| Course | NUR 616 Primary Care of Adults and Gerontological Patients |
|---|---|
| Module | Module 10 |
| Paper type | Closing reflective journal on primary care of older adults |
| Length | About 380 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 616 Module 10
Module Ten Journal
The Prescriptions I Learned Not to Write
In eight years of home health visits, I counted pills at many kitchen tables. I checked that patients took what was prescribed; I almost never asked whether they should. This course changed the question. The most important decisions in several of our cases were prescriptions not written and medicines stopped, and I finish the term thinking of those as clinical skills, not omissions.
The first case that shifted my thinking was the 72-year-old woman with a TSH of 7.2. My instinct was levothyroxine; the evidence from a trial in her age group said it would not help her tiredness, and her snoring and low mood were better explanations. The second was the nursing home resident whose cloudy urine grew E. coli. I would once have called that an infection. Applying explicit criteria showed it was colonization, and the real problems were dehydration and a new sedative. In both, the harder and better decision was to look past a laboratory value to the person.
The final project taught me how deliberately stopping has to be done. Reducing Mr. J.'s medicines from eleven to nine meant identifying which drugs caused harm, using the Beers Criteria to confirm that sulfonylureas and NSAIDs were poor choices for him (American Geriatrics Society Beers Criteria Update Expert Panel, 2023), keeping the heart failure drugs that protect him and changing no more than two drugs affecting fluid in a week. The deprescribing framework I leaned on lays out a sequence (Scott et al., 2015): reviewing every drug, weighing its current benefit and harm, prioritizing which to stop and then monitoring. I had thought of stopping a drug as simply crossing it off.
I also expected patients to resist. The evidence says otherwise: in a national survey of older Medicare beneficiaries, 92% said they would be willing to stop one or more medicines if their physician said it was possible (Reeve et al., 2018). The barrier is often the clinician's habit, not the patient's wish.
In practice, I will review every older patient's full medication list at least yearly, ask what each drug is for and whether it still serves the patient's goals and document the reason when I choose not to treat an abnormal result. Stopping will get the same care I give to starting.
References
American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Reeve, E., Wolff, J. L., Skehan, M., Bayliss, E. A., Hilmer, S. N., & Boyd, C. M. (2018). Assessment of attitudes toward deprescribing in older Medicare beneficiaries in the United States. JAMA Internal Medicine, 178(12), 1673-1680. https://doi.org/10.1001/jamainternmed.2018.4720
Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., Gnjidic, D., Del Mar, C. B., Roughead, E. E., Page, A., Jansen, J., & Martin, J. H. (2015). Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Internal Medicine, 175(5), 827-834. https://doi.org/10.1001/jamainternmed.2015.0324
What the NUR 616 Module 10 instructions ask for
The NUR 616 closing journal invites you to consider how the term changed your approach to adults and older adults in primary care. Prompts may name themes such as evidence-based prevention, chronic disease management, geriatric syndromes or polypharmacy and ask how you will carry them into practice. Expect around 400 to 700 words in the first person, often with one or two APA 7 sources. Choose a small number of lessons, show each through a case you worked on during the term, connect it to evidence and close with concrete habits, since the entry is judged on the depth of the change it describes and on how clearly that change will show up in your future practice.
How this NUR 616 Module 10 journal example is built
The writer here is a composite home health nurse entering family practice who used to count pills without questioning them. The entry centers on one lesson, that stopping and not starting are clinical skills, shown through three course cases: the 72-year-old with a TSH of 7.2 who did not need levothyroxine, the nursing home resident whose positive urine culture needed no antibiotic and the 78-year-old whose eleven medicines became nine in the final project. The Beers Criteria, the Scott deprescribing process and a Medicare survey showing 92% of older adults willing to stop a medicine support the reflection, which ends with commitments to yearly medication reviews.
Where the NUR 616 Module 10 rubric puts the points
NUR 616 journals tend to be marked on what the writer learned about themselves, how closely the entry follows the cases, whether the lessons will travel into practice, the sources and the writing. Entries score best when the change is visible through specific cases and when the writer shows how a previous assumption was tested and revised, as with the belief that patients resist stopping medicines. Linking each lesson to a source shows the reflection rests on evidence. Specific, measurable commitments demonstrate application. A focused entry that develops one theme across several cases generally shows more depth than a survey of every module, which graders tend to read as summary rather than as genuine reflection.
NUR 616 Module 10 help: the mistakes that cost points
Closing reflections lose marks when they recap topics, claim growth without showing it, skip sources or end with vague intentions such as practicing holistically. Pick one or two lessons, show each through cases from the term, name the assumption that changed, cite evidence and describe habits a colleague could observe. Keep the voice personal and professional, and stay within the word limit. When the prompt names specific outcomes or a practice setting, include it with your order along with notes on the cases you remember best; the draft will be built from your own term and the kind of practice you are heading into.
Get NUR 616 Module 10 written to your instructions
Pass along the journal prompt, the outcomes listed in it and a sentence or two about each case that stayed with you. You will receive an entry in your own voice that grows out of those cases, cites the evidence and closes on practical commitments, will be ready within 24 to 48 hours, and it is free the first time. 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.
More NUR 616 papers and related MSN samples
- NUR 616 Module 1 Discussion: Daily Aspirin After Sixty
- NUR 616 Module 2 SOAP Note: Diabetes With Albuminuria: Adding an SGLT2
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- NUR 607 Module 6 Pediatric Well Visit: A 13-Year-Old's Blood Pressure and BMI
- NUR 520 Module 3 Measures of Disease Frequency: Crude and Age-Adjusted COPD Across Ten Counties
NUR 616 Module 10 questions, answered
Where can I find a free NUR 616 Module 10 Journal sample?
A full closing journal is shown on this page: a deprescribing reflection in which a thyroid result, a urine culture and an eleven-drug list each teach the same lesson, with APA 7 sources.
What is deprescribing?
A planned process of reviewing a patient's medicines, weighing each drug's current benefit and harm, deciding which to stop or reduce and monitoring the effects, ideally with the patient's goals in mind.
Are older adults willing to stop medicines?
In a national survey of older Medicare beneficiaries, 92% said they would be willing to stop one or more medicines if their physician said it was possible.
What are the Beers Criteria?
An American Geriatrics Society reference, updated in 2023, naming drugs that usually carry more risk than benefit after 65, which clinicians use to choose safer options and decide what to stop.
How long should the NUR 616 closing journal be?
Length is set by each section's prompt; entries of roughly 400 to 700 words are common, and some prompts require a source or two.