the new role most nearly touches; the cardiology clinic nurse practitioner sits further away, since the role passes dose decisions to that position rather than sharing them.
The Table
Values: L, leads the activity; C, contributes to it; N, does not do it. Cells were filled from the current job descriptions and from a week of observation on the unit, before any argument about who should do what.
| Activity | Transitions nurse | Case manager | Pharmacist |
|---|---|---|---|
| Identify heart failure patients within 24 hours of admission | L | C | N |
| Take the admission medication history | N | N | L |
| Compare the discharge medication list with the inpatient list | L | N | L |
| Recommend a dose change for a guideline medication | N | N | L |
| Teach the discharge medication list with teach-back | L | N | C |
| Teach daily weights and symptom thresholds | L | N | N |
| Arrange home health | C | L | N |
| Book the first cardiology visit within seven days | L | L | N |
| Secure insurance authorization for equipment or services | N | L | N |
| Call the patient within 72 hours | L | N | N |
| Escalate a reported weight gain the same day | L | N | N |
| Decide the patient can go home today | N | C | N |
The Contested Cells
Two rows carry L in two columns. Those are the cells the analysis exists to explain.
Comparing the discharge medication list with the inpatient list: transitions nurse L, pharmacist L. Both can legitimately do it. The pharmacist brings drug knowledge the nurse does not, such as interactions and renal dosing. The nurse brings knowledge of what the patient said during teaching, such as "I stopped taking that one last month." What decides who does it in practice is who is on the unit when the discharge order is written. On weekdays before 15:00, the pharmacist usually reviews; after 15:00 and on weekends, nobody does. The proposed rule: the transitions nurse compares every list, and refers any discrepancy to the pharmacist on weekdays or to the prescriber when no pharmacist is available. The pharmacist keeps every dosing recommendation.
Booking the first cardiology visit: transitions nurse L, case manager L. Both can do it. The case manager does it now, by sending a request to the clinic, which books when it can. What decides the outcome is not who sends the request but whether a slot within seven days is held. The proposed rule: for heart failure patients only, the transitions nurse books directly into slots the clinic agrees to hold, and the case manager stops sending requests for those patients. Studies of early follow-up suggest the visit within seven days is the part that matters (Hernandez et al., 2010).
What Happens on a Sunday
On a Sunday, neither the transitions nurse nor the pharmacist is in the building, and the case manager covers by phone. A patient discharged on Sunday leaves with whatever the hospitalist wrote, teaching from the bedside nurse and no booked visit. The role brief says Monday catches these patients with a call and a booking. The table shows the cost: on Sunday, the comparison of medication lists does not happen at all. That cell is empty in every column, and the analysis states it rather than hiding it.
Cells Filled Once
Most rows have one L, and they are not contested. Taking the admission history stays with the pharmacist. Insurance authorization stays with the case manager. Teaching daily weights, the 72-hour call and same-day escalation belong to the new role and are currently done by nobody; those three rows are the strongest part of the case for the role, because they are work no current position holds.
The Row Nobody Leads From the Three
Deciding the patient can go home today belongs to the attending physician. The case manager contributes by confirming the plan is in place. The transitions nurse does not decide, and the analysis says so, because a role that claimed discharge decisions would be a different and much larger role.
What the Role Actually Claims
Three activities nobody does now: teaching daily weights and thresholds, the 72-hour call and same-day escalation. Two activities shared with a rule for who does them: the medication list comparison and the seven-day booking. Everything else stays where it is. Guideline-directed therapy for heart failure depends on careful titration by prescribers (Heidenreich et al., 2022), and the role's line on dosing protects that.
Why These Two Comparators
The case manager and the pharmacist were chosen because their job descriptions already include parts of the transition. A comparison with the bedside nurse would have shown almost no overlap, since bedside nurses teach but do not book or call; a comparison with the clinic nurse practitioner would have shown the dosing line, which is already settled. The two near comparators are where the arguments would actually happen. Choosing them deliberately also keeps the table to three columns, which is about as many as a reader can compare at once without losing the contested cells among the agreed ones.
What the Table Implies for Workload
Moving the booking from the case manager saves the case manager perhaps ten minutes per heart failure patient. Asking the pharmacist for more discharge reviews adds perhaps five. The new role absorbs the call, the teaching and the escalation, which together take about 40 minutes per patient. Transitional care trials that changed outcomes invested this kind of time per patient (Naylor et al., 2004).
Checking the Table
The pharmacist and the case manager each reviewed their own column on 24 September. The pharmacist changed "Teach the discharge medication list" from N to C, since pharmacists teach high-risk medications on request. The case manager agreed to give up the booking for heart failure patients if the clinic holds slots, and asked to be copied on each booking so that home health visits can be timed around the clinic date. Both corrections are in the table above, which is why it differs slightly from the first draft circulated on 20 September.
References
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., . . . Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
Hernandez, A. F., Greiner, M. A., Fonarow, G. C., Hammill, B. G., Heidenreich, P. A., Yancy, C. W., Peterson, E. D., & Curtis, L. H. (2010). Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA, 303(17), 1716-1722. https://doi.org/10.1001/jama.2010.533
Naylor, M. D., Brooten, D. A., Campbell, R. L., Maislin, G., McCauley, K. M., & Schwartz, J. S. (2004). Transitional care of older adults hospitalized with heart failure: A randomized, controlled trial. Journal of the American Geriatrics Society, 52(5), 675-684. https://doi.org/10.1111/j.1532-5415.2004.52202.x
Reading the NR 662 Week 3 instructions
Choose activities concrete enough to argue about, such as adjusting a dose, booking the follow-up or deciding a patient can go home today. Set your proposed role against two near comparators, positions whose work genuinely overlaps, and explain why you chose them. Fill the table with simple values, such as leads, contributes or does not, before writing any argument. Then write only about the contested cells, those filled in twice: why both positions can legitimately do the work, what decides who does it in practice and what rule you propose. Describe what happens on a weekend or night when only one position is in the building. Finish by stating what the role actually claims, and have each comparator check their own column.
How the NR 662 Week 3 example is put together
The sample's twelve rows run from identifying patients on admission to deciding discharge. Two cells are contested: comparing medication lists, where the pharmacist brings drug knowledge and the nurse brings what the patient said, with time of day deciding who does it now; and booking the first visit, where the case manager sends requests and the outcome depends on held slots. Rules are proposed for each. On a Sunday, nobody compares lists at all, and the table says so. Three rows nobody holds now carry the case for the role. Time moved between positions is estimated, and the pharmacist and case manager corrected their columns before submission. The writer explains why the two comparators were chosen over others.
NR 662 Week 3 rubric: what full points look like
Boundary analyses lose most when the activities are too general to argue about, such as patient education or care coordination, so every cell looks shared. Next is a comparison with positions that barely overlap, which makes the table tidy but tells the reader nothing. Many students write the argument first and fill the table to match, which hides real overlap. Contested cells are often explained by asserting that the new role is better placed, without saying what actually decides who does the work in practice. Weekend and night coverage is usually ignored, though that is where boundaries fail. Tables never checked by the comparator positions often contain errors those positions would catch immediately. Analyses that never estimate the time moved between positions also leave the workload argument unmade.
NR 662 Week 3 help from the desk
Building a boundary table means describing other people's jobs accurately, which usually requires asking them. We can help you choose activities concrete enough to argue about, pick two near comparators and fill the table before writing. We can also help you explain the contested cells and describe what happens when only one position is present. Having each comparator review their own column is the step most students skip and graders notice. The analysis is yours. Estimating the minutes each change moves between positions also strengthens the case.
Get a NR 662 Week 3 example written to your instructions
Send the assignment page and any comparison template your classroom uses, and a custom analysis built around the two positions that actually sit closest to yours comes back inside 24-48h, the first one at no cost. Name those two if you already know them, and say whether your section wants regulatory sources cited row by row.
More NR 662 papers and MSN samples
- NR 662 Week 1: One Task Post
- NR 662 Week 2: Role Description Brief
- NR 662 Week 4: Competency Evidence Write-up
- NR 662 Week 5: Cross-course Integration Paper
- NR 662 Week 6: Gap and Development Analysis
- NR 662 Week 7: Role Justification Memo
- NR 662 Week 8: Closing Synthesis Paper
- NR 560 Week 3: Background and Significance Section
- NR 500 Week 3: Professional Standards Review
- NR 559 Week 3: Research Design Comparison
- NR 500NP Week 3: Population Focus Rationale
NR 662 Week 3 questions, answered
How many comparison positions is enough?
Two done properly beats four done thinly. Each comparator needs its own contested cells worked through, and a paper carrying four rarely gets past listing them. Choose one position that overlaps clinically and one that overlaps on coordination, since those are different kinds of contest, and a reader learns more from that pair than from four clinical near neighbors.
What if regulation clearly gives the work to my role?
Then say it once and move to the harder question, which is why somebody else is doing it anyway. Permission and practice separate constantly: a pharmacist may adjust a dose under a protocol nobody has revisited in years, and a resident may do a procedure because the schedule assumes it. An analysis stopping at what is legally allowed answers a smaller question than the one asked.
Is it acceptable to conclude that a cell should stay where it is?
Yes, and it usually strengthens the paper. Conceding a contested cell to the position that currently holds it shows the writer applied a test rather than claimed everything the test touched. Marks go the other way when every contested cell resolves in favor of the new position, since a test that never returns an unwelcome answer was decorative.
Where can I find a free NR 662 Week 3 sample paper?
You can read the whole role boundary analysis for a heart failure transitions nurse, with its twelve-row table, right here.
Why does the NR 662 Week 3 analysis describe a Sunday?
On a Sunday only the case manager is reachable, and nobody compares medication lists, which shows exactly where the boundary fails.