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Summer Exemplar

Nursing graduates share significant clinical experiences

"The following exemplars offer a peek into the moments of life as a nursing student that shape and help inform who they become as professional nurses. The exemplar writing assignment is to "describe a significant moment in practice where the student had an impact on the patient or the patient had an impact on the student." One of the prompts is to "write about a time when you knew you had become a nurse". These stories from practice describe pain and pain relief, fear and courage, despair and hope and the search for health that defines the journey of all nurses and patients. The faculty of the Cedar Crest College Nursing Department are so proud of our students and all that they do in the name of healing. We hope you enjoy their stories."
~Professor Amy Edgar

These are the stories written by the July 2013 nursing graduates.
*please note that the names of all patients have been changed for confidentiality.

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Timothy Sullivan

During our geriatric rotation at a hospital in the area I cared for an elderly man who had arrived via ambulance after a fall in his hotel room. I will refer to him as Phil and describe a major portion of our day. He had bruises on his face and a large area covering his right hip. His knees had cuts and it was obvious he had not been cleaning himself often. Phil was almost unresponsive to me verbally and he just wanted to lie in bed as it took great effort for him to move. He was bruised, but after reading his chart I realized he was just so down that he just didn’t want to. His chart stated that he was an alcoholic and was very intoxicated upon arrival. I cleaned him up and cared for his skin as well as his cuts and bruises. He almost had to be talked into ambulating to the bathroom. He just didn’t care. I assessed him for suicidal tendencies and his drinking patterns. He agreed that he would like to speak with a psychiatrist and I requested one through his RN. They would be up much later in the day. This small interaction prompted him to talk more. He was drinking a large bottle of vodka a day, had a restraining order from his wife, and really was unsure how he ended up in the hospital. As we talked he would open up, and pull back; state he had a problem, and then give many reasons why he couldn’t or wouldn’t stop. He said he didn’t even know what hotel he staying at or where his car was. I pulled out the yellow pages and we went down the list. We ended up locating his hotel and his car was there. He was relieved and he opened up more as we proceeded. I then asked him if there was anybody we could call. Sadly it became apparent that nobody knew he was there and he had no family to call. He had a lawyer, but was having trouble remembering who and how to get in touch. He asked that I check his clothes in the closet. They smelled like urine and there was nothing there. I pulled out the yellow pages and we went line by line again and found a contact for him. He felt better and then proceeded to cry and state he knew he had to stop drinking. I felt compelled to be as positive as possible and getting help is a great step. He again gave reasons why he couldn’t. For some reason I asked if he knew when he last had a drink and if he knew how long he had been in the hospital. He said since last night. I told him it had been 3 1⁄2 days. He was sad and happy at the same time. We talked more about it and he was pleased it was a few days without alcohol. The consult arrived and after some time he agreed to seek professional counseling at a facility near the hospital. He again gave me reasons why he couldn’t and I would give a positive thought and easy solution to show up and try. I couldn’t do it for him, but I wanted to be positive. In the end he told me he would go. At the end of the shift, he was far more engaged and showed some life. For the first time, and only time, a patient thanked me. I shook his hand, wished him the best, and told him it could be done.

According to Benner (2001), there are seven domains of nursing practice. I feel there were two that come to light with this brief account. The main one is the Helping Role, and more specifically the healing relationship, which falls under the helping role. Unknowingly I gave the patient hope, as well as myself, gained an understanding of the patient’s illness and anxiety, and assisted Phil to use social and emotional support (Benner, 2001). I did not know I was doing these things; it just seemed like a natural progression of the day. I am very happy that it did, and maybe this is why the day was successful.

I also feel to some extent that the domain of the teaching-coaching function was involved here. More to the point, timing, and capturing the patient’s readiness to learn was very important in this case, even though it seemed on the surface as just a conversation (Benner, 2001). At times, without realizing it, I was assessing the patient, and moving the conversation to a goal of learning and it seemed to fall at the right time for Phil to seek treatment. I will always remember the courage it took for him to speak openly and his trust in me. I hope it went well!