Running head: CLINICAL EXEMPLAR

Clinical Exemplar
Amanda Poplin
University of South Florida

Running head: CLINICAL EXEMPLAR

Introduction
Throughout my time spent in preceptorship on the Ante-Postpartum unit at Tampa
General Hospital, I have had the opportunity to learn an incredible amount. This experience has
been very beneficial in solidifying my decision to pursue mother-baby nursing, as well as giving
me the opportunity to get a taste of what a career in mother-baby looks like and allowing me to
gain experience in the field to aid in beginning my nursing career in that specialty. A clinical
exemplar, as defined by Christine M. Pacini, is a story of a real patient that is told in order to
illustrate an RNs practice/experience (Pacini, 2006). This clinical exemplar will utilize a
personal experience that impacted my patient care techniques, as well as encouraged me to
continue learning in this field.
Personal Experience
During one of my clinical shifts on the ante-postpartum unit, I completed the admission
of a postpartum cesarean section mother to the floor and she was placed under my care. The
mother was very exhausted yet calm, and though I did notice that I rarely saw her holding her
new infant, I attributed it to exhaustion and the remaining anesthesia. I only had this patient for a
few hours before my shift was over, but she was calm, cooperative and pleasant for the time I
was caring for her. I assisted her with breastfeeding, which happened to be the only time I took
note of her interacting with the infant or performing skin to skin, but she spoke positively of him.
Both the mother and child were healthy and content at the end of my shift. I returned to the
hospital two days later, and this particular client was placed under my care again. It was her
second day postpartum, which meant she would most likely be discharged either during that shift
or the following day. Upon entering her room for bedside report, the patient was irritated and

Running head: CLINICAL EXEMPLAR

exhausted. It was still early morning, so I took note of the irritation but did not think too heavily
upon it, and continued on to my other patients. When I returned to her room for morning
medications and assessment, the patient appeared even more irritated, and voiced those
frustrations to me. The client stated that she was cranky, that the hospital is just such a
depressing experience, and that she had nightmares of waking up in the recovery room after
giving birth because she had been in so much pain. She also stated that she was tired of people
always coming in and out of the room, and that she could not get any sleep because of the
nurses, doctors and hospital staff entering and exiting her room throughout the day. I explored
those feelings a bit further and inquired upon whether there was anything I personally could do
to give her a better experience, and she dismissed the inquiry and reluctantly allowed me to
complete morning assessment on her. I told her that I would give her several hours to rest and
would be back at noon for medication pass, and instructed her to call if she needed anything at
all. When I returned to the patients room at noon, her disposition had not changed; she was flat,
withdrawn, frustrated, and would not visit her infant that was now in the NICU. This was an
entirely different affect than she had when I first admitted her to the floor two days prior. When I
discussed her experience and frustrations with her, she never spoke of the baby and would not
reply to my questions about the child, but instead continued to speak of how frustrated she was
with the hospital and her lack of sleep. The clients blood pressure remained elevated throughout
the day, which she explained was a result of staff constantly entering her room and not allowing
her to rest. All of these findings taken into consideration, I contemplated whether she was
experiencing postpartum depression. My first action was to care for the patient by placing a do
not disturb before notifying nurse sign on the door, which the patient agreed to, and then
proceeded to notify first the charge nurse, then the patients OB provider. After discussing the

Running head: CLINICAL EXEMPLAR

situation with the provider, I scheduled a social work consult for the patient. Following the social
work consult, the social worker confirmed my suspicions of postpartum depression and would
proceed to consult psych for the patient. I was unable to see how the situation ended with this
particular patient, as my shift ended shortly after the social work consult and the patient was
discharged before my next shift at the hospital. This particular situation was a pivotal one for me
as it was the first experience I had with postpartum depression. This experience allowed me to
learn how to properly care for and talk with new mothers who were experiencing postpartum
depression, and also showed me a new aspect of postpartum care. Since this experience, I have
been able to more quickly identify the signs and symptoms of possible postpartum depression,
and also have become more effective at caring for these mothers and infants through this difficult
period.
Conclusion
This situation was one of many experiences that allowed me to learn and grow in the
specialty of mother-baby nursing. Through experiencing this and situations similar to it, I have
gained knowledge necessary to provide more effective patient care that is specific to motherbaby nursing. My time spent on this unit also encouraged me to continue learning in this field, as
I hope to one day further my education to become a Certified Nurse Midwife and continue to
care for this patient population that I have come to enjoy so thoroughly.

Running head: CLINICAL EXEMPLAR

References

Pacini, Christine M. (2006). Presentation notes: nurse action days. University of Michigan
Health Systems.