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Clinical Exemplar
Farrah Jimenez
Clinical Exemplar
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
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
CLINICAL EXEMPLAR 3
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
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.
CLINICAL EXEMPLAR 4
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