| Course | NU 700 Knowledge for Nursing Practice |
|---|---|
| Unit | Unit 8 |
| Paper type | End-of-course reflection paper |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU 700 Unit 8
From Research Hierarchy to Patterns in Tension: How My Account of Nursing Knowledge Changed This Term
Student Name
Department of Nursing, Herzing University
NU 700: Knowledge for Nursing Practice
Instructor Name
April 14, 2026
From Research Hierarchy to Patterns in Tension: How My Account of Nursing Knowledge Changed This Term
Where I Started
At the start of this term I believed that nursing knowledge was, in practice, the evidence hierarchy. A systematic review of randomized trials sat at the top, expert opinion at the bottom, and everything a nurse knew from experience was a placeholder until a study replaced it. I wrote as much in my first discussion post, even while arguing that an experienced clinician's feeling that an older patient was not herself deserved to be called knowledge; I treated that sense as valuable mainly because it prompted tests that would produce real evidence. My position was simple, and I held it confidently: the more empirical the knowledge, the better. I would have ranked my own clinical experience below any published case series, and I would have described a theory as useful mainly for organizing a literature review.
What My Own Work Exposed
Six pieces of my work this term complicated that position, in the order they were produced.
The concept analysis of alarm fatigue in Unit 2 was the first. When I gathered uses of the concept, the most clarifying source was not a nursing study but a psychologist's account of the cry wolf effect (Breznitz, 1984). My attribute list only held together when I recognized that alarm fatigue is a learned loss of trust in a signal. That insight came from a field outside nursing's own evidence, and from careful reasoning about meaning, which is not something a hierarchy ranks.
The theory analysis in Unit 3 was the second. I expected transitions theory to be decorative. Instead, when I mapped it against missed postpartum glucose testing, it explained something the outcome data could not: why women who knew about their risk still did not come back, because three transitions were competing for their attention (Meleis et al., 2000). Theory did explanatory work that no single study in my literature matrix did.
The literature matrix in Unit 4 added a quieter lesson. Building columns that stayed identical down the page forced me to notice that every trial of home blood pressure telemonitoring had been run in an integrated health system or a national health service, and none in a safety-net clinic like the one where I work. The hierarchy rated those trials highly, and they deserved it, but the gap column mattered as much as the findings column for the decision I actually face. I had never before thought of a missing population as a finding.
The appraisal in Unit 5 was the third, and it undid my faith in the hierarchy most directly. Three Level I trials of chlorhexidine bathing, all well conducted, disagreed. The disagreement was explained not by quality but by context, the baseline infection rates in the units studied. Knowing which trial applied to a community ICU required judgment about the setting, which the hierarchy itself does not provide (Dang et al., 2022).
The ways of knowing paper in Unit 6 was the fourth. Writing about a hospice family who asked for an infusion for their dying father, I found that the empirical evidence was clear and still insufficient. The trial told me fluids would not help; it did not tell me how to help a son who believed his father was dying of thirst. Ethical, personal, and aesthetic knowing did that work (Carper, 1978).
The synthesis brief in Unit 7 confirmed the pattern. The early mobilization trials disagreed partly because usual care had changed between 2009 and 2022; what counted as the comparison had moved. Evidence, I realized, has a date and a context attached, and the same intervention can look effective or ineffective depending on what it is compared with.
My Revised Position
I now think of nursing knowledge as several patterns that must be held in tension, each checking the others. Empirical knowledge remains essential, and I would still not start an intervention that the best trials show to be ineffective. But the hierarchy ranks designs, not knowledge. It tells me how much to trust a study's internal validity, not whether its findings apply to my patient, what they mean to my patient, or what I ought to do when two obligations conflict. Chinn and Kramer (2018) describe the patterns of knowing as integrated in expert practice, with each pattern capable of correcting distortions in the others; I understood that as a sentence in September and understand it as a description of my own work now.
Set beside my original position, the change is this: I used to ask whether a piece of knowledge was empirical enough to count. I now ask what kind of knowledge a question needs and which patterns are missing from my answer.
What Remains Unsettled
Two questions remain open for me. First, I have not resolved how to document personal and aesthetic knowing so that colleagues can check it. My first discussion post asked this question, and I still do not have a satisfying answer beyond recording observations and expectations explicitly. Second, I worry that my new position could become an excuse. If every pattern counts, a clinician could justify ignoring evidence by appealing to intuition or values. The safeguard I would propose is the one Carper implied: no pattern should stand alone, and a decision that relies on one pattern while contradicting another should be treated as a warning sign, not a judgment call.
What I Will Do Differently
In practice, this changes three concrete things. When I appraise evidence for a practice change, I will write an applicability section separate from the quality rating, as I did for the chlorhexidine trials. When I write a plan for a patient whose family disagrees with the evidence, I will document the conversation, not only the decision. And when I evaluate a new protocol, I will ask which theory explains why it should work, because the transitions analysis showed me that an intervention without an explanation is hard to adapt when it fails.
References
Breznitz, S. (1984). Cry wolf: The psychology of false alarms. Lawrence Erlbaum Associates.
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. https://doi.org/10.1097/00012272-197810000-00004
Chinn, P. L., & Kramer, M. K. (2018). Knowledge development in nursing: Theory and process (10th ed.). Elsevier.
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.
Meleis, A. I., Sawyer, L. M., Im, E.-O., Hilfinger Messias, D. K., & Schumacher, K. (2000). Experiencing transitions: An emerging middle-range theory. Advances in Nursing Science, 23(1), 12-28. https://doi.org/10.1097/00012272-200009000-00006
What the NU 700 Unit 8 instructions ask for
The Unit 8 assignment asks you to reflect on your learning across the course and how your understanding of nursing knowledge has developed. Expect to describe where you started, identify specific assignments or readings that changed your thinking, and state your current position. Many versions ask what questions remain unresolved and how the course will change your advanced practice. First person is expected. The reflection still needs scholarly grounding, so cite the theorists and evidence you are discussing, even when referring to your own earlier papers. Check whether your section wants a particular reflection model, such as Gibbs or Driscoll, or leaves the structure open. Ground every claim of growth in something concrete from the term rather than general statements about learning.
Inside the NU 700 Unit 8 example
The paper begins with a short, honest statement of the starting position, which gives the reflection something to move away from. The middle section lists six earlier assignments in the order they were written and says what each one complicated. For example, the alarm fatigue analysis showed that some knowledge comes from defining a problem well, not from testing an intervention. The revised position is stated in its own section with a clear thesis, so the grader can compare it with the starting point. A section on what remains unsettled admits two open questions, including how to document personal knowing so colleagues can check it. The final section names three practice changes, each tied back to a specific assignment, such as writing a separate applicability section in future appraisals.
NU 700 Unit 8 rubric: what full points look like
Herzing reflection rubrics usually give points for depth of reflection, connection to course content, application to practice, and writing. Depth is the most heavily weighted criterion and rewards papers that show a change in thinking with evidence, not a list of topics covered. Course content points go to reflections that cite the theorists, models and studies from the term and use them accurately. Application to practice earns full points when the changes are specific and tied to the student's future role. Some rubrics include a criterion for self-assessment of strengths and areas for growth. The writing criterion covers organization, appropriate first person, grammar and APA 7. Concrete examples, such as naming the chlorhexidine appraisal, make each of these easier to credit.
Common NU 700 Unit 8 mistakes, and how to avoid them
The usual problem with a Unit 8 reflection is that it summarizes the course instead of showing how thinking changed. Statements like I learned so much do not earn depth points without an example from a real assignment. Students also leave out scholarly sources because the paper is personal, which costs points in most rubrics. Another frequent issue is a revised position that sounds identical to the starting one, so the paper shows no change. Practice changes are often too general, such as using more evidence; name the specific habit you will adopt. Avoid overstating certainty, since an honest open question often reads as stronger reflection. Finally, keep each earlier assignment brief, one or two sentences, so the paper does not turn into a list.
Get a NU 700 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NU 700 classroom, plus the earlier work you want the reflection to draw on and any program outcomes it has to address. We write a custom example against those instructions, built on your own artifacts, and return it in 24 to 48 hours. The first one is free.
More NU 700 papers and MSN samples
- NU 700 Unit 1: Discussion post
- NU 700 Unit 2: Concept analysis paper
- NU 700 Unit 3: Theory analysis
- NU 700 Unit 4: Literature matrix
- NU 700 Unit 5: Evidence appraisal
- NU 700 Unit 6: Ways of knowing paper
- NU 700 Unit 7: Evidence synthesis brief
- NU 726 Unit 8: Leadership philosophy reflection
- NU 730 Unit 8: Outcome evaluation plan
- NU 760 Unit 8: Peer review response
- NU 780 Unit 8: Population outcome evaluation
NU 700 Unit 8 questions, answered
Is first person acceptable in this piece?
In a reflection it is normally expected, and writing around it produces awkward constructions that hide who did what. Check your instructions, since some sections still ask for scholarly register in the parts that draw on the literature. The usual pattern is first person for the account of your own work and standard academic voice wherever a source is being used.
Do I need sources in a reflection?
In most sections yes, and reflections arrive without them more often than any other piece. The revised account of nursing knowledge is a claim about the discipline, so it should point at the literature that produced the revision. A workable rule is a citation wherever you describe what nursing knowledge is, and no citation where you describe what you did.
How specific should the practice change be?
Specific enough that a colleague could tell whether it happened. Naming the situation, the behavior and the point at which it would apply beats a general commitment to evidence-based care. If the change involves your workplace, keep the description at the level of role and setting rather than naming the employer, the department or the people involved.
Where can I find a free NU 700 Unit 8 sample paper?
This page holds the complete NU 700 Unit 8 reflection at no cost, from the starting position through the three practice changes. A custom reflection can draw on your own assignments from the term and the model your section requires.
Do I need citations in a reflection paper for a nursing course?
Usually yes. Even a first-person reflection should cite the theorists and studies it discusses. This sample cites Carper, Chinn and Kramer, Meleis and the appraisal model alongside its own earlier assignments, and lists them in an APA 7 reference list.