A death after a capable patient refused transfusion is examined in this NU655 reflection, through the author's unspoken disagreement and the bloodless measures the team did use. Searches like "nu 655 unit 9 assignment example", "nu655 unit 9 sample" and "nu655 unit 9 example" land here.
What a finished NU655 Unit 9 end-of-life reflection looks like
Roughly [950] first-person words arranged by the cue questions of Johns's model for structured reflection: description, reflection, influencing factors, alternatives and learning. The description covers [four] days: rectal bleeding on admission, a signed refusal of blood and its components, [two] angiographic embolizations that slowed but did not stop the bleeding, a colectomy judged too dangerous without transfusion, and a hemoglobin falling from [9.2] to [3.8] g/dL. It lists what was given instead: intravenous iron, [epoetin alfa], pediatric blood tubes and high-flow oxygen. The reflection section names the author's frustration directly. Influencing factors include a conversation with the patient's son and the author's years on a trauma unit where transfusion was routine. Alternatives weighs what pressing her again would have meant. Learning cites the principle of informed refusal and ends with what the author would say next time.
How a NU655 Unit 9 example is structured
The reflection examines a disagreement the author never voiced, so the event is told once and briefly, and most of the words go to why the author felt it. Johns's cue questions give each section a job, answered in order rather than woven together. The frustration is stated plainly and traced to a specific source: years on a trauma unit where blood was given within minutes. The influencing factors section records the son's calm account of his mother's convictions, which unsettled the author's assumption that she had been pressured. The alternatives section admits that pressing her again would have respected her less without changing the outcome. Learning corrects a belief with principle: a capable adult's informed refusal is a limit on treatment the team is bound to honor, and honoring it well meant using every bloodless measure available. Blame falls on no one.
Four days in one paragraph
Admission, refusal, two embolizations, the falling hemoglobin and the death fit in a single paragraph. Everything afterward is analysis, and the narrative does not return to retell scenes for effect.
An argument never spoken
The author writes that each morning's hemoglobin felt like a verdict against the team. That sentence stays, and the reflection asks where the feeling came from instead of replacing it with a professional conclusion.
What the son explained
Her son described decades of conviction and a signed directive renewed each year. That conversation removed the author's assumption that she had been pressured, and the section records what remained after it.
Everything short of blood
Iron, [epoetin alfa] that could not work in time, pediatric sampling tubes, high inspired oxygen and repeated embolization are credited as the care she accepted. The reflection argues that these measures, not the refusal, define how well she was treated.
Informed refusal as a limit
Learning centers on one principle: a capable adult may refuse treatment even when refusal leads to death, and the refusal binds the team. The author records what changed in understanding and what still feels unresolved.
Where marks go in NU655 Unit 9
Depth and honesty carry these reflections, and one that narrates a death at length and closes on a single lesson reads as a case report. Examining the writer's own reaction is expected; a reflection that describes only the patient and the team misses the assignment. Blame of the patient, the family, a colleague or the writer is marked down, since the prompt asks for examination without it. Respect matters where belief enters: language that treats the refusal as irrational, or the patient as a victim of her faith, draws criticism. The named reflective model should organize the sections rather than appear once. Accuracy counts on informed refusal and bloodless management. A specific closing helps, while identifying details or silence about support used afterward cost a few points.
Get a NU655 Unit 9 example written to your instructions
End-of-life encounters belong to the student alone, and the sample respects that by modeling a different composite death. Tell us whether yours ended in a death or in a decision to withhold or stop treatment, which reflective model is required and what the rubric asks. A first reflection is free within 24-48h and examines the feeling at its center.
NU655 Unit 9 questions, answered
Is it acceptable to admit disagreement with a patient's choice?
Yes, if it is examined rather than argued. The sample states the author's frustration in its first analytic paragraph and spends several sections tracing it, while the patient's decision stands unchallenged throughout. Rubrics for this unit generally reward that honesty. Your own reflection should describe your own response to an encounter that was yours.
Could the team have transfused her in an emergency?
Not while she had capacity and had refused, and her signed directive covered the situation. A capable adult's informed refusal of treatment is generally binding even when death may follow. The reflection covers this in two sentences and turns to what could be done within her wishes, which is where the quality of her care is judged.
What reflective model does the sample use?
Johns's model for structured reflection, whose cue questions move from description through influencing factors and alternatives to learning. Many sections assign Gibbs's cycle or another model instead. If your prompt names one, the reflection is rebuilt around its stages so each section answers the questions that model asks.