| Course | NURS 6912 Symptom Management for the Hospice and Palliative Care Clinician |
|---|---|
| Week | Week 9 |
| Paper type | Family teaching plan |
| Length | About 1,030 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6912 Week 9
The Night Shift Is His: A Family Teaching Plan for a 24-Year-Old Grandson Caring Overnight for His Grandmother in Home Hospice
Student Name
College of Nursing, Walden University
NURS 6912: Symptom Management for the Hospice and Palliative Care Clinician
Instructor Name
Month Day, Year
The Night Shift Is His: A Family Teaching Plan for a 24-Year-Old Grandson Caring Overnight for His Grandmother in Home Hospice
Background
At 90, this composite patient has end-stage heart failure and has been in home hospice for five weeks. She lives with her daughter, who works days, and her 24-year-old grandson, who moved in to help and covers nights while he studies online. Over the past week her days have become mostly sleep, her meals a few spoonfuls, and at night her breathing has paused in ways that frightened him. Twice he called the hospice line at 3 a.m., unsure whether she was dying. The hospice nurse has planned a teaching session with him during an afternoon visit.
Learner Assessment
What he knows. He knows her diagnosis, understands that hospice is focused on comfort and has watched the nurse give mouth care. He does not know which changes are expected as death approaches.
What he fears most. That she will struggle to breathe and he will not know what to do, and that she will die while he is asleep or in the next room.
How he learns. He says he learns best by seeing and doing, and he likes something written he can look at later on his phone.
Reading and language. He reads comfortably in English and asked for short points rather than paragraphs. No assumption was made from his age or schooling; he was asked directly.
Readiness. He is tired but motivated. The session is scheduled for mid-afternoon, after he has slept, and kept to about forty-five minutes.
Learning Objectives
When the visit ends, he will be able to:
1. Describe three breathing changes that are expected as death approaches and explain that they are usually not distressing to her.
2. Demonstrate repositioning and mouth care for his grandmother.
3. Explain how to use the medicine the hospice left for breathlessness, following the instructions on its label and the nurse's directions.
4. State which changes mean calling the hospice line right away, and which can wait for the morning visit.
5. Describe what to do if she dies during the night.
Content
The content is organized around the changes he is most likely to see, summarized in Table 1.
Table 1
Expected Changes, What They Mean and What He Can Do
| Change | What it usually means | What he can do | Call now? |
|---|---|---|---|
| Pauses in breathing, sometimes long | A common change as the body slows | Stay with her; note the time if it worries you | No, unless she looks distressed |
| Noisy, rattling breathing | Secretions in the throat she can no longer clear | Turn her onto her side; gentle mouth care | Call if she seems distressed |
| Fast breathing with visible effort or distress | Breathlessness she may feel | Raise her head; fan; medicine as labeled | Yes, if it does not settle within 15 minutes |
| Sleeping most of the time, hard to wake | Expected as the body weakens | Speak to her; she may still hear | No |
| Not eating or drinking | The body no longer needs food | Moisten her mouth and lips | No |
| Restlessness, pulling at sheets, calling out | May be pain, discomfort or delirium | Check for a wet bed or a full bladder; speak calmly | Yes |
| Cool, mottled hands and feet | Circulation slowing | Keep her covered; no heating pads | No |
Noisy breathing near death is common, and although families often find it distressing, it is uncertain whether it causes distress to the patient, and repositioning is among the first measures used (Lokker et al., 2014). Changes in breathing, responsiveness and circulation are among the signs clinicians use to recognize that death is near, though most research on them comes from patients with cancer (Hui et al., 2014).
The Medicine for Breathlessness
The hospice left a medicine for breathlessness in the home. The plan teaches him where it is kept, how to read its label and how to give it exactly as the label and the nurse direct. He will be taught to write down the time of each dose and to call the hospice line if he has given it and she is still distressed. This plan gives no dose; the amount and frequency are on the label and set by the hospice prescriber.
If She Dies During the Night
He is frightened of not knowing what to do if she dies, so this part is taught directly. When she dies, there is no emergency; he does not need to call 911. He can take his time, call his mother, and call the hospice line when he is ready. The hospice nurse will come to confirm the death, help with the next steps and contact the funeral home the family has chosen. He can sit with her, talk to her and say goodbye. The nurse will also explain that if she dies while he is asleep or out of the room, this is common and does not mean he failed her; many people die in a moment when family has stepped away.
Teaching Methods and Teach-Back
The nurse will demonstrate repositioning and mouth care, then have him do both while she watches. Each section will close with teach-back, in which he explains the point in his own words. In a study of patients with limited health literacy, asking patients to restate information was associated with better outcomes, and the method is simple to use with any learner (Schillinger et al., 2003). The questions will be phrased so the responsibility rests with the nurse: "Let me check that I got this across. If her breathing turns noisy tonight, walk me through what you would do." A one-page summary of Table 1 and the phone number will be sent to his phone and taped by her bed.
Evaluation
Learning will be evaluated at the end of the session through teach-back on all five objectives and a return demonstration of mouth care and repositioning. At the next morning visit, the nurse will ask whether he called the line overnight and whether he felt he knew what to do. The goal is not zero calls; it is calls made for the right reasons, and a grandson who feels able to stay with her through the night.
References
Hui, D., dos Santos, R., Chisholm, G., Bansal, S., Silva, T. B., Kilgore, K., Crovador, C. S., Yu, X., Swartz, M. D., Perez-Cruz, P. E., Leite, R. D. A., Nascimento, M. S. D. A., Reddy, S., Seriaco, F., Yennu, S., Paiva, C. E., Dev, R., Hall, S., Fajardo, J., & Bruera, E. (2014). Clinical signs of impending death in cancer patients. Oncologist, 19(6), 681-687. https://doi.org/10.1634/theoncologist.2013-0457
Lokker, M. E., van Zuylen, L., van der Rijt, C. C. D., & van der Heide, A. (2014). Prevalence, impact, and treatment of death rattle: A systematic review. Journal of Pain and Symptom Management, 47(1), 105-122. https://doi.org/10.1016/j.jpainsymman.2013.03.011
Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C., Leong-Grotz, K., Castro, C., & Bindman, A. B. (2003). Closing the loop: Physician communication with diabetic patients who have low health literacy. Archives of Internal Medicine, 163(1), 83-90. https://doi.org/10.1001/archinte.163.1.83
NURS 6912 Week 9 instructions, in plain terms
Family teaching plans in Week 9 generally ask you to prepare a caregiver for a specific part of end-of-life care, using principles of adult learning and health literacy. Plans typically run three to five pages. Assess the learner first: what he knows, what he fears, how he learns and when he can take information in. Write objectives as things he will recognize or do. Organize content around what he will actually see, and tell him which changes are expected and which need a call. Teach medicines from their labels and the hospice's instructions. Address the moment of death directly if it is likely. Use demonstration and teach-back, leave a written summary and plan how you will know it worked.
How this NURS 6912 Week 9 example is built
A background section describes the household and the 3 a.m. calls. The learner assessment covers five areas and notes that reading level was asked, not assumed. Five numbered objectives follow. Table 1 sets out seven changes with their meaning, his action and whether to call, followed by Lokker and colleagues on noisy breathing and Hui and colleagues on signs of approaching death. A section on the breathlessness medicine teaches from the label. A section on death at night tells him he need not call 911. Teaching methods cite Schillinger and colleagues on teach-back and describe the phone summary. Evaluation sets goals for the next morning visit. The plan gives no dose for any medicine.
Reading the NURS 6912 Week 9 rubric
Teaching plans are commonly graded on learner assessment, clarity of objectives, accuracy and relevance of content, teaching methods and evaluation. Learner assessment earns credit when its findings change what the nurse does, such as timing the session after he has slept. Objectives are scored on whether they are measurable. Content is judged on accuracy and on whether it answers the learner's real questions, such as when to call. Methods earn credit for demonstration and teach-back. Evaluation should link back to the objectives. Health literacy and cultural sensitivity are often named criteria. Safety around medicines is weighted, and teaching from the label without inventing doses meets it. Plans that tell the caregiver which changes can wait until morning tend to earn more than plans that only list warning signs.
NURS 6912 Week 9 help from the desk
Teaching plans lose marks when they are written for a generic caregiver rather than the person in the scenario. Another loss is content that explains the dying process in textbook terms without telling the caregiver what to do or when to call. Some plans include medication doses the writer invented. Others avoid the moment of death, which is often the caregiver's greatest fear. Assess your learner, write measurable objectives, organize content around what he will see, teach from the label, address death directly, use teach-back and evaluate at the next visit. The desk can draft a plan for the caregiver in your prompt. Keep the written summary to one page.
Get a NURS 6912 Week 9 example written to your instructions
Outline the caregiver and patient in your Week 9 case, attach the prompt and rubric, and note any teaching format your course expects. A teaching plan written for that learner, with objectives, plain-language content, teach-back evaluation and a one-page card, arrives in 24-48 hours at no charge the first time.
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NURS 6912 Week 9 questions, answered
What is teach-back?
A method in which the learner explains or demonstrates, in their own words, what they were taught, so whoever taught can see what landed and repair what did not. In the example it comes the morning after teaching, asking the grandson to walk through his night card. It checks comprehension instead of mere exposure, which is why many nursing rubrics prefer it to a simple question about whether he understood.
Does the plan tell him how much medication to give?
No. It explains what the medication left by the hospice is for and directs him to give it only as the label and the hospice nurse instruct. Dosing belongs to the prescription, not to a teaching plan. Your rubric may ask how medication teaching is handled; the example shows purpose, safety and whom to call, without numbers.
Why include what happens at the time of death?
Because he may be the only person present, and not knowing whom to call is a common source of distress for families in home hospice. The section is short and practical: what he may notice, that there is no need to rush, and that the hospice line is the call to make. Leaving it out tends to cost completeness marks.
Where can I find a free NURS 6912 Week 9 sample paper?
The whole teaching plan, learner assessment, objectives, change table, death at night section and teach-back, is offered here at no cost. A plan for the caregiver in your prompt can be requested.
What does the NURS 6912 Week 9 plan tell him if she dies at night?
That it is not an emergency and he need not call 911; he can take his time, call his mother and then the hospice line, and the nurse will come to confirm the death and help with next steps.