Confidentiality bent without breaking for one self-harming fifteen-year-old; the NU572 seminar reflection traces why its writer moved from telling the mother at once to a plan made with the teen. Searches like "nu 572 unit 5 assignment example", "nu572 unit 5 sample" and "nu572 unit 5 example" land here.
Did Confidentiality Hold? A Reflection on a 15-Year-Old's Forearm and the Threshold I Wrote Down Afterward
[Student Name]
Purdue University Global
NU572: AGNP I - Primary Care of the Adolescent and Adult
Unit 5 Seminar Reflection
[Instructor Name]
[Date]
The patient is a composite posed in the seminar; no real person is described.
The Case
Our facilitator presented [Lily], 15, seen for a school physical. After her mother stepped out, she pushed up her left sleeve and showed healed and fresh superficial linear cuts on the inner forearm. She said she started cutting three months ago, after a breakup, and does it when she feels overwhelmed because it calms her down. She said she does not want to die. Then she said, "Please don't tell my mom."
Where I Started
My view, stated in the first minute: her mother must hear the same day, because a parent has a right to know when a child is injuring herself and needs to be able to keep her safe.
How the Seminar Turned
The first turn came from a classmate who asked, "What did the ASQ show?" I had not thought to ask. The Ask Suicide-Screening Questions are four brief questions about wishes to be dead, thoughts of killing oneself, and past attempts, developed and validated for young people in medical settings (Horowitz et al., 2012). A positive screen calls for a further assessment of suicide risk. My view had been about the cutting, but the screen would tell us about something else.
The second turn followed. Another classmate pointed out that nonsuicidal self-injury and suicidal intent are assessed separately. Self-harm without suicidal intent is common in adolescents and is often a way of managing distress, as [Lily] described (Hawton et al., 2012). It is a serious warning sign, since adolescents who self-harm are at higher risk of later suicide, but it is not the same as a plan to die. Treating every cut as an emergency disclosure risks teaching her not to show the next one.
That argument unsettled me. I had imagined that informing her mother would protect her. The classmate asked what would happen at the next visit if [Lily] learned that showing her arm meant her mother was called that night. I realized she might hide the cuts, or stop coming.
The third turn came from the facilitator, who reminded us of the exceptions in our clinic's confidentiality statement: someone hurting her, a risk that she might seriously hurt herself, a risk to others, the exceptions that professional guidance on adolescent confidentiality recognizes (Ford et al., 2004). Superficial cuts without suicidal intent sit on the line of the second exception, and the room split almost evenly on which side.
Where I Ended
I did not end on the opposite of where I began. I ended on a threshold, which I wrote down so I could use it:
1. A positive ASQ, or any stated intent or plan to die, triggers disclosure to a parent or guardian at once, with the teen told first, and an urgent mental health assessment.
2. Self-injury that is medically serious, needs treatment, is escalating, or involves other risks such as substance use, also triggers disclosure the same day.
3. Otherwise, superficial nonsuicidal self-injury is not kept secret, but the teen helps decide how and when her mother learns about it, within a few days, with a counseling referral made today and a return visit inside seven days.
For [Lily], with a negative ASQ, the third line applies. The plan would be to tell her plainly that this is too important to keep between us for long, to offer her the choice of telling her mother herself, with me in the room, or having me help her, and to set the date together.
What I Took From It
My starting view assumed that disclosure and safety were the same thing. They overlap, but not completely. Safety depends on her continuing to tell someone, and the way disclosure happens shapes whether she will. The threshold gives me a way to move quickly when the risk is high and to move with her when it is not.
There was one more thing the seminar did not settle, and I want to record it rather than pretend it was resolved. A classmate asked what I would do if [Lily] refused every option for telling her mother, even with a few days to think. I did not have a good answer. The facilitator's view was that the clinician would then tell the mother, having told [Lily] first and explained why, because a secret of this size cannot be held indefinitely by someone who sees her once a month. I think that is right, but I also think the few days matter, because a teenager who is given time to choose often chooses to speak. I will find out whether that is true in practice.
I also noticed that my first instinct had been about her mother's rights rather than her risk. The seminar reframed the question: not who has a right to know, but what keeps her safest over the next month.
References
Ford, C., English, A., & Sigman, G. (2004). Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 35(2), 160-167. https://doi.org/10.1016/S1054-139X(04)00086-2
Hawton, K., Saunders, K. E. A., & O'Connor, R. C. (2012). Self-harm and suicide in adolescents. The Lancet, 379(9834), 2373-2382. https://doi.org/10.1016/S0140-6736(12)60322-5
Horowitz, L. M., Bridge, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenstein, D. L., Wharff, E. A., Ginnis, K., Cannon, E., Joshi, P., & Pao, M. (2012). Ask Suicide-Screening Questions (ASQ): A brief instrument for the pediatric emergency department. Archives of Pediatrics & Adolescent Medicine, 166(12), 1170-1176. https://doi.org/10.1001/archpediatrics.2012.1276
How this NU572 Unit 5 example is structured
Argument, not the session clock, sets the order of the reflection. Its opening position is stated without apology, since rubrics usually reward honest movement over a starting view dressed up as the final one. Each turn in the discussion is attributed to a role, not a name: the facilitator, a classmate with school nursing experience, a classmate who had worked in inpatient psychiatry. The pivot is conceptual. Treating self-injury as a suicide attempt had justified immediate disclosure, and separating the two with a validated screen revealed a middle course between secrecy and a phone call over her head. The revised position is written as a rule with its trigger stated, plus a safety plan and a conversation about access to means. What remains unsettled gets a closing paragraph of its own: what to say if the mother asks directly before her daughter has spoken.
Get an NU572 Unit 5 example written to your instructions
Seminar reflections can follow the actual case your facilitator ran, or a composite built on the same dilemma if details must stay private. Include the seminar question, the reflection criteria and any word limit. A first sample is free; it keeps to your instructions and reaches you in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU572 Unit 5 questions, answered
Should the reflection admit that the author's first view was wrong?
If it changed, yes. Most reflection rubrics reward visible movement in reasoning, and a starting position described honestly makes the change believable. The piece does not need to call the first view foolish; it needs to show which argument or piece of evidence shifted it, and what the new position now rests on.
Which screening tool fits a self-harm case like this?
The ASQ is widely used for suicide risk screening in young people from age ten and is short enough for primary care, with a fuller assessment such as the Columbia scale when it is positive. Self-injury itself is assessed through history: method, frequency, function and medical severity. A good reflection keeps those two assessments distinct.
Can the reflection disagree with the facilitator?
Yes, provided the disagreement is argued. A reflection that records the facilitator's view, explains the reasoning behind a different conclusion and cites guidance or law in support usually scores well. Disagreement without reasons reads as opinion. The tone stays professional, and the facilitator is identified by role rather than by name.