Clinical Narrative(s)

Purpose: The purpose of writing narratives is to focus on an incident that is significant to the student and provides the student with an in-depth learning opportunity (Benner, 1984)

 Process:

1. Select a significant incident that you view as critical in your continued learning about nursing and functioning in a health care environment. The incident might include, but is not limited to a clinical experience:
   1. that you think captures what it means to be a nurse
   2. in which your intervention made a difference
   3. that was demanding of you, your preceptor, or manager
   4. that went very well
   5. where things did not go well
2. Use the “Reflective Process” to provide a guide to narrative writing (see the article titled Reflection of Practice).
3. When writing the narrative, please include the following: Introduction write about the situation that occurred and then answer the 3 areas
   1. The narrative should capture the three areas listed in the grading rubric: (1) clinical knowledge decision-making, (2) caring, and (3) collaboration (Note: if collaboration is not included write about who you could have collaborated with).
   2. Describe what you saw, said, did, thought, or felt during a significant clinical experience. (what happened- story, what were you thinking and feeling, what were the thoughts and feelings of others involved, how do you know, what other options were open to you, what would you do if the situation arose again)

(Introduction: 31 year old blind woman who was readmitted after kidney and pancreas transplant.

. She told V.P. that I look like her best friend and then smiled at me in an accepting way. V.P. began to try to picture what I look like by asking descriptive questions such as “are you brown skinned, how tall are you?” I knew my experience with V.P. and her mother was going to be a good one. V.P. was very vocal and looked at situations from the brighter side. She was called to come in for a kidney on five different occasions, but was sent home. When V.P. received her recent call, she stated it was worth the wait because she received a young person kidney and pancreas. She stated different people told her she was going to have to take a lot of pills after her kidney transplant. That did not bother V.P. She reported she told those individuals “taking pills is better than being on dialysis and having diabetes.” She also stated “I have an alarm clock to remind me to take my medication.” She later stated “I am going to follow all the instructions the doctors tell me. I don’t mind scrubbing my grapes before eating them. The only thing that is going to stop me from anything – is if the side effect is death.” I listened attentively. V.P. had a hopeful demeanor. V.P. was able to do many thing independently such as go to the bathroom room, use her cell phone and shower. I took V.P. for a walk around the entire 4NW floor. She tolerated it well. We engaged in conversation on our walk. I learnt that she does motivational speaking, works at a reception desk for disability, and was selected to perform on the Spotlight on Life for the National Kidney Foundation of Wisconsin. According to V.P. the Spotlight on Life is similar to dancing with the stars. I was thinking “wow.” I was inspired by her motivation. She spoke with such conviction it made me reevaluate how I was viewing the trials and tribulation I was facing in my own life. The patient was scheduled to be discharged at 3pm. I did her discharge teaching and educated her on her low potassium diet. I educated her on specific foods that were low in potassium and provided her mother with the handout. Afterwards V.P. was able to verbalize specific foods (cabbage, blueberries, and applesauce) that she could eat that was low in potassium. She gave me a compliment after the teaching because I was able to tell her specific foods that were low in potassium. If this situation was to happen all over again I would do everything the same way. I cannot think of anything that I could have done differently.

1. Analyze and reflect on the experience that you described.
2. The emphasis of the narrative should focus on your perceptions, thoughts, and insights into the situation, not on your clinical actions alone.
3. Discuss how your personal and clinical strengths and limitations played in the unfolding or resolution of the incident or situation. (strength: limitations:)
4. Reflect on the lessons you learned and how this contributed to your growth toward being a professional nurse.

Benner, P. (1984). From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley Publishing.