An ‘Ordinary’ Day of Clinical
Arielle Greenlee
University of Detroit Mercy
I’m going to write about an experience that occurred my first day of clinical. My day began in the vascular clinic with Ms Mary Sieggreen, my clinical nurse specialist preceptor. It was a cold day in Detroit, the first day after one of our many January snowstorms. The clinic was scheduled to see patient after patient, but many ended up no shows. Mary explained to me that oftentimes patients have difficulty coming to their appointments when it’s so cold out. Not only can they not afford the warm clothing, but also transportation ends up being the major barrier.
The third patient we came in contact with that day was a middle aged African American male. Mary informed me that he attends his weekly appointments at Harper Hospital religiously. After examining both of his venous stasis ulcers, one on each leg, we collaborated with the vascular surgery team, including vascular surgeon and registered nurse, to determine the best treatment and plan of care. Collaboration is defined by Hamric (2008) as working jointly with others to optimize clinical outcomes. It was evident to all of us that in order to optimize outcomes, the patient would need to be involved in the process. Coming from inner city Detroit, resources are minimal. It was important to keep that in mind when determining what kind of medication and what kind of dressing was going to be applied to this patient’s wounds.
After consulting with the wound specialist and the registered nurse, who has spent many years dressing wounds of this type, we were able to decide on a una boot after allowing the patient to scrub his own wounds with soap and water. By allowing the patient to wash himself, the clinical nurse specialist is promoting autonomy and independence, in line with the values of adult-gerontological clinical nurse specialist practice. Consultation, defined by Hamric (2008), is system-focused interaction between professionals and patient in which the consultant is recognized as having specialized expertise.
Being only my first day of clinical, I was not upfront with my own opinions. I have experience in wound and burn care, and spent three years in a burn intensive care unit. Understanding that it’s important for the clinical nurse specialist to guide and collaborate with others and promote evidence-based practice, I might [MM1] have decided to share my opinion with my preceptor or the care team as a whole. Other knowledge that helped with decisions regarding wound care was being informed of this patient’s restrictions. Not only were there a shortage of supplies, but it was important to keep in mind that by empowering the patient to be involved in his treatment and decide on a modality that was congruent with limited funds (una boot application), we were more likely to succeed in achieving high quality outcomes.
As a whole the clinical nurse specialist, Mary Sieggreen, displayed nurse characteristics that were in line with the adult-gerontological clinical nurse specialist. These characteristics include integrating knowledge, skills, experience, and attitudes that meet the needs of patients (Hardin, 2004). I feel enlightened by this experience and look forward to becoming an integral part of these patients’ treatment and outcomes as the semester continues. I’ve become aware of the importance of listening and effectively responding and collaborating as a team.
References
Hamric, AB, Spross, JA, & Hanson, CM. (2008). Advanced Practice Nursing: An integrative
approach. St. Louis, MO: Elsevier.
S. Hardin, R. Kaplow. (2004). Synergy for Clinical Excellence: The AACN Synergy Model for
Patient Care. Aliso Viejo, CA: American Association of Critical Care Nurses.
[MM1]Be careful with writing how you speak. Everyone says “might’ve” when speaking which sound like “might of”….but it’s really “might have”. Just a minor thing….but you’ll need it when you publish and do your formal teaching plans.
