" Without continual growth and progress, such words as improvement, achievement and success have no meaning." - Benjamin Franklin
My CLINICAL EXEMPLAR.....thru benner's perspective
Since my college days, I have been dreaming to work abroad as an RN. A month after my graduation in 1992, I left the Philippines and migrated to the US. It’s not an easy start for me since I arrived in SC. Looking for a job as a nurse is hard. I had to take the RN Board Exam for me to be able to qualify. I work as a Customer Service in a Grocery store while reviewing for my exam. Failing for the first time devastated me, however, it did not stop me to achieve my dream. So I decided to take the LPN Board instead. Luckily I passed and able to land a job in a Nursing Home. From then on I tried my luck again and took the RN NCLEX Board Examination. This time I passed and the rest is history.
Before coming to MUSC in 2014, I have been working as a Certified Rehabilitation Registered Nurse for 12 years. I considered myself as a proficient/expert in a Rehabilitation setting, dealing with the overall nursing holistic approach of patient’s disease process and disability. I remember a certain life-threatening situation involving a Spinal Cord Injury patient that experiencing an “Autonomic Dysreflexia”. The patient had an onset of excessively high blood pressure, sweating profusely and tachypnea. My coworker, notified me immediately as I am the Charge Nurse at that time. I responded by assessing patient noxious stimuli that causing the problem, the kink was found in his Foley tubing. After making sure that the Foley tubing is patent & draining, patient condition and crisis quickly resolved. It seems a simple intervention, but the ability to recognize what to do is a very useful knowledge to have.
Looking back, I realize that being a Nurse Case Manager has a whole different concept of nursing approach, it involves Psychosocial and Patient/Family- Centered Health Management. Most of the time, the socioeconomic barrier of the patient population such as poverty or uninsured determines the effective recovery result and compliance.
For example, It was summer of 2014 when I met this man while he’s in the hospital, I was handling his case.
He just had a stroke and he end up a wheelchair-bound. He’s also unemployed and lives in the third story of an apartment building with his wife. Due to his condition, living in that apartment was inevitable unless he can transfer to the first floor. Getting him to a safe discharge will be a problem without a proper home arraignment.
With the help of my brother and a colleague, we able to move the patient in a new single floor apartment. Thus, increase his chance of physical functional improvement and at the same time for him living to the fullest.
Presently, working in a Neuroscience Unit. I learned the complexity of how the brain function works. Complication can arise so quickly that examination and monitoring of patient neurological changes should be managed carefully. At one time, I had a patient having a seizure episode and as a new nurse in Neurology, I felt being overwhelmed, but the support of a more experienced colleague makes me calm and collected.
The Benner’s Stages of Clinical Competence described the 5 level of Nursing experience, from novice to expert. Throughout my nursing career, Benner’s theory, I believe, helped to contribute to my development and allowing me to fully understand what it meant to provide high quality patient care. It continues to guide and allow me to never stop learning.
FRANKLIN REBAY DELACRUZ BSN RNII CRRN SCRN