Running head: THE CLINICAL EXPERIENCE

The Clinical Experience

Christopher Kwong
University of South Florida

THE CLINICAL EXPERIENCE

The clinical experience is a unique opportunity that the program offers for us to witness
practice in action, learn and hone our skill and practice, and experience patient interaction and
care. Clinical exemplars are a way to capture this true nature of nursing. It is through sharing of
clinical exemplars that we celebrate our own practice and share our uniqueness with others
(Harvey & Tveit, 1994). The clinical experience takes ideas and theory from the classroom and
puts them into a realistic perspective from which I grew the most.
Within the first few weeks of starting the nursing program, I felt thrown into clinicals. I
felt I lacked the knowledge, tools or confidence to work with patients. The time between then
and now, the end of preceptorship when we became responsible for the total patient care of
nearly an entire nursing assignment in the span of 16 months, is a credit to the clinical exemplar.
Different patient cases, varying nursing assignments and the ability to see so many different
areas nurses practice transitioned into preceptorship where we are paired with one nurse in one
area of practice for a complete clinical rotation. It is in this preceptorship rotation I felt I
completely began to put the pieces together in terms of skill sets, communicating with patients
and the patient care team, documentation, and protocols.
One such example of this is the case of a 25-year-old female with a laparoscopic
appendectomy the week prior who came into the ED with complaints of severe abdominal pain.
CT showed a possible intra-abdominal abscess, removed via abdominocentesis, and patient
returned to the floor with normal vitals. Realized there was a problem when post-procedure
protocol vitals revealed a temperature of 102.3 an hour after returning. Patient complains of
feeling feverish. Respiratory rate is 26, but other vitals remained within normal range.
Completed a head-to-toe assessment and reconfirmed the vitals before notifying the
provider. Physician wanted to reassess the vitals again in an hour, although she did not seem very
concerned. Before the abscess was sealed in the abdomen, it was walled off, and the body was

THE CLINICAL EXPERIENCE

not having an infectious response like this to it. A fever like this might be a concerning thing in
another patient, but the physician wanted the fever to help combat the infection and she wanted
to wait for the fever to break, but of course monitor it in the meantime.
This clinical exemplar helped me to realize I made the right decision to inform the
provider, and I had all the information she was looking for when I talked to her. I was proud I
collected the vitals and assessment information the physician would be asking for when I called,
and I was glad to get the experience of needing to call the provider because of a change in patient
status. The patient would look to me for answers a lot when her temperature was staying high or
when an antibiotic was changed or a new lab sample was being sent out, and the clinical
experience offered me the opportunity to feel more confident talking to and comforting patients
about their condition or change in condition or change in plan of care. I know a lot of that will
come with experience and seeing and being in different situations and I feel honored to be
entrusted in a patients total care through the clinical exemplar.

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References

Harvey, C. V. Tveit, L. C. (1994). Clinical exemplars to recognize excellence in nursing

practice. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7831083