NUR 676 Module 10 Journal Example

Reviewed by Delia Ravenscroft, MSN, RN

This NUR 676 Module 10 Journal sample closes the mental health course with a student's honest account of how her practice changed. It is written for SNHU NUR 676 (NUR-676), the MSN course on mental health in primary care, where the final entry typically asks what students will carry into practice. The writer, a former emergency department nurse, admits she once treated mental health as a matter for referral. Three lessons changed that. Ahmedani and colleagues' finding that most people who die by suicide see a clinician in the preceding year made her stop rushing past the self-harm question. The three-question AUDIT-C that Bush and colleagues validated uncovered a patient's hidden alcohol use disorder. And the collaborative care model that Unutzer and colleagues tested showed her that treating depression in primary care is a team effort. She closes with habits for her first year as a nurse practitioner.

CourseNUR 676 Primary Care for Mental Health
ModuleModule 10
Paper typeclosing reflective journal on mental health care in primary care
LengthAbout 450 words, 3 pages
FormatAPA 7 student paper
SchoolSouthern New Hampshire University
ProgramMSN
UpdatedSeptember 2026

Free sample paper for NUR 676 Module 10

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Module Ten Journal

Mental Health Was Somebody Else's Job, Until It Wasn't

In the emergency department, mental health meant a psychiatric hold, a sitter and a transfer. When I started this course, I assumed primary care would work the same way: find the problem, refer it, move on. Ten weeks of cases changed that assumption, and three moments stand out.

The first was a 19-year-old at a sports physical who marked the self-harm item on his PHQ-9. My instinct was to note it and hand him a hotline number. Then I read Ahmedani et al. (2014): across eight health systems, the large majority of people lost to suicide had been seen by a clinician during their final year, roughly half within their last month, and often in a primary care office. That number stopped me. The young man in front of me could have been one of those visits. Instead of rushing past the question, we worked through a structured assessment and wrote a safety plan together, and his sister agreed to help secure their father's gun.

What this page is doingThe writer contrasts her emergency department habits with a moment when evidence changed how she responded to suicide risk.
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The second moment was quieter. A 52-year-old came in for blood pressure, and his AUDIT-C came back at 9. Bush et al. (1998) showed that these three consumption questions perform nearly as well as the full screening test for problem drinking, and in this case they revealed a disorder no one had named. I had treated plenty of intoxicated patients but had never thought about the ones who drink heavily and still show up to their appointments. A brief, respectful conversation and a prescription for naltrexone gave him a plan his blood pressure pills never could.

The third lesson was about who does the work. I worried that primary care clinicians cannot manage depression in fifteen-minute visits, and alone, they often cannot. In the IMPACT study, pairing a symptom-tracking care manager with a psychiatrist who reviewed patients who were not improving substantially increased the share of patients whose depression lifted (Unützer et al., 2002). At my clinical site, the care manager called patients between visits and flagged anyone whose PHQ-9 was not falling. Watching her work, I understood that integrated care is not about one clinician doing everything; it is about a team that does not let anyone fall through the gaps.

What this page is doingThe second and third moments describe a hidden alcohol disorder found by screening and the role of a care manager in team-based care.
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Three habits are coming with me into my first NP job. I will ask the suicide question myself, in private, and never leave a positive answer without a plan. I will screen every adult for alcohol use and follow a positive result with a real conversation. And I will look for, or help build, a care manager role wherever I practice. Mental health used to be somebody else's job. I now see it as part of every visit.

What this page is doingThree practice habits follow, and the closing line returns to the title's idea.
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References

Ahmedani, B. K., Simon, G. E., Stewart, C., Beck, A., Waitzfelder, B. E., Rossom, R., Lynch, F., Owen-Smith, A., Hunkeler, E. M., Whiteside, U., Operskalski, B. H., Coffey, M. J., & Solberg, L. I. (2014). Health care contacts in the year before suicide death. Journal of General Internal Medicine, 29(6), 870-877. https://doi.org/10.1007/s11606-014-2767-3

Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158(16), 1789-1795. https://doi.org/10.1001/archinte.158.16.1789

Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., Areán, P. A., Hegel, M. T., Tang, L., Belin, T. R., Oishi, S., & Langston, C. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. JAMA, 288(22), 2836-2845. https://doi.org/10.1001/jama.288.22.2836

What the NUR 676 Module 10 instructions ask for

The final NUR 676 assignment is a short personal essay on how your thinking about mental health care changed and what you will now do as a nurse practitioner. It is written in your own voice, yet graders still expect a couple of peer-reviewed sources in APA 7. Something in the range of 400 to 600 words works. Pick two or three patients or cases that stayed with you, set your first reaction beside the approach you took or would take now, attach the study or guideline that moved you and finish with a few routines you will actually follow once you are practicing on your own. Keep it honest and specific throughout.

How this NUR 676 Module 10 journal example is built

This journal comes from a former emergency department nurse who once saw mental health as a referral matter. A 19-year-old's positive self-harm item, read alongside the Ahmedani study of health care contacts before suicide, leads her to complete a structured assessment and safety plan. A 52-year-old's AUDIT-C of 9, explained by the Bush validation, uncovers a hidden alcohol use disorder. Watching a care manager work, informed by the Unutzer IMPACT trial, shows her that integrated care is a team effort. She closes with three habits: ask about suicide privately, screen for alcohol and build care manager roles. Each lesson starts from her first instinct, which makes the change visible.

Where the NUR 676 Module 10 rubric puts the points

Graders of the NUR 676 reflection generally look at how much the writer's practice shifted, whether evidence explains the shift, how well it applies to nurse practitioner work, how the entry is organized and how cleanly APA 7 is handled. The strongest entries use particular patients, including the writer's first instinct with each, and show exactly where the evidence changed the response. Accurate reporting of study findings matters. Routines that a colleague could observe, for example always asking the self-harm question in private, carry more weight than broad promises, and an appreciation of team roles shows the integrated thinking this course is built on. Brief, honest admissions of early mistakes also read well.

NUR 676 Module 10 help: the mistakes that cost points

In NUR 676, reflections tend to be marked down when they survey topics instead of patients, when a change is claimed with no evidence behind it, when study findings are misreported or when the closing routines are vague. A frequent gap is skipping the first instinct you had before the evidence changed your mind, which is usually where the learning is most visible. Pick patients, contrast your first reaction with your later approach, cite what moved you and end with routines others could notice. For a prompt on stigma, cultural humility or clinician well-being, add those details to your NUR 676 notes and we will shape the essay around them.

Get NUR 676 Module 10 written to your instructions

Name the NUR 676 patients or cases that changed how you practice and send us the assignment wording. Expect an honest essay in your voice, grounded in those encounters and the studies behind them and ending with routines your preceptor could see, within 24 to 48 hours, 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.

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NUR 676 Module 10 questions, answered

Where can I find a free NUR 676 Module 10 Journal sample?

Read the full reflection here: an FNP student on asking about suicide, alcohol screening and team-based mental health care, with three practice habits.

What should a NUR 676 closing reflection include?

Specific clinical moments, how your approach changed, the evidence behind each change and observable habits for practice.

Why ask every patient about suicidal thoughts?

Most people who die by suicide had a health care visit in the prior year, often in primary care, so asking can reach people at risk.

Why screen adults for alcohol use in primary care?

Brief screens like the AUDIT-C reveal problem drinking that patients rarely raise and that can drive conditions such as high blood pressure.

What does a care manager add to mental health care?

They track symptoms between visits, flag patients who are not improving and coordinate with psychiatric consultants, improving outcomes.