Running head: CLINICAL EXEMPLAR

Clinical Exemplar
Emma Jagasia
University of South Florida

CLINICAL EXEMPLAR

My Clinical Exemplar

I have always heard that nurses have or will have one patient who truly
provides meaning to their career. As nurses we may face many challenging or
meaningful situations in our careers. This past semester during my preceptorship I
faced one particular patient scenario that showed me, even as nurses we can feel
helpless.
Patient B had been in the Pediatric Intensive Care Unit for a week before I
was assigned to take care of her. She came into the Emergency room for
respiratory distress, which ended up being a neurological, seizure issue. This
patient suffered from severe hypoxia at birth. Currently at five months old, she
suffers from ten seizures a minute every minute. She had minimal brain activity
and had met no developmental milestones. My whole shift was spent suctioning
her airway to maintain stable vital signs and turning her every two hours to
prevent skin breakdown.
Homecare and family involvement was also a pertinent issue for this
patient. Since admission, family had not been present. Mom and dad had called
maybe three times in sixteen days. They had been offered courtesy rides, but
denied and asked for money instead. The doctor had requested them to come in to
visit. After eight days to this request, the parents finally came in and stayed for a
twenty-minute duration. During this time they were very apprehensive to help and
defensive about their own actions. Several times home health care was offered to

CLINICAL EXEMPLAR

the family, but each time they denied. The reasoning changed from the healthcare
team not believing they parents were capable of care to the grandparents not open
to the suggestion. The parents also started to blame all of Patient Bs current
problems on the hospital. The plan of care was in the middle of being discussed
and the family stated they could no longer be there and left.
Being a novice nurse, this situation was unfamiliar and made me feel
extremely uneasy. I fully understood the importance of keeping a child with the
family but my main concern was patient safety. At the moment of discharge I felt
helpless. I had no confidence in the home safety for my patient. My only hope was
during home care the parents were receptive to the patients needs.
From this experience, I learned that we as nurses do not always have the
answers. We cannot guarantee the safety of our patients outside of the hospital
walls. Our job is to provide patient comfort and safety to all patients while in the
hospital, and provide patients family members with all appropriate tools and
resources to promote successful outcomes. I will never forget Patient B.