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head: CLINICAL EXEMPLAR

Clinical Exemplar: The Journey
Renee Dabydeen
University of South Florida, College of Nursing
Rdabydeen95@yahoo.com

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Clinical Exemplar: The Journey

As a nursing student I have taken everyday that I walk into the hospital as a learning

experience. Not only do I learn the nursing skills I need to meet the requirements of an
entry-level nurse, but I also learn life lessons and culturally dynamic views from my clients.
Each day that I enter a clinical setting I further recognize how rewarding and satisfying this
career choice is, as I juggle the many hats that a nurse must wear; i.e patient advocate,
detective, teacher and sometime just a shoulder to lean on. Throughout my clinical
experience, I have encountered many memorable clinical situations and would like to take
the time to discuss one of them through a clinical exemplar. A clinical exemplar is used to
enable nurses to demonstrate the critical thinking and decision making that define
delivery of excellent patient care (Black, 1997). A Clinical exemplar is a great tool to make
invisible work of nursing visible to nursing colleagues, other health care professionals and
the health care consumer (Black, 1997).

During a vital check before a 19-year-old patient admitted to the hospital for

pyelonephritis was to be discharged the patient had an elevated temperature of 102.2 degrees
Fahrenheit. The patient went in and out of tachycardia. The patient was excited to go home and
said she felt fine. On examination, the patient was diaphoretic, had shivers and a fever of 102.2
when rechecked. The previous vitals demonstrated that the patient did not have a fever with 98.6.
I felt that this was an inappropriate vitals to discharge this patient and felt more comfortable
informing the doctor before continuing with the discharge process.
Since the patient came in with an infection and went in and out of tachycardia throughout
the day. I felt that a fever is critical, and should be passed on to the MD.

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When responding to this situation, I decided to do something right away; my patient was
to be discharger however, this finding could affect her discharge. I also administered Tylenol that
was PRN for fever. I felt that I was making the right decision by ensuring the best care possible
to my patient and recognizing possible signs of sepsis. I also seen this situation as a huge priority
in my task list and decided to not delegate any responsibilities with dealing with this patient.
However, I did inform my charge nurse, to make sure that my other patients were properly taken
care of while I dealt with the problem at hand.
In conclusion, I felt that I did achieve the desired outcome, which was to ensure the best
care to my patient and evaluate that discharge was appropriate. I feel that I learned how easily
patients outcomes could change as a registered nurse; one must be ahead of these changes. The
slightest mistake, such as ignoring the spike in the patient temperature may have changed her
entire outcome. Every experience that I encounter builds upon my skills as a nurse and makes me
a better nurse for my patients.

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References
Black, P. (1997, August). Use of the Clinical Exemplar in Performance Appraisals. Newborn
Network, 5(73), 8th ser. Retrieved June, 2016