Running head: CLINICAL EXEMPLAR 1

Clinical Exemplar
Kimberly Cremerius
University of South Florida College of Nursing
July 18, 2014














CLINICAL EXEMPLAR 2
Clinical Exemplar
Brykczynski (1998) defines clinical exemplars as a holistic research approach which
emphasizes understanding the meanings embedded in situations rather than abstracting specific
details for comparison and prediction It is clinical story from one persons perspective, which
describes a situation which other professionals can learn from and can then use the experience of
the one person in their clinical practice (Brykczynski, 1998). My exemplar describes my last day
in the Neonatal Intensive Care Unit (NICU) and the roles I played throughout the experience.
My last day in the NICU was on 6/9/14, a very sad but exhilarating day. The day started
off rather slow with a break in the morning after the first feeding. However, the day became
hectic as soon as we heard that there was a newborn from Labor of Love currently on the way to
the Emergency Room. We only knew that EMS was coding the baby girl in the ambulance on the
way over. She was breech birth and there were complications. The transport team and one of the
nurses went down to the ER to be there when she arrived. After they arrived, the neonatologist
called and said they were going to initiate cooling, which is where they decrease the newborns
body temperature to 92 degrees for three days to try to save brain function. This treatment works
in 50% of cases.
In the meantime, amid all this preparation for the new patient, both of my patients were
due for feedings and medication. One of the babies was a 33-week premature infant who was
three weeks old. His feedings were q4h and he had an NG tube to administer whatever he did not
eat orally. I had never had a patient that was on this type of feeding schedule so it was a new
experience. For the morning feed, I was with Becky and she instructed me on his care. When the
second feeding came around, Becky and most of the other nurses were setting up the cooling
system for the new patient, so I completed the whole assessment and feeding for my patient,
CLINICAL EXEMPLAR 3
without needing help from Becky. Besides the general assessment that is the same for every baby
I needed to aspirate the residual milk in the stomach, record the amount before the next feeding,
check the placement of the NG tube, weigh the diaper, and record the specific gravity.
I was very proud of myself for taking control of the situation and helping out where I was
needed. The other nurses were busy setting up the cooling machine. They even called in help to
cover their patients while they were busy. After I was done attending to my other patients and
finished the necessary charting, I was able to watch how the nurses dealt with the little girl from
the ER. It was a great experience to see how everyone worked together in a stressful situation.















CLINICAL EXEMPLAR 4
References
Brykczynski, (1998). Clinical exemplars describing expert staff nursing practices. Journal of
Nursing Management, 6(6), 351-359. Retrieved from
http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2834.1998.00088.x/full