| Course | NUR 444 Innovation in Nursing |
|---|---|
| Module | Module 3 |
| Paper type | Journal club discussion (two parts) |
| Length | About 536 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 444 Module 3
Journal Club Discussion: Change
When Nurses Push Back: Change, Resistance and Risk in Launching Bedside Recovery Videos on an Orthopedic Unit
Part 1: Change, Resistance and Risk
My innovation idea for this course comes from a workaround, the kind of quick fix nurses use instead of correcting the process behind it (Vanbelleghem et al., 2022). Our joint replacement patients receive a printed exercise sheet at discharge, and many of them, especially Spanish-speaking patients and older adults, cannot follow it at home. I started recording short videos with an interpreter on my own phone. The improvement I want to test is a set of short, approved recovery videos in English and Spanish, reached through a QR code posted at each bedside so patients and families can watch them before and after discharge.
A planned change model helps me think about this. Lewin's classic model describes change as loosening the current way of doing things, moving to the new way, and then making the new way stick; in my case, that means showing staff why the handout fails, piloting the videos with a few patients, and then building the QR code into discharge teaching and the unit's orientation (Friberg & Saewert, 2023). The model reminds me that the last step is the one most changes skip. If no one owns the videos after the pilot, they will be outdated within a year.
Resistance is likely. Some nurses will worry about time, others about patients who lack smartphones, and others about whether the hospital will allow videos at all. Risk-taking is part of innovation, and for a staff nurse the risk is mostly social: proposing a change to colleagues and leaders and being seen as criticizing current practice. I plan to reduce that risk by starting small, inviting skeptical colleagues to review the scripts, and keeping the printed handout available so no patient loses anything.
Part 2: Introducing the Literature
For our journal club I chose McMillan and Perron (2021), a qualitative critical hermeneutic study of 14 registered nurses at an urban pediatric teaching hospital in Canada. The authors noted that failed changes in health care are often blamed on nurse resistance, but that most of the literature describes change from administrators' point of view. Through interviews, they found that nurses' resistance was rarely open opposition. Instead, it took the form of covert acts in small ethical moments at the bedside, which nurses used to provide what they saw as morally authentic care. Nurses described feeling powerless in the planning and evaluation of change, and resistance gave them back some control over their practice.
This article challenges how I was planning to think about my colleagues. If a nurse quietly keeps handing out the printed sheet instead of showing the video, that may not be stubbornness; it may be a judgment that the sheet is safer for a patient who cannot use a phone. The study suggests the better response is to involve nurses in planning and to treat their objections as information about patient care. Questions for the group: Have you seen resistance on your unit that was really about protecting patients? And how could a change leader tell the difference between that kind of resistance and simple reluctance to change habits?
References
Friberg, E. E., & Saewert, K. J. (Eds.). (2023). Conceptual foundations: The bridge to professional nursing practice (8th ed.). Elsevier.
McMillan, K., & Perron, A. (2021). Change resistance as practicing moral authenticity: A qualitative study. Research and Theory for Nursing Practice. Advance online publication. https://doi.org/10.1891/RTNP-D-20-00078
Vanbelleghem, S., De Regge, M., Van Nieuwenhove, Y., & Gemmel, P. (2022). Barriers and enablers of second-order problem-solving behavior: How nurses can break away from the workaround culture. Quality Management in Health Care, 31(3), 130-142. https://doi.org/10.1097/QMH.0000000000000385
NUR 444 Module 3 instructions, in plain terms
The posted syllabus describes the Journal Club Discussion on Change as a Module 3 assignment, and journal club discussions together carry 20 points across the course. Each one has two parts: in Part 1 you answer the discussion prompts, and in Part 2 you introduce literature, usually a peer-reviewed article that adds to the group's understanding. The module's outcomes focus on theories of change and how they apply to nursing, approaches to managing change and resistance, risk-taking and its relationship to innovation, and the principles of innovation as they relate to change. Check Canvas for the exact prompts, the article requirements, the reply count and the deadlines for each part.
How this NUR 444 Module 3 example is built
Part 1 introduces the writer's own innovation idea in one paragraph, born from a workaround, then applies a planned change model to it, noting which step is most often skipped. It names likely sources of resistance and describes the social risk a staff nurse takes, with steps to reduce it. Part 2 introduces a 2021 qualitative study, summarizing its design, setting, sample and main findings in the writer's own words, then explains how the article changes her plan. Two discussion questions invite the group to respond, which is what a journal club post is meant to do. Sources are cited throughout. Both parts stay within the length a busy classmate will actually read.
Where the marks sit in the NUR 444 Module 3 rubric
Journal club posts in NUR 444 are commonly graded on both parts. For Part 1, graders look for accurate application of change theory and course concepts to a real situation, including resistance and risk. For Part 2, points depend on choosing a relevant, credible article, summarizing it accurately, explaining its significance and prompting discussion. Replies to peers, APA citations and timeliness complete the rubric. Posts that summarize an article without connecting it to practice, or that describe change theory in general terms only, usually lose points in the application rows. Graders sometimes check that the article is recent enough to add something the textbook does not.
NUR 444 Module 3 help with common mistakes
Students often summarize a change model by reciting its stages without applying them; show what each stage would look like for your change. Another common gap is choosing an article that is not peer reviewed or is too old to add anything new. Summarize the article's design and findings in your own words, then say what it means for practice. Ending with questions helps peers reply. Keep both parts clearly labeled. If you would like help selecting an article or drafting Part 1 around your own change idea, send the prompt and your idea to the desk. Post Part 2 early enough in the week for classmates to respond to your questions.
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 444 Module 3 questions, answered
Where can I find a free NUR 444 Module 3 sample paper?
The full journal club discussion is on this page: Part 1 on change, resistance and risk for a bedside video idea, and Part 2 introducing a qualitative study of nurse resistance, with references.
What article should I choose for the NUR 444 journal club?
Choose a recent peer-reviewed article on the module topic, such as change management or resistance in nursing, that adds a new idea for the group to discuss.
Which change theory can I use in NUR 444?
Lewin's model, Rogers' diffusion of innovations, Kotter's steps and other planned change models all work. Apply the one you choose to a specific change.
What are the two parts of a NUR 444 journal club?
Part 1 answers the discussion prompts. Part 2 introduces literature, usually by summarizing an article and explaining its relevance.
How do I discuss resistance to change in NUR 444?
Name the forms of resistance you expect, explain what may drive them, and describe how you would respond. Treat objections as information as well as obstacles.