| Course | NSG 233 Medical-Surgical Nursing III |
|---|---|
| Unit | Unit 6 |
| Paper type | High-acuity case file |
| Length | About 480 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 233 Unit 6
Thirty-Five Minutes in Room 412, Written in Two Tracks: What the Bedside Nurse Did, What Everyone Else Did, and Where the Two Met
Student Name
Department of Nursing, Herzing University
NSG 233: Medical-Surgical Nursing III
Instructor Name
February 20, 2026
Thirty-Five Minutes in Room 412, Written in Two Tracks: What the Bedside Nurse Did, What Everyone Else Did, and Where the Two Met
The Period Covered
From the rapid response call at 1205 to the patient leaving the ward for the step-down unit at 1240, for the composite 79-year-old woman with a hyperosmolar crisis described in Units 1 and 2. The left track records the actions and observations of the primary nurse assigned to her, with the nursing student working alongside. The right track records what other roles were doing, kept thin on purpose. The notes column marks what the nurse contributed at each point where the tracks touched.
The File
Times are from the built record.
| Time | Nurse track | Other roles | Where the tracks met |
|---|---|---|---|
| 1205 | Calls rapid response; raises head of bed; checks airway: snoring breaths ease with a jaw lift and turning her slightly to the side | The first two minutes were entirely the nurse's | |
| 1207 | Stays at bedside; recounts breathing 22; saturation 93% on 2 L; responds to name only | Charge nurse arrives, takes over other patients on the assignment | Nurse asks charge nurse to bring the glucose, sodium, and creatinine printout |
| 1211 | Gives the team a 30-second summary: baseline, change since morning, key values, working concern | Rapid response nurse and physician arrive; respiratory therapist arrives | The summary set the team's first actions; no one had to reread the chart |
| 1213 | Places a second intravenous line in the right forearm at the physician's request | Physician examines; orders fluid, blood gas, serum osmolality, and a urinary catheter | Nurse chose the right arm because the left had the existing line and a bruise |
| 1216 | Starts the first liter of fluid on a pump; records the start time | Respiratory therapist draws arterial blood gas | |
| 1220 | Inserts urinary catheter with the student; 350 mL of pale urine drains | Rapid response nurse calls step-down for a bed | Nurse reports the volume at once; the team uses it to judge the fluid deficit |
| 1225 | Rechecks responsiveness: opens eyes and says "what?" | Physician speaks with daughter by phone | Nurse gives the physician the daughter's number from the chart and the residence's baseline note |
| 1230 | Prepares for transfer: portable monitor, oxygen, medication record printed | Blood gas: no significant acidosis, consistent with the working diagnosis | |
| 1236 | Gives bedside report to the step-down nurse, including the times the fluid and the call started and the last glucose | Transport arrives | Nurse's times became the step-down unit's starting record |
| 1240 | Leaves the room with the patient; documents |
What the Bedside Nurse Specifically Contributed
Three things in this file would not have happened without the bedside nurse, and they are the point of writing in two tracks. First, the first two minutes: positioning and airway support before anyone else arrived, when her breathing was noisy and her consciousness low. Second, the 30-second summary at 1211, which carried the history the team could not see: that she had been talking that morning, that her memory problem did not include losing track of the month, and that the provider had been paged half an hour before. Rapid response teams depend on the ward nurse for exactly this kind of context, because they arrive knowing nothing about the patient (Jones et al., 2011). Third, the times. Every time in the file came from the nurse's track, and the step-down unit used them to judge how much fluid she had received and how quickly her glucose was falling, which guidance on hyperglycemic crises treats as central to safe treatment (Umpierrez et al., 2024).
The other roles did what they are there to do, and the file does not credit their work to the nurse. It records, instead, that the nurse's work made theirs faster. The course text describes the ward nurse's role in a rapid response in the same terms: recognize, call, support, and provide the history (Hinkle et al., 2022). The patient is a composite.
What the File Leaves Out, and Why
The other-roles track does not record the physician's reasoning, the respiratory therapist's interpretation of the blood gas, or the conversation with the daughter beyond the fact that it happened. Those belong in their own notes. Including them here would make the file look complete while blurring whose work was whose. The file also leaves out the student's feelings during the event, which were recorded separately in a reflection, because a case file is a record of care. One thing the file does include on purpose is the moment the nurse handed the daughter's number and the residence's baseline note to the physician: small acts like this are rarely written down, yet they decide how quickly the rest of the team can work.
References
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
Jones, D. A., DeVita, M. A., & Bellomo, R. (2011). Rapid-response teams. New England Journal of Medicine, 365(2), 139-146. https://doi.org/10.1056/NEJMra0910926
Umpierrez, G. E., Davis, G. M., ElSayed, N. A., Fadini, G. P., Galindo, R. J., Hirsch, I. B., Klonoff, D. C., McCoy, R. G., Misra, S., Gabbay, R. A., Bannuru, R. R., & Dhatariya, K. K. (2024). Hyperglycemic crises in adults with diabetes: A consensus report. Diabetes Care, 47(8), 1257-1275. https://doi.org/10.2337/dci24-0032
What the NSG 233 Unit 6 instructions ask for
Unit 6 asks you to document a high-acuity event with clear roles and times. Expect to define the period covered, record events in tracks for the bedside nurse and other roles, name the bedside nurse's specific contributions and explain what the file leaves out. Students often ask how to document team actions without speaking for others. Record what you saw others do, with times, and leave their reasoning to their own notes. Two tracks make roles visible. The bedside nurse's contributions often include recognizing the change, calling early and giving the history. Exact times let reviewers reconstruct the event. Name what is outside your documentation scope.
How this NSG 233 Unit 6 example is built
The file opens with the period covered, from the 1205 call to transfer. Two columns list timed events: the bedside nurse's actions on the left and other roles on the right, such as the physician ordering fluids and the respiratory therapist checking a blood gas. The contribution section names three nurse actions that shaped the outcome: the early call, the glucose trend she reported and the line she placed while others assessed. The scope section explains what is not recorded and why, such as the physician's reasoning. The two-track layout keeps roles visible without overstating the nurse's part. Times come from the built record, so the file can be checked minute by minute, and the language stays factual about every team member.
Where the points sit in the NSG 233 Unit 6 rubric
Herzing's rubric for a high-acuity case file typically covers the period defined, timed events, separation of roles, the bedside nurse's contributions and appropriate scope. Separation of roles and timing draw the closest reading: the nurse's actions must be distinct from the team's, and every event needs a time. Period points reward a clear start and end. Event criteria look for actions, not impressions. Contribution points go to specific nurse actions that mattered, named with their times. Scope earns credit when the file records what others did but leaves their reasoning to their own notes. Factual language about colleagues is expected. Family updates and handoff at transfer are often credited. Rapid response literature, including the Jones review, frames the two-track format.
Common NSG 233 Unit 6 mistakes, and how to avoid them
A Unit 6 high-acuity file often goes wrong when roles are mixed so the nurse's actions cannot be found. Times are frequently missing or rounded to the nearest quarter hour. Students often record the physician's reasoning, which belongs in another note. The bedside nurse's contributions are understated, as if the team did everything, or overstated. The period is not defined, so the file drifts into the next shift. Language judges other team members. Family communication is left out. The handoff at transfer to step-down is not recorded. Medications given during the event lack doses and times. Finally, keep the tracks separate, because graders reward a file that a reviewer could use to reconstruct who did what and when.
Get a NSG 233 Unit 6 example written to your instructions
Send the Unit 6 instructions and your NSG 233 rubric, plus the scenario if the assignment supplies one. We return a custom file with two parallel tracks, the second kept thin, annotated contact points, a pull-out section naming specific moments, and a forward-looking close. First custom sample free, delivered in 24 to 48 hours.
More NSG 233 papers and BSN samples
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- NSG 233 Unit 5: Acuity ranking exercise
- NSG 233 Unit 7: Urgent report script
- NSG 233 Unit 8: Unstable patient timeline
- NSG 123 Unit 6: Condition and nursing response paper
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- NSG 221 Unit 6: Stigma and language review
NSG 233 Unit 6 questions, answered
Why keep the other roles thin?
Because the criterion is about your part. A file recording everything a team did reads as a report on the group, and the individual reasoning it was meant to show disappears inside it. Include other roles where they touch what the nurse was doing, and let them stay out of focus everywhere else in the document.
Can I write this about a simulation I did?
No, and this one catches people out. Simulation work, debriefs and anything performed on a real unit belong to your own record and often to your instructor's, and none of it is material for a written example. Compose the period from the kinds of unstable admissions your course has taught, and say in a line that the team and the period are fictional.
How do I show two tracks in a word processor?
A two-column table is the usual answer and most sections accept it, though some ask for headed sections instead, so check the instructions first. Where the format has to be prose, keep the tracks apart by alternating short headed blocks rather than mixing roles inside paragraphs, since the separation is what is being marked.
Where can I find a free NSG 233 Unit 6 sample paper?
Read the complete NSG 233 Unit 6 high-acuity case file here at no charge, 35 minutes in two tracks with the nurse's contributions named. Ask for a custom file if your event differs.
How should a nurse document a rapid response event?
Record exact times, what you did and what you saw others do, and leave their reasoning to their own notes. This sample uses two tracks so the bedside nurse's actions are separate from the rest of the team's.