| Course | NUR 607 Advanced Health Assessment |
|---|---|
| Module | Module 10 |
| Paper type | Closing reflective journal on assessment and documentation |
| Length | About 410 words, 3 pages |
| Format | Journal entry with APA 7 citations |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 607 Module 10
Module Ten Journal
Writing for the Next Reader
Ten years in the emergency department made me quick at examining patients and careless at writing down what I found. My notes leaned on templates, and the word normal did a great deal of work. This course slowed my hands down in the right place. I now write every note for the clinician who will read it next, and three habits came out of that change.
The first is measuring instead of describing. When I wrote up the man with the neck lump, I had to record it as 2.8 by 2.2 cm, firm, mobile horizontally and less so vertically, rather than as an enlarged node. The difference is not style. A surgeon reading my note can tell whether the lump has grown by the time he sees it, and I can tell at follow-up whether it is shrinking. A description invites the reader to trust my impression; a measurement lets the reader judge for themselves.
The second habit is writing not assessed. In the same case I could not see the base of the tongue because of the patient's gag reflex, and my first draft said oropharynx normal. It was not normal; it was unseen. Singh et al. (2014) estimated that diagnostic errors affect about 5% of US adults seen in outpatient care each year, around 12 million people, and a note that implies an examination that did not happen is one small way those errors begin. Writing down what I did not examine is uncomfortable, but it tells the next clinician exactly where to look.
The third habit is repeating a surprising number before trusting it. The adolescent's machine blood pressure of 132/80 would have given her a label she did not have. Rechecked by auscultation with a measured cuff, her average was 124/76. The pediatric guideline asks for exactly that confirmation before a high oscillometric reading is classified (Flynn et al., 2017), but the deeper lesson was humility about my own first reading.
The American College of Physicians has argued that notes stuffed with template text serve billing more than clinicians (Kuhn et al., 2015), and I recognize my old notes in that criticism. In practice, I will turn off default normals where my electronic record allows, record measurements for every abnormal finding and write not assessed without apology. My notes will be shorter in some places and longer in others, and I hope more useful in all of them.
References
Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., de Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simasek, M., Thaker, V. V., & Urbina, E. M. (2017). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140(3), Article e20171904. https://doi.org/10.1542/peds.2017-1904
Kuhn, T., Basch, P., Barr, M., & Yackel, T. (2015). Clinical documentation in the 21st century: Executive summary of a policy position paper from the American College of Physicians. Annals of Internal Medicine, 162(4), 301-303. https://doi.org/10.7326/M14-2128
Singh, H., Meyer, A. N. D., & Thomas, E. J. (2014). The frequency of diagnostic errors in outpatient care: Estimations from three large observational studies involving US adult populations. BMJ Quality & Safety, 23(9), 727-731. https://doi.org/10.1136/bmjqs-2013-002627
What the NUR 607 Module 10 instructions ask for
The closing NUR 607 journal asks you to look back over the term's assessment and documentation work and name what changed in your practice. Prompts may point to specific competencies, such as history taking, examination technique, documentation or health promotion, and ask how you will use them as a nurse practitioner. Entries usually run 400 to 700 words in a personal voice, and instructors often want one or two APA 7 sources. Anchor each point in a write-up you completed rather than a general impression, show the before and after of a habit and close on commitments specific enough to check, since that is what separates reflection from summary in the grading. Keep a professional tone.
How this NUR 607 Module 10 journal example is built
This entry is written in the voice of a composite emergency department nurse entering family practice who relied on templates and the word normal. It is organized around three habits built during the course, each tied to a module: measuring the neck lump at 2.8 by 2.2 cm instead of calling it enlarged, writing not assessed for a base of tongue that could not be seen and repeating a teenager's high machine blood pressure by auscultation before trusting it. Evidence that diagnostic errors affect about 5% of outpatients and the American College of Physicians position on template-heavy notes support the reflection. It closes with concrete commitments, such as turning off default normals.
Where the NUR 607 Module 10 rubric puts the points
Reflective journals in NUR 607 usually earn their points through evidence of a genuine change in practice, links to specific assignments, application to the nurse practitioner role, scholarly support and writing quality. Entries score highest when they show the change with a before-and-after example from their own work rather than stating it, and when each lesson is connected to a reason it matters for patients. Admitting an earlier weakness honestly tends to read as professional maturity. A short list of concrete habits for practice demonstrates application to the nurse practitioner role, and a focused entry built on two or three lessons generally outperforms one that touches every module lightly.
NUR 607 Module 10 help: the mistakes that cost points
Closing journals are marked down when they describe the syllabus, praise the course without evidence of change, omit sources or end with a promise too vague to test, such as documenting better. Pick two or three habits the term built, show each one with a line from your own write-ups before and after, give a reason it matters and state what you will do in practice. Keep the tone professional and the length within limits. If your prompt names course outcomes you must address, send it along with notes on the write-ups that taught you most, and a reflection can be built from your own experience in the course.
Get NUR 607 Module 10 written to your instructions
Share your journal prompt, the course outcomes it names and two or three write-ups whose lessons stuck with you. A first-person entry built on those examples, supported by sources and ending in commitments you can keep, will arrive within 24 to 48 hours, and the first is on us. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
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NUR 607 Module 10 questions, answered
Where can I find a free NUR 607 Module 10 Journal sample?
A full closing journal is on this page: a reflection on writing assessment findings another clinician can trust, built from three course write-ups and supported by two APA 7 sources.
What should an advanced health assessment reflection include?
Specific changes in how you take histories, examine or document, each shown with an example from your own work, a reason it matters for patients and a concrete habit you will keep in practice.
Why write not assessed in a physical exam note?
It tells the next clinician exactly what was not examined, instead of implying a normal finding. Notes that suggest examinations that did not happen can contribute to diagnostic error.
How common are diagnostic errors in outpatient care?
A combined analysis of three large US studies estimated that about 5% of adults seen in outpatient care each year experience a diagnostic error, roughly 12 million people.
How long is the NUR 607 closing journal?
Expect somewhere between 400 and 700 words; the prompt for your section decides the exact limit and how many sources to cite.