N6919B is a supervised clinical practice course designed for Adult-Gerontology Acute Care Nurse Practitioner learners at the DNP level. It’s typically completed in high-acuity environments such as:

• ICUs (medical, surgical, cardiac, neuro)
  
• Emergency/trauma settings
  
• Step-down or progressive care units
  
• Inpatient hospitalist services
  
• Specialty acute services (cardiology, pulmonology, nephrology, critical care)
  

The goal is to demonstrate competency in advanced assessment, diagnosis, clinical decision-making, and management of acutely/critically ill adult and older adult patients—while strengthening professional leadership and evidence-based practice.

Core Learning Outcomes You’re Usually Expected to Demonstrate

While every university has its own rubric, N6919B preceptorship commonly evaluates your ability to:

1) Manage Complex Acute Conditions

You should be confident managing conditions like sepsis, shock states, acute respiratory failure, DKA/HHS, ACS, stroke, acute kidney injury, GI bleeding, and delirium in older adults.

2) Apply Advanced Diagnostics

Expect frequent use of labs, ABGs, imaging, cultures, ECG interpretation, and clinical scoring tools to support diagnosis and treatment decisions.

3) Develop Safe, Evidence-Based Plans of Care

You’ll be assessed on treatment plans that show clinical reasoning—not just “what” you did, but why you chose it, supported by guidelines and evidence.

4) Communicate and Coordinate Care

Strong SBAR handoffs, consult calls, documentation quality, and interprofessional collaboration are major success factors.

5) Demonstrate Professionalism and Leadership

You’re expected to act like an advanced practice clinician in training: punctual, prepared, ethical, and proactive—while seeking feedback and improving.

What Your Preceptor Typically Expects From You

Your preceptor’s trust grows quickly when you consistently do the basics well:

• Arrive early and review patient lists before rounds
  
• Present concise patient summaries (problem-focused)
  
• Suggest a plan and be ready to justify it
  
• Follow up results promptly and communicate changes
  
• Document cleanly and complete tasks without reminders
  
• Ask smart questions (showing preparation)
  

N6919B Common Assignments and How to Nail Them

1) Clinical Logs and Hour Tracking

Clinical logs often include:

• Date/time, setting, patient age group
  
• Presenting problems/diagnoses
  
• Procedures/skills performed
  
• Level of involvement (observed, assisted, performed)
  
• Preceptor verification
  

How to excel:

• Log daily while details are fresh
  
• Use consistent terminology (ICD-style problem names where possible)
  
• Match your log categories to course outcomes
  

2) Case Studies / Patient Narratives

Case studies usually test clinical reasoning and evidence-based decision making.

A strong acute care case write-up includes:

• Chief complaint + brief HPI
  
• Relevant PMH, meds, allergies
  
• Focused assessment findings
  
• Differential diagnosis (ranked)
  
• Diagnostics ordered and rationale
  
• Final diagnosis + management plan
  
• Red flags, safety, escalation criteria
  
• Discharge/transition planning (if applicable)
  
• Evidence support (current guidelines, primary research)
  

3) SOAP Notes or Progress Notes

Your notes should show clarity, safety, and acute care thinking:

• S: focused and relevant, not a narrative dump
  
• O: vital trends, key labs, imaging, exam highlights
  
• A: problem list with clinical interpretation
  
• P: diagnostics, treatment, monitoring, consults, education
  

4) Reflective Journals

Instructors want growth, insight, and professional development—not just “today was good.”

Use a simple reflection framework:

• What happened? (brief)
  
• What did I do well?
  
• What would I do differently and why?
  
• What evidence supports the improved approach?
  
• What’s my action plan for next shift?
  

5) Competency/Skill Validation

Depending on your site, you may need validation for skills such as:

• Central line/arterial line care (role-dependent)
  
• Ventilator basics and ABG interpretation
  
• Rapid response participation
  
• Advanced medication management in unstable patients
  
• Interpretation of ECGs and imaging findings
  

How to Prepare Before Each Clinical Day

A simple routine that makes you stand out:

1. Pick 1–2 clinical topics related to your unit (e.g., sepsis bundles, AKI management).
   
2. Review one guideline or quick evidence summary.
   
3. Prepare a one-minute plan for likely scenarios.
   
4. Bring a template for patient presentations:
   
   • Problem, key vitals, key labs, what changed overnight, plan
     

This reduces anxiety and improves performance fast.

Common Challenges in N6919B

Struggling With Differentials

Use a consistent method:

• Life-threatening first
  
• Most common next
  
• “Can’t miss” diagnoses
  

Documentation Taking Too Long

Create reusable templates for:

• Sepsis reassessment
  
• Acute respiratory failure
  
• Chest pain/ACS
  
• Altered mental status/delirium
  

Feeling Overwhelmed in High Acuity Settings

Focus on priority frameworks:

• ABCDE
  
• Hemodynamic stability
  
• Oxygenation/ventilation
  
• Infection control and early antibiotics
  
• Frequent reassessment
  

FAQs

Final Thoughts

N6919B is demanding—but it’s also one of the most rewarding stages of the DNP journey. If you treat each clinical day as preparation for real AGACNP practice, align your documentation to outcomes, and consistently reflect and improve, you’ll build both confidence and competence.