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Running head: CLINICAL EXEMPLAR

Clinical Exemplar
Alexandra Bair
University of South Florida

Clinical Exemplar
As nurses, critical thinking is one of the most crucial skills to develop. New novice
nurses do this through clinical experience during school. Reflection on clinical events help to
develop these critical thinking skills. A clinical exemplar is a professional example of reflection
of a clinical situation to other healthcare professionals (Owens & Cleaves, 2012). Through
sharing of clinical exemplars, we discover more about our abilities and qualities, as well as
celebrate our own growth in practice.
I was working in a critical care area when I was taking care of a patient with leukemia.
Her access was a port in her chest. She was unresponsive and localized the left upper and lower
extremities to painful stimuli. As I began to assess her in the morning at the beginning of my

shift, the patient began to have a localized seizure on her right side. Her seizure lasted
approximately five minutes. It was a slight rhythmic movement in her shoulder, foot, and head.
It could have been missed if not closely observed. She had allergies to many of the common
seizure medications. I noted the seizure, informed my preceptor and checked for PRN
medication for her seizure.
Information I needed to make my decision is what medications she was allergic to as well
as if there were any PRN orders for her seizures. I, also needed to determine her area of IV
access to administer the medication necessary to stop the seizure. The patient needed to be
monitored during the seizure for safety and to determine how long the seizure lasted.
The admitting physician and the neurologist on her case were notified. The charge nurse
was also alerted of the situation and helped manage the situation, as well as stepped in to manage
my other patient until the situation resolved.
I knew there was something wrong when the patients right side started rhythmically
pulsating. The patients seizure lasted approximately five minutes which is a critical situation
because the brain does not receive oxygen during the duration of the seizure. This can cause
irreversible damage to the brain and patient.
Something should be done immediately but unfortunately, the patients port was not
working properly and there was no other IV access to administer the medication. The physicians
were notified immediately to adjust the orders and prevent more seizures. Reflecting upon the
situation, I believed I acted appropriately with the patient by asking for help during the seizure,
notifying the physicians immediately, receiving new orders, and requesting a PICC line for
access. Eventually, the desired outcome was reached and the patient remained seizure free for

CLINICAL EXEMPLAR
the next day. I believe my critical thinking and assessment skills were useful and emerging that
day.

CLINICAL EXEMPLAR

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References

Owens, A. L., & Cleaves, J. (2012, October). Then and now: Updating clinical nurse
advancement programs. Nursing, 42, 15-17.
http://dx.doi.org/10.1097/01.NURSE.0000419437.60674.45