| Course | NURS 6912 Symptom Management for the Hospice and Palliative Care Clinician |
|---|---|
| Week | Week 8 |
| Paper type | Discussion post with two peer replies |
| Length | About 640 words, 4 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6912 Week 8
Week 8 Discussion: Initial Post
Friday Night, No Pharmacy: Why a Symptom Plan Must Be Audited Against the Resources Behind It
At 6 p.m. on a Friday, a hospice nurse in a rural county learns that the symptom plan for a composite patient, a 67-year-old man with advanced lung cancer at home, depends on a medication for breathlessness and anxiety that the only pharmacy within an hour's drive does not stock and cannot order before Monday. The prescriber is reachable by phone, but the medicine is not reachable by road. What should a symptom plan look like when the pharmacy, the prescriber or the pharmacist may not be there when the symptom arrives?
First, this is a structural problem, not a family's failure or a nurse's oversight. Rural hospice patients face longer distances, fewer pharmacies and fewer staff, and access to medications and after-hours support is among the barriers described for rural hospice and palliative care (Lynch, 2013). A plan written as if the county had a city's resources will fail on the first weekend.
Second, many hospices answer this problem with anticipatory prescribing: an emergency comfort kit placed in the home at admission, containing small amounts of medications for the symptoms most likely to arise suddenly, such as pain, breathlessness, anxiety, agitation, nausea and secretions, to be used only as the hospice nurse directs. A national survey found that most responding hospices used such kits and that nurses believed they helped prevent emergency visits and hospital admissions (Bishop et al., 2009). A kit placed at admission would have made this Friday a phone call instead of a crisis.
Third, and my main argument: every symptom plan should include a resource audit at admission. Before the plan is finalized, someone should answer a short list of questions. Which pharmacy will fill it, and what are its hours? Does that pharmacy stock each medication in the plan, or can it order it within a day? Who will prescribe after hours, and how is that person reached? How long does it take the on-call nurse to reach this home? Is there working phone service, and does the family have transportation? A gap found on day one can be fixed with a kit, an alternate pharmacy or a change of medication. A gap found on a Friday night is an emergency.
Question for the thread: does your agency audit the resources behind a plan, or only the plan itself?
Reply to Marisol
Marisol, you said that in your agency the weak link is not the pharmacy but the people: one on-call nurse covering three counties overnight. That is an important addition to my audit, because a kit is only useful if someone can guide the family in using it. Lynch (2013) describes staffing and travel distance as barriers alongside medications. I would add two questions to the audit: how long would it take the on-call nurse to reach this home, and is there a second person who could go if she is already on a visit? Has your agency found any way to share on-call coverage with a neighboring hospice?
Reply to Ben
Ben, your point about telehealth is a good one. A video visit could let the on-call nurse see the patient's breathing and guide the family in real time. But I would add internet access to the audit too. Many rural homes have unreliable broadband or poor cell signal, and a plan that depends on video will fail in the same way my Friday plan did. In my example, the family had a landline and weak cell service. For them, a plain phone call with a nurse who knows the kit would work better than a video visit that drops. Walker and McPherson (2010) found that hospice staff valued emergency kits highly, which suggests the low-technology solution still matters most in homes like this one.
References
Bishop, M. F., Stephens, L., Goodrich, M., & Byock, I. (2009). Medication kits for managing symptomatic emergencies in the home: A survey of common hospice practice. Journal of Palliative Medicine, 12(1), 37-44. https://doi.org/10.1089/jpm.2008.0193
Lynch, S. (2013). Hospice and palliative care access issues in rural areas. American Journal of Hospice and Palliative Medicine, 30(2), 172-177. https://doi.org/10.1177/1049909112444592
Walker, K. A., & McPherson, M. L. (2010). Perceived value and cost of providing emergency medication kits to home hospice patients in Maryland. American Journal of Hospice and Palliative Medicine, 27(4), 254-260. https://doi.org/10.1177/1049909109350178
The Walden NURS 6912 Week 8 instructions
The Week 8 discussion commonly asks you to consider a barrier to symptom management in hospice or palliative care, such as access, cost, policy or workforce, and to propose a response. A concise initial post with sources is expected, and two replies follow. Open with one moment that makes the barrier visible. Explain whether it is structural or individual. Describe what current practice already does about it, with evidence. Then add your own proposal and make it specific enough to adopt, such as a checklist or a policy change. End with a question that invites classmates to compare their agencies, and in replies push each other's proposals against the same barrier.
Inside the NURS 6912 Week 8 example
The opening paragraph sets the scene and poses the question. The second calls the problem structural and cites Lynch on rural hospice barriers. The third describes emergency comfort kits by purpose, without doses, and cites Bishop and colleagues' national survey. The highlighted fourth proposes a resource audit at admission and lists its questions. A question to the thread follows. The reply to Marisol adds staffing and on-call travel to the audit and asks about shared coverage. The reply to Ben tests telehealth against rural internet access and cites Walker and McPherson on how hospice staff value medication kits. Neither reply simply agrees; each adds a question to the audit.
Reading the NURS 6912 Week 8 rubric
Barrier discussions tend to be graded on analysis of the problem, use of evidence, originality of the proposal and engagement with peers. Analysis credit goes to posts that explain why a barrier exists rather than describing one bad night. Evidence is scored for supporting both the problem and existing solutions. Originality is rewarded when the writer adds something beyond the literature, as long as it is practical. Engagement earns credit when replies extend or test classmates' ideas. Avoiding medication specifics outside the prompt shows appropriate scope. Timely posting, APA citations and a respectful tone complete the standard criteria in most sections. Graders often reward a proposal that a small agency could adopt next month without new money.
NURS 6912 Week 8 help: mistakes that cost marks
Posts on barriers lose marks when they describe a problem and stop there, with no proposal. Another loss is blaming the family or a single nurse for a gap the system created. Some posts list medications and doses for comfort kits, which goes beyond what the prompt asks and invites error. Replies that simply agree add nothing. Set the scene, explain the structural cause, credit what already works, propose something specific and testable and use replies to test your classmates' ideas against the same barrier. The desk can draft a post on the barrier your prompt names. Keep proposals realistic for the size of agency you describe.
Get a NURS 6912 Week 8 example written to your instructions
Copy in your Week 8 discussion prompt and rubric, and say which missing resource your case centers on if it is not a medication. The desk drafts an initial post with a clear stance and two replies that widen the problem, back to you inside 24-48 hours, and a first one is free.
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NURS 6912 Week 8 questions, answered
What is an emergency comfort kit?
A small supply of medications for common end-of-life symptoms, often called a comfort kit or emergency kit, that many hospices place in the home at admission so relief does not depend on reaching a pharmacy in a crisis. The example describes contents by purpose only. Citing a source for the practice earns more than listing drugs and doses.
Is a missing resource an ethical issue or a practical one?
Both, and the example says so. Practically, it asks what a plan needs to function; ethically, it raises justice, since rural and low-income households bear the gap more often. Framing it only as logistics usually costs the analysis credit, while framing it only as injustice can leave your post with no remedy. The example holds both.
Why do the replies discuss people and internet access?
To show that a resource is anything the plan relies on. A caregiver who works nights leaves the plan without hands; a home without reliable internet makes a telehealth visit impossible. Extending the thread this way demonstrates reasoning beyond the initial post, which is what substantive replies are usually graded for, and it gives classmates something new to answer.
Where can I find a free NURS 6912 Week 8 sample paper?
The initial post on the Friday pharmacy gap and both replies are reproduced here in full for free. A post on the barrier your course assigns can be requested.
What questions does the resource audit in the NURS 6912 Week 8 post ask?
Which pharmacy fills the plan and its hours, whether each medicine is stocked, who prescribes after hours, how long the on-call nurse takes to arrive, whether phone service works and whether the family has transport.