| Course | NU657 AGACNP Critical Care Management Clinical |
|---|---|
| Unit | Unit 7 |
| Paper type | Resuscitation reflection |
| Length | About 870 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU657 Unit 7
Eighty Seconds Too Long: A Resuscitation Reflection on a Missed Compressor Swap and a Thirteen-Second Pause, Using Gibbs' Cycle
[Student Name]
Purdue University Global
NU657: AGACNP Critical Care Management Clinical
Unit 7 Resuscitation Reflection
[Instructor Name]
[Date]
The event and the team are composite; times, depths and counts are bracketed.
Description
During my rotation, a [68]-year-old man on the unit who was two days out from a bowel resection became unresponsive and pulseless at [15:40]. The monitor showed a narrow-complex rhythm without a pulse, pulseless electrical activity. The team leader was the attending; I was assigned as the second compressor. The defibrillator's feedback display showed rate and depth for each compression.
I took over compressions at the start of the second two-minute cycle. For the first [40] seconds my depth held between [5.2] and [5.8] cm at a rate of about [110]. From about [80] seconds my depth readings fell to [4.4 to 4.7] cm, and I did not ask to switch. At the rhythm check that ended my cycle, the pause lasted [13] seconds while the team looked at the monitor and waited for the leader to call the next step. Circulation returned after [four] cycles, and the patient was later found to have had a large pulmonary embolism.
Feelings
I was relieved to be asked to help and wanted to prove I could keep up with the nurses and residents. When I saw the depth readings fall, I felt embarrassed, and I think that feeling is part of why I said nothing. After the code, when the nurse educator showed the team the feedback report, I felt exposed. I also felt that my part had been small next to the leader's decisions, which I now think was a way of avoiding the lesson.
Evaluation
What went well: my first [40] seconds were within the target depth and rate, I took over at the swap point without delay, and I kept my hands in position during the pause. The team leader ran a clear, calm code.
What did not go well: for about [40] seconds my compressions were too shallow, and the pause at the rhythm check was longer than it should have been. Neither moment came from not knowing the rule; both came from waiting for someone else to apply it.
Analysis
The 2020 AHA guideline sets the standards I missed. It recommends a compression depth of at least 5 cm, a rate of 100 to 120 a minute, switching compressors about every two minutes or sooner if fatigued, and keeping pauses as short as possible, with rhythm checks under ten seconds (Panchal et al., 2020). I knew all four numbers before the code.
Why did I not call for a swap? I found two reasons. First, I was waiting for the team leader to call the switch at two minutes, as if the rule belonged to the leader and not to the person compressing. Second, I did not want to appear unable to keep up. My fatigue also came earlier than I expected. In a manikin study of forty rescuers compressing without a break, the number of satisfactory compressions fell from each minute to the next while the overall rate stayed near 100 a minute (Ashton et al., 2002). My cycle followed that pattern exactly: my rate held, my depth did not, and I felt fine at [60] seconds even though the pad showed the decline soon after.
Why did the pause run to [13] seconds? The team, me included, waited for the leader's permission to resume instead of resuming on the leader's count. Pauses matter because the share of time spent compressing is linked to survival; in a large cohort of out-of-hospital ventricular fibrillation, a higher chest compression fraction was associated with better survival to discharge (Christenson et al., 2009). A [13]-second pause in each of [four] cycles would lower that fraction noticeably.
Gibbs' cycle was useful here because it separated how I felt from what I did (Gibbs, 1988). Written together, the embarrassment and the shallow compressions would have become a story about nerves. Written apart, they show a specific, fixable behavior.
Conclusion
I could have done two things differently: said "switch" as soon as I saw the depth fall below [5] cm, and started compressions again the moment the rhythm check was complete, without waiting to be told. Both are within the compressor's role. The feedback device gave me the information; I did not act on it.
Action Plan
1. In every code I join, I will treat the feedback display as my cue and call "switch" the first time depth falls below 5 cm, whatever the time on the cycle.
2. Before taking over compressions, I will say to the next compressor, "ready at two minutes or when I call," so that the swap is expected.
3. At rhythm checks, I will keep my hands hovering over the chest and resume on the leader's count, and I will suggest at our next mock code that the team practice resuming within [ten] seconds.
4. I will ask the nurse educator for [two] sessions on the unit's training manikin with feedback, to learn how my depth changes over two minutes when I am tired.
References
Ashton, A., McCluskey, A., Gwinnutt, C. L., & Keenan, A. M. (2002). Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resuscitation, 55(2), 151-155. https://doi.org/10.1016/S0300-9572(02)00168-5
Christenson, J., Andrusiek, D., Everson-Stewart, S., Kudenchuk, P., Hostler, D., Powell, J., Callaway, C. W., Bishop, D., Vaillancourt, C., Davis, D., Aufderheide, T. P., Idris, A., Stouffer, J. A., Stiell, I., Berg, R., & Resuscitation Outcomes Consortium Investigators. (2009). Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation, 120(13), 1241-1247. https://doi.org/10.1161/CIRCULATIONAHA.109.852202
Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Further Education Unit, Oxford Polytechnic.
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O'Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., Arafeh, J., Benoit, J. L., Chase, M., . . . Magid, D. J. (2020). Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 142(16 Suppl. 2), S366-S468. https://doi.org/10.1161/CIR.0000000000000916
What the NU657 Unit 7 assignment asks for
The Unit 7 reflection asks you to examine your part in a resuscitation or other high-acuity event using a recognized reflective model. Prompts usually specify the model, often Gibbs, and ask for a factual description, your feelings, a balanced judgment of the good and the bad, an analysis supported by evidence, a conclusion and an action plan. Plan on roughly 900 words in your own voice. The event itself matters less than what you learn from it, so graders reward a narrow focus on a specific behavior. The action plan should describe things a preceptor could observe you doing at the next code, not a general promise to improve. Cite the guideline that sets each standard you discuss.
How the NU 657 Unit 7 example is put together
The description gives the arrest, the rhythm, the author's role and the depth readings in two short paragraphs. Feelings are named plainly, including embarrassment and the wish to keep up. The evaluation lists what went well before what did not, and the highlighted sentence gives the central finding. The analysis sets out the four AHA numbers the author already knew, then explains the missed swap with two reasons and the Ashton manikin data on fatigue, and the long pause with the Christenson data on compression fraction. A paragraph explains why Gibbs suited this event. The conclusion names two things that could have been done differently, and four numbered actions close the reflection.
NU657 Unit 7 rubric: what earns full points
Reflection rubrics in this course tend to reward depth of analysis, use of the reflective model, integration of evidence, honesty and a practical action plan. Full marks for depth go to a reflection that explains why a lapse happened, not only that it happened. Use of the model is judged on whether each stage does its own work, with feelings kept out of the evaluation. Evidence points go to sources that set the standard missed and explain the mechanism, such as fatigue. Honesty is rewarded when the writer names a specific lapse of their own. The action plan scores well when each item is a behavior that could be observed and checked at the next code.
Common NU657 Unit 7 mistakes, and how to avoid them
Many reflections describe the whole code in detail and leave little room for analysis. Another common problem is blending feelings into the evaluation, which turns a lapse into an excuse. Students sometimes focus on the team leader's decisions instead of their own role. Some cite the guideline without saying which standard was missed and by how much. Others blame fatigue as if it were unavoidable, when the guideline expects compressors to call for a swap. And action plans such as "be more confident" cannot be checked, so each item should describe what you will say or do the next time you are on the chest.
Get an NU657 Unit 7 example written to your instructions
Name the reflective model your NU657 Unit 7 prompt requires, describe in general terms the role you want examined and attach the rubric. Returned inside 24-48h, the first reflection without charge, it examines one composite role in a code, second by second, and ends on commitments that can be checked at the next debrief. 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.
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NU657 Unit 7 questions, answered
Should the reflection describe a code I actually took part in?
Your own reflection should rest on your own experience, and only you can supply it. A composite arrest carries the sample's structure. Your actual role, any entries you made in a code record and what was said at a debrief belong to you and the team; the sample never reproduces or stands in for them.
Why use Gibbs rather than another model?
Gibbs separates feelings from evaluation, which suits an event where embarrassment or fear shaped what happened. Rolfe's three questions fit a brief lesson, and Johns' cue questions go further into the context of practice. The sample uses Gibbs because the author's silence had an emotional cause. Any model your prompt names can carry the same analysis.
Should the author admit to tiring during compressions?
It is expected. Compression quality falls with fatigue, often within the first two minutes, which is why guidelines advise rotating compressors. The sample treats the failure to announce fatigue as the problem, not the fatigue itself. Reviewers usually credit an honest account of a specific lapse over a narrative in which the author performed flawlessly.
Where can I find a free NU657 Unit 7 sample paper?
This page holds the complete NU657 Unit 7 resuscitation reflection, with all six Gibbs stages, the analysis of the missed swap and the long pause, four numbered actions and four references. A reflection on your own event can be written to your prompt.
What standards does the NU657 Unit 7 reflection use?
The 2020 AHA guideline: compression depth of at least 5 cm, a rate of 100 to 120 a minute, switching compressors about every two minutes or sooner if tired, and rhythm checks kept under ten seconds.