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Running head: CLINICAL EXEMPLAR 1

Clinical Exemplar

Farrah Jimenez

University of South Florida College of Nursing


CLINICAL EXEMPLAR 2

Clinical Exemplar

According to Greenfield et al (2015), the use of a clinical exemplar provides a reflective

and interpretive framework for analyzing and making sense of literature and other experiences

within a learning environment. This is an important quality for any nurse to be able to attain

since the medical field is ever-evolving and requires constant reflection in order to improve

patient outcomes. Throughout the two years I have been in the nursing program, I have had many

experiences that have been memorable and significant to me. However, one in particular stood

out to me and changed my practice due to the demanding nature of the patient.

In my preceptorship during this last semester I was given much more responsibility and

freedom as far as caring for patients and performing assessments on my own. Since the

beginning of the program I was extremely soft spoken and hesitant with patients and would

typically just try to please the patient and go at their pace. Then on my fifth shift of preceptorship

I was assigned a well-known patient on the cardiac unit due to his intravenous drug that

ultimately caused endocarditis and subsequently called for long term IV antibiotics. The patient

was known for his demanding and aggressive behavior towards the nurses on the unit. During the

morning shift change the night shift nurse admitted to my preceptor nurse that he had not been to

the room more than three times during his shift because he did not want to deal with the patient’s

nasty attitude. This inadvertently set the tone for how the care would be for the patient from my

nurse and me throughout the day.

As I entered the patient’s room for the morning assessment and medication

administration, the patient seemed to already be dissatisfied with the care he was receiving from

us and vocalized the complaints repeatedly. I was unsure how to handle the patient’s negative

attitude so I reverted to my soft spoken and shy behavior and just tried to meet the patient’s
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needs without properly thinking things through and checking the orders that were set for the

patient. I was so intimidated by the patients strong and irritable attitude that when he demanded

more water, I rushed to grab him some without checking for any fluid restrictions in the patient’s

chart since he had a heart condition that was causing him fluid overload. Several hours after I

gave the patient the mug of water he called for a nurse due to his worsening edema in his upper

extremities which was agitating him even more. When the nurse and I entered his room, his arms

had 2 plus pitting edema and the nurse noticed the little water that was left from the mug that I

brought him. She explained to me then that the patient was on a fluid restriction which I was

aware of but since I allowed the patient to get me flustered, I committed this mistake. It was also

a mistake on mine and my preceptor’s part to have allowed for that much time between the

morning assessment and rounding since the night nurse convinced us to stay away from the

patient’s room in the morning shift change report.

In summary, I believe this situation taught me two valuable lessons that I have kept in

mind since caring for this patient. First, is to have a firm and confident demeanor when caring

for patients and not allowing myself to get flustered when dealing with strong personalities.

Second, it is necessary to not let the biases of other nurses create a bias in myself when caring for

my patients. One of the ethical principles of nursing is justice which demands that all patients

receive the same care from nurses no matter what their background is. In order to provide my

patients with optimal care, I will use what I learned with this patient and apply it in my future

practice.
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References

Greenfield, B. H., Jensen, G. M., Delany, C. M., Mostrom, E., Knab, M., & Jampel, A. (2015).

Power and Promise of Narrative for Advancing Physical Therapist Education and

Practice. Physical Therapy, 95(6), 924-933 10p. doi:10.2522/ptj.20l 40085

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