| Course | NUR 392 Health Promotion Across the Life Span |
|---|---|
| Module | Module 6 |
| Paper type | Critique of nursing practice paper |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 392 Module 6
A Checkbox Is Not Counseling: Critiquing How an Intensive Care Unit Addresses Smoking Before Discharge
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 392: Health Promotion Across the Life Span
Instructor Name
Month Day, Year
A Checkbox Is Not Counseling: Critiquing How an Intensive Care Unit Addresses Smoking Before Discharge
Nurses are expected to promote health in every setting, including the intensive care unit, where the focus is understandably on survival. This paper critiques one health promotion practice on a 24-bed medical ICU, the way nurses address tobacco use with patients before they transfer or go home. It describes current practice, compares it with the evidence on hospital-based smoking cessation, considers the nurse's role and communication, and recommends changes. The unit is a composite of several large hospitals, and no patient details are drawn from real records.
Current Practice on the Unit
On admission, nurses complete a screening question about tobacco use in the electronic health record. If the patient smokes, an education task appears, and nurses check a box confirming that cessation education was given. In practice, education usually means handing the patient or family a pamphlet about the state quitline, often on the day of transfer to the floor. Many ICU patients are sedated or intubated on admission, so the screening question is answered by family or skipped and never revisited. Nicotine replacement is ordered for some patients to manage withdrawal, but it is rarely discussed as a step toward quitting.
On a typical week, about a third of the unit's patients have a smoking history, and many are admitted for conditions made worse by smoking, such as chronic obstructive pulmonary disease exacerbations, pneumonia and heart attacks. Hospitalization is often described as a teachable moment, because patients are away from cigarettes, often frightened by their illness and surrounded by health professionals. On this unit, that moment passes with a pamphlet.
What the Evidence Supports
A Cochrane review of 50 trials of smoking cessation interventions for hospitalized patients found that intensive counseling begun during the admission, with follow-up contact lasting a month or more after the patient went home, raised quit rates after discharge compared with usual care (Rigotti et al., 2012). Less intensive counseling did not show a statistically significant benefit. Adding nicotine replacement therapy to intensive counseling increased quit rates further. The review also found that post-discharge contact itself contributed to the benefit.
For adults in general, national prevention guidance calls on clinicians to screen every adult for tobacco, urge those who smoke to quit, and offer both counseling and approved medications (US Preventive Services Task Force et al., 2021). Together, these sources describe a standard of care in which asking is only the first step and the effective part is counseling with follow-up and medication.
Critique
Measured against this evidence, the unit's practice has three strengths and several weaknesses. The strengths are that tobacco use is screened on admission, withdrawal is treated with nicotine replacement for some patients, and a quitline referral exists. The weaknesses are more important. First, screening is often done when the patient cannot answer and is not repeated when the patient can. Second, the education is brief and passive, closer to the less intensive interventions that showed no significant effect in the Cochrane review. Third, there is no follow-up after the patient leaves the unit, even though post-discharge contact was a key part of the effective programs. Fourth, nicotine replacement is treated as withdrawal management rather than offered as part of a quit plan. Finally, the checkbox records that education happened without recording what was said or how the patient responded, so the unit cannot tell whether its practice works.
Timing compounds these weaknesses. A patient admitted on a ventilator may spend three or four days on the unit, be extubated on the fifth, and transfer to the floor on the sixth, by which point the ICU nurses who know the patient best are no longer involved. If the conversation about smoking happens at all, it falls to a floor nurse who first met the patient that morning, on the day of discharge. Nicotine withdrawal also complicates the picture. Some agitation in recovering ICU patients may be partly withdrawal, and nurses who recognize this can treat it and open a conversation about quitting at the same moment, which turns a symptom into an opportunity. The current workflow separates those two tasks, so withdrawal is managed and the opportunity is missed.
The Nurse's Role and Communication
Our module readings describe nurses in health promotion as educators, counselors, advocates and coordinators (Friberg & Saewert, 2023), and they emphasize communication that is respectful and tailored to the person. On this unit, nurses act mostly as distributors of information. A counseling approach would look different: asking the patient, once alert, how they feel about their smoking now; advising in clear, personal terms that quitting will help their lungs or heart recover; and asking whether they would like help, then arranging it. This approach takes a few minutes, does not lecture, and treats the patient as the decision maker. ICU nurses have unusually close, prolonged contact with patients and families, which gives them credibility for this conversation.
Recommendations
First, move the tobacco conversation to the point when the patient is alert and able to talk, and make it a nursing task with a prompt to revisit screening after extubation or sedation ends. Second, replace the pamphlet with a brief scripted conversation and an opt-out referral to the hospital's tobacco treatment service or the state quitline, so that follow-up contact after discharge is built in. Third, change the documentation from a checkbox to a short structured note that records the patient's readiness and the referral made, and review the data quarterly. These changes use existing staff and resources and align the unit with the interventions that the evidence shows are effective.
Conclusion
The ICU's current approach to tobacco use is well intended but too brief and too early to change behavior. The evidence points to counseling that begins in the hospital and continues after discharge, supported by medication. Nurses are well placed to start that process, and modest changes in timing, communication and referral could turn a missed opportunity into effective health promotion.
References
Friberg, E. E., & Saewert, K. J. (Eds.). (2023). Conceptual foundations: The bridge to professional nursing practice (8th ed.). Elsevier.
Rigotti, N. A., Clair, C., Munafò, M. R., & Stead, L. F. (2012). Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews, 2012(5), CD001837. https://doi.org/10.1002/14651858.CD001837.pub3
US Preventive Services Task Force, Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., Donahue, K., Doubeni, C. A., Epling, J. W., Jr., Kubik, M., Ogedegbe, G., Pbert, L., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2021). Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. JAMA, 325(3), 265-279. https://doi.org/10.1001/jama.2020.25019
NUR 392 Module 6 instructions, in plain terms
The posted syllabus puts the Critique of Nursing Practice in Module 6, whose topics are the role of nurses in health promotion across the life span, communication and types of nursing roles, with readings from the Friberg and Saewert text. Written assignments make up 29% of the course grade. The prompt typically asks you to choose a health promotion practice you have seen nurses carry out, describe it, compare it with current evidence or standards, analyze the nurse's role and communication, and recommend improvements, in APA format. Look in Canvas for the length cap, the required number of scholarly sources, and whether the practice must come from your own workplace.
How this NUR 392 Module 6 example is built
The paper describes a specific practice on a composite medical ICU in enough detail to show its gaps, then summarizes the evidence from a Cochrane review of 50 trials and a national recommendation, including which interventions did not work. The critique names three strengths and five weaknesses and ties each weakness to the evidence. A section on the nurse's role and communication applies the module's reading to how the conversation could sound. Three recommendations follow, each with a reason and a note on resources, and a short conclusion restates the judgment. Margin notes explain why each section earns credit. Margin notes point out how each section answers a row of the grading rubric.
NUR 392 Module 6 rubric: what earns full marks
Critique papers in this course usually earn points for a clear description of the practice, accurate use of current evidence, a balanced critique that names strengths as well as weaknesses, analysis of the nurse's role tied to the readings, and realistic recommendations. Writing, organization and APA format complete the rubric. Instructors look for a critique that compares practice with a standard rather than giving opinions. Recommendations should follow from the weaknesses identified and fall within nursing's control. Papers that describe the practice and stop, or that recommend sweeping changes without evidence, tend to score lower. A paper that ties its recommendations to the nurse's role as educator and counselor usually reads as complete.
NUR 392 Module 6 help from the desk
Students often choose a practice that is too large, such as all patient education, and end up with a general essay. Pick one practice on one unit. Another mistake is criticizing colleagues personally; critique the process, not people. Use evidence that matches the practice and report what it found accurately, including results that were not significant. Make recommendations specific enough to start next month. Keep patient and facility details out. Include strengths, since a critique that finds nothing good reads as unbalanced. If you would like help with a critique of a practice from your own unit, send the prompt and a description. Before submitting, check that every recommendation responds to a weakness you named.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 392 Module 6 questions, answered
Where can I find a free NUR 392 Module 6 sample paper?
The complete critique of nursing practice sits above: an ICU's approach to smoking before discharge compared with a Cochrane review and national guidance, with strengths, weaknesses, recommendations and references.
What practice should I critique in NUR 392?
Choose one health promotion practice you have seen nurses carry out, such as discharge teaching, vaccination screening, fall prevention teaching or tobacco counseling, on a specific unit.
Do I need to include strengths in the NUR 392 critique?
Yes. A balanced critique names what the practice does well before identifying weaknesses, which makes your recommendations more credible.
What evidence works for a NUR 392 critique?
Systematic reviews, national guidelines and recent studies that test the practice or its alternatives. Report their findings accurately and connect them to what you observed.
Can I critique a practice at my own workplace in NUR 392?
Usually yes. Remove names and identifying details and focus on processes rather than individual colleagues.