Samantha Heath

A clinical exemplar describes a clinical experience that held some significance for the healthcare professional in some way. The clinical narrative takes you through the experience of a nurse and should explain why this patient or situation had an impact on the healthcare professional.

I watched a YouTube video about a transgender man that got pregnant and had a baby with his wife that was called, “Man Gives Birth To His Child, My Pregnant Husband.” If I were to be assigned this birthing couple, or this birthing person my reaction would be excitement to meet the couple or person and really get to know who they are and their story while aiding them in the birthing process. Since labor can be such a long process, that was the case with Ari being in labor for 30 hours, you can really get to know the patient and I just know that would be such a special experience with this couple. To learn about their experience navigating gender fluidity and blurring the lines of the stereotypical heterosexual pregnant couple’s experience would be an honor. Anytime I can learn about other people’s experiences I take that as a gift because it helps me be more empathetic, more sensitive to what other people are going through, and aids me in acting more kind to all.

Some ways of promoting inclusivity in a healthcare setting would be by asking patients what their preferred pronouns are when you are meeting them and then also let them know what your preferred pronouns are during introductions. Nurses should always add a note into the patient’s chart and pass it along in report if a patient requests to be addressed by a certain name or certain pronouns to make sure the whole team is aware. There could also be a note left on the patient’s whiteboard in the room with something such as, “Please use he/him pronouns,” or something similar, if they were comfortable with it. As nurses it is important to create a safe space for patients to explain their emotions and advocate for themselves and this will help patients be more comfortable during their vulnerable time while they are at the hospital. We need to utilize therapeutic communication and be the best listeners we can possibly be!

If someone were to incorrectly use female-specific language while giving their nursing report to the next nurse coming on shift, it could severely negatively impact the delivery of care because the nurse could immediately misgender the patient when they meet them. If the nurse giving the report uses the wrong gender the other nurse will likely write that down and go with that information. This could negatively impact the client nurse relationship if the patient is offended and it is very likely to leave the patient feeling hurt and misgendered. The patient will then begin to distrust the healthcare workers around them if they are constantly having to remind people of their correct gender when it should be vital information that is passed onto all members of that patient’s care team. If this keeps happening to this patient in many healthcare settings they may start to distrust healthcare as a whole the more it happens which could be very detrimental to their health in the future. 

Three statements that the nurse made in this virtual scenario in which the nurse is giving report on a patient that made me uncomfortable were: “Who knows where he is from?” “He’s one of those, if you know what I mean.” and  “Oh you know the type of people that hang out at the park just east of here. The one the police are always at.”

Each statement is important because the nurse giving report does not see that these statements can be seen as racist and hurtful. She needs to be told that each of these statements indicate that she looks down on this patient and judges him for where he is from and where he hangs out. This judgment about the patient can affect how we care for the patient and may have negatively impacted the care she provided for this patient if she had a negative opinion about him before she even met him.

In this scenario I was really uncomfortable with how she was rolling her eyes and trying to rush through the report. Report is a time where you can tell the patient’s story to the next nurse on shift and help create a picture about who these patients are above and beyond what is factually said in their chart already. If I was receiving this report it would upset me and I would have to say something to the nurse because her comments are so negative and not respectful of the patient.

One time that I experienced an uncomfortable situation was when I was at a clinical and the nurse I was with was receiving report on a patient that had a history of IV drug use. During report I could tell that the nurse was judging the patient for their tolerance to pain medications. She was judging the patient for how she would ask for pain medications directly at the time that they were due and that the patient would be extra cranky when she wanted pain medications. All I could think about was how much pain this patient must be in because she had endocarditis and since she has a history of iv drug use, medications that help with pain are less effective. I feel like patients that have this history deserve so much sympathy from nurses because they are dealing with high levels of pain and the medications are not as effective as they would be for a patient that does not have a tolerance in their body from past opiate use. After the night nurse gave us the report I discussed with the nurse I was following about the night nurse’s tone of judgment while talking about the patient and the nurse told me she was going to speak with her manager about this because it made her uncomfortable as well and she didn’t know that travel nurse well enough to feel comfortable addressing the comments with the nurse herself in that moment.