Running head: CLINICAL EXEMPLAR

Marissa Peery
University of South Florida College of Nursing
Clinical Exemplar

Clinical Exemplar

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I have had many clinical experiences throughout my two years in nursing school,
but one during my internship had me use my critical thinking more than I expected
during what I thought would be a normal day on the Medical/Surgical Unit. A clinical
exemplar is a way for nurses to share their stories about their patients and experiences
(Harvey & Tveit, 1994). As students in nursing school, we are taught how to assess
patients, so our assessment skills are ready for the real world. First thing when I started
my shifts during my internship, I would go into my patients rooms, introduce myself,
and assess my patients. During this shift, my assessment skills would be more important
than I ever expected coming into work that morning.
I had three patients to start out with and I knew one was going to be discharged
sometime before noon. As I started to introduce myself to one of my patients, I received a
call on my pager saying that one of my other patients was in severe pain and vomiting. I
went to check on the patient and he had been admitted for a below the knee amputation. I
started my assessment and the patient had thrown up coffee ground emesis and had
severe pain in his abdomen. His abdomen was also very distended. I knew that the coffee
ground emesis was not good, so I contacted the provider and my preceptor gave the
patient pain medication through his IV. The provider put in orders for an XRAY and labs
to be drawn. Once the patient returned from XRAY, the provider came to the floor and
wanted to put in a NGT. Once the NGT was in place, coffee ground emesis was being
suctioned out into the container.
Once the NGT was placed, the senior physician came in and put in an order for an
MRI. While the patient was down at MRI, I was able to discharge my other patient. My
patient came back from MRI and we were waiting on the results. At this time, it was 1330

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and I was finally able to take a break and eat. Right when I sat down to eat, I received a
call to get report from an admission that my preceptor and I were receiving. At the same
time, I see the doctors rushing to my other patients room, so I had a feeling something
was not good. Once I finished receiving report, I went into my sick patients room to listen
to the providers. The MRI results had come back and the patient had gas in his colon,
which meant if he didnt go to the OR right away he would lose his colon and possibly
die. My preceptor and I rushed him to the ICU as the doctors ordered where he would
wait to have emergency surgery.
This experience was such an eye opener for myself as a nursing student. I knew
assessments were important for nurses to perform, but this day made me realize even
more what could go wrong if you do not assess patients. If I had not gone into that
patients room and assessed properly, the patient could have become even sicker and
would have been at a greater risk of dying. It was a very busy day for me, but I would not
have wanted to change anything about this day. I learned so much this day and now have
an even better appreciation for assessing and knowing your patients. Assessments are a
very important skill and I am glad that my skills were able to help this patients life this
day.

Resources

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Harvey, CV. & Tveit, LC. (1994). Clinical exemplars to recognize excellence in nursing
practice. US National Library of Medicine National Institutes of Health. 13(4) 45-53