| Course | NURS 8002 Foundations and Essentials for the Doctor of Nursing Practice |
|---|---|
| Week | Week 9 |
| Paper type | Discussion post with two peer replies |
| Length | About 540 words, 3 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NURS 8002 Week 9
Week 9 Discussion: Initial Post
The Group Visits That Faded: Using Lewin to Explain a Failed Change and Plan a Second Attempt
The change I want to lead is a second attempt at shared medical appointments, group visits for people living with type 2 diabetes, in a composite family medicine practice. Three years ago the practice started monthly group visits, in which eight to twelve patients met with a clinician, a nurse and a dietitian for ninety minutes. Within five months they had quietly stopped. Pooling the trials of group visits in diabetes care, Edelman et al. (2015) reported modest improvements in glycemic control compared with usual care, which is enough to justify trying again, but not if the second attempt fails for the same reasons.
The change model Lewin (1947) proposed has three stages: unfreezing the current state by making the need for change felt and reducing resistance, moving to the new state and refreezing it so the new behavior becomes the norm. Looking back, the first attempt skipped the first stage. Leaders announced group visits as a good idea but never addressed why clinicians preferred individual visits: they worried about productivity targets, were unsure how group visits would be billed and had no room large enough except the break room. Those reasons were never surfaced, so they became quiet resistance. The practice moved without unfreezing, and with nothing holding it in place, it slid back. Shirey (2013) argues that Lewin's model remains useful for nurse leaders precisely because it forces attention to the forces that hold the current state in place.
As a scholar-practitioner, my role in a second attempt would be to unfreeze deliberately: meet with each clinician to hear their concerns, bring the billing office's answer on how group visits are coded, find a room and show the practice the local diabetes data alongside the evidence. Only then would the practice move, with a three-month pilot. Refreezing would mean putting group visits into the scheduling template and the clinicians' productivity calculations, so that they no longer depend on enthusiasm.
Question for the thread: in your experience, which stage of Lewin's model do organizations most often skip?
Reply to Olivia
Olivia, you suggested that Kotter's eight steps would suit this change better because they include forming a guiding coalition. I agree that a coalition matters, and I would want the dietitian and at least one clinician to lead alongside me. But I chose Lewin because the first attempt's failure was specifically about the forces holding individual visits in place, and Lewin's force-field thinking makes those forces the center of the analysis (Lewin, 1947). Perhaps the two models could be combined: Lewin to diagnose, Kotter's steps to organize the work.
Reply to Samir
Samir, you asked whether I have the authority to change productivity calculations, since I am a nurse manager, not the medical director. I do not, and that is an important limit. What I can do is bring the medical director a proposal with the billing office's figures and the pilot's results, and ask her to decide. A scholar-practitioner's influence often comes from evidence and relationships rather than position, and I would be honest in the proposal about which decisions are mine and which are hers.
References
Edelman, D., Gierisch, J. M., McDuffie, J. R., Oddone, E., & Williams, J. W., Jr. (2015). Shared medical appointments for patients with diabetes mellitus: A systematic review. Journal of General Internal Medicine, 30(1), 99-106. https://doi.org/10.1007/s11606-014-2978-7
Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1(1), 5-41. https://doi.org/10.1177/001872674700100103
Shirey, M. R. (2013). Lewin's theory of planned change as a strategic resource. Journal of Nursing Administration, 43(2), 69-72. https://doi.org/10.1097/NNA.0b013e31827f20a9
What the NURS 8002 Week 9 instructions ask for
Change agent discussions late in the course usually ask you to describe a change you would lead as a DNP-prepared nurse and to explain it with a change model. Posts are typically a few paragraphs with two or three sources, and replies follow. Choose a specific change in a specific setting, ideally one with a history. Use your model to explain why earlier attempts failed before you plan a new one. Describe what you would do at each stage and what would hold the change in place. Be honest about your authority and who else must decide. End by asking classmates which stage organizations most often skip, or a similar question drawn from your case.
How the NURS 8002 Week 9 example is put together
Paragraph one describes the change, the first attempt and the evidence for group visits, citing Edelman and colleagues. Paragraph two explains Lewin's three stages and why the first attempt skipped unfreezing, citing Lewin and Shirey. Paragraph three, partly highlighted, describes how the author would unfreeze, move with a pilot and refreeze by building group visits into scheduling and productivity. It ends by asking which of Lewin's stages organizations skip most. The reply to Olivia defends Lewin for diagnosis and suggests pairing it with Kotter for organizing the work. The reply to Samir acknowledges that productivity rules belong to the medical director and describes how to bring her a proposal. Neither reply retreats from the position.
Where the marks sit in the NURS 8002 Week 9 rubric
Change agent posts are commonly weighed on the specificity of the change, correct use of the model, analysis of past failure and awareness of authority. Specificity earns credit when the change, setting and people are concrete. Model use is judged on whether each stage is applied to the case. Explaining an earlier failure with the model shows analytic depth. Awareness of positional limits reads as maturity. Evidence for the change itself should be cited. Replies score well when they defend choices with reasons and engage classmates' alternatives. APA citations, a scholarly tone and timely posting complete the usual criteria. Posts that name the forces holding the old practice in place usually score higher than posts that only praise the new one.
Common NURS 8002 Week 9 mistakes, and how to avoid them
Change posts lose marks when they describe change in general terms, such as improving teamwork, with no specific practice. Another common loss is naming a model's stages without applying any of them. Some posts ignore earlier failed attempts, which are often the richest evidence. Others assume the writer can change policies outside their authority. Pick one change with a history, use the model to explain the failure, plan each stage, name who must decide and cite evidence for the change. The desk can draft a post on the change you want to lead. Describe your organization by type rather than by name.
Get a NURS 8002 Week 9 example written to your instructions
Share the change discussion prompt, its rubric and the readings your section assigns, and a post drawing on those readings is written. The first comes free, finished within 24 to 48 hours. Leading an actual change at your workplace is your role to take on, and nothing produced here proposes a change to any real organization or speaks for you in one.
More NURS 8002 papers and DNP samples
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- NURS 8002 Week 5: DNP problem statement
- NURS 8002 Week 6: Problem significance thread
- NURS 8002 Week 7: DNP systems leadership analysis
- NURS 8002 Week 8: Translation evidence summary
- NURS 8002 Week 10: DNP practice problem synthesis
- NURS 8002 Week 11: DNP identity reflection
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- DNRS 6211 Week 9: Business case
NURS 8002 Week 9 questions, answered
Is Lewin required, or can another change model be used?
The example uses Lewin because his three stages explain a relapse clearly, but many change frameworks appear in DNP coursework. Your assigned readings usually indicate which models the section favors. Choosing one that fits your case, and saying briefly why it fits, usually scores better than applying a model the readings emphasize but the case does not suit.
Does the post need to describe the author's own authority?
It strengthens the argument. The example admits that its author holds no formal authority and needs a sponsor, which faculty tend to read as maturity. Posts that ignore positional limits often receive comments asking how the change would actually happen. A sentence on who would support the change is usually enough in a discussion of this length.
Can the post describe a change that has not happened yet?
Yes, and the example partly does. It analyzes a failed rollout and describes how a second attempt could differ, without claiming the second attempt occurred. Faculty generally accept prospective reasoning in a discussion, provided it rests on evidence and admits uncertainty. Presenting imagined results as though they happened is what draws criticism, in this thread and in every later course.
Where can I find a free NURS 8002 Week 9 sample paper?
Both the change agent post and its two replies, plus the reference list, are reproduced here without a fee. A post on the change you want to lead can be requested.
Why did the first group visits fail in the NURS 8002 Week 9 post?
Because the practice skipped unfreezing: clinicians' concerns about productivity, billing and space were never surfaced, so they became quiet resistance and the visits slid back.