RUNNING HEAD: Clinical Exemplar 1

Clinical Exemplar

Marc-Allen Dy

University of South Florida

RUNNING HEAD: Clinical Exemplar 2

A clinical exemplar is a demonstration of the nurse’s critical thinking and decision-

making skills in order to provide exceptional patient care (Black, 1997). The clinical exemplar is

an actual experience or story that becomes sentimental due to lessons that are learned from the

experience (Thompson, 2005). An example that comes to mind involves a patient that I had

during my last few shifts of preceptorship.

I had a patient that was admitted to the hospital for diverticulosis. The patient was a

middle-aged woman that was a single mom of three kids. Because conservative management was

not effective, the patient had to have surgery. During the surgery, there were complications and

peritonitis happened as a result. The patient had right ileostomy and a left mucous fistula placed.

The patient had an abdominal incision that was covered with Steri-strips to help the wound close.

During trauma rounds that day, the nurse practitioner and the physician had ordered my nurse to

change the Steri-strips. My nurse had agreed to change them, and we both worked together to

change them out. We gave her pain medication beforehand because we knew it would be painful.

The patient was horrified by the surgeries and ileostomies and did not want to watch us change

the dressing. Despite our attempts to reduce her pain, she grimaced while we were changing the

Steri-strips. After we finished redressing the Steri-strips, we made sure she was settled before we

left to see our other patients.

Later in the afternoon, the nurse practitioner and physician’s assistant deemed our Steri-

strips inadequate. They wanted the Steri-strips to be placed in a particular way, so it would help

the wound close. They did not specify when the placed the order, so made my nurse feel

frustrated. They decided they would change the dressing themselves while rounding on the

patients. My nurse and I gathered all of the necessary supplies for them in advance. I went to

Central Supply to ensure they had everything to change the dressing. I inform the patient that
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they would be changing the dressing, and she was devastated. She was horrified at the mere

thought of experiencing the pain she felt earlier. After giving the nurse practitioner and

physician’s assistant all of the supplies, they began to remove our Steri-strips without placing an

order to give her pain medication. They eventually ordered my nurse to give her pain medication

STAT. My nurse gives the patient Fetanyl IV, but it will still take time for it to take effect. After

they assessed the wound, they decided to change the dressing to a wet-to-dry dressing. I watched

them during this process because I wanted to change the dressing accordingly if needed. I

decided to return to the nurse’s station to help my nurse with a discharge because I assumed they

would handle the dressing to its entirety. The physician’s assistant exits the room and stops at the

nursing station. He states that the dressing is complete, and all that needs to be done is to put

abdominal pads and tape it down. He jokingly laughs and passes the information to us and then

leaves. The nurse practitioner had left for the day because it was past time for them to leave. I

ponder for a few seconds assessing the situation. I think about my patient lying there, exposed,

horrified, and abandoned.

I immediately rush out of my seat and run to the room. I see my patient fully exposed,

crying, and lying in wait. The room is a semi-private room, and there is a patient and family

members next to the curtain. As I stumbled upon the situation, I am left utterly speechless. I feel

tears well up inside me, but I hold back because I wanted to comfort my patient first. I fumble as

a grab the abdominal pads and tape to finish the dressing. The patient silently cries as I begin to

open the packages. I completed the dressing the wound and covered her body with the gown and

blankets. I lowered the bed and I kneeled next to her. I was so speechless, I couldn’t even form

the words to say. I apologized for the situation, because I never predicted that they would

abandon her. They should have never left a job incomplete, because they are legally and
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medically responsible for her well-being. I squeeze her hand and I direct make eye contact. She

cries because she feels overwhelmed with the entire situation. I remain silent and let her express

her feelings. She felt that everything medically is going wrong, and she is overwhelmed with

being a single mom with three kids. I empathized with her and gave her reassurance. I told her

that I wanted to complete this dressing to at least give her some form of physical comfort. She

thanked me my time and efforts, and she squeezed my hand back. She said that everyone is

human, and deserves to be treated like a human. I completely agreed with her and vowed to

make sure this never happens to any of my patients.

After this experience, I learned the importance of remembering the compassion and

empathy we need to have as nurses. No matter how many years of experience one may have, the

heart for people is what matters in the end. The art of being genuine is a skill that cannot be

trained.
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References

Black, P.J. (1997). Use of the clinical exemplar in performance appraisal. Neonatal Netw. 16(5),

73-8. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/9325873

Thompson, G. T. (2005). The concept of presencing in perioperative nursing. AORN Journal,

82(3), 465-466, 468