Describe one specific clinical event or situation within the past 12 months in which you played akey role that illustrates how you demonstrated clinical proficiency as expected of a ClinicalNurse III.

Describe one specific clinical event or situation within the past 12 months in which you played akey role that illustrates how you demonstrated clinical proficiency as expected of a ClinicalNurse III.My clinical event:80-year-old man with relapsed/refractory IgG kappa multiple myeloma and history of hypertension, GERD, lung nodules.He was admitted for progressive neurologic symptoms and MRI spine that showed apparent diffuse leptomeningeal enhancing lesions with cord invasion and cord edema. He underwent LP that revealed plasma cells. His MRI showed supra and infratentorial leptomeningeal malignant involvement. In preparation for Ommaya placement, he underwent lower extremity Dopplers that revealed a new thrombus in the left common femoral vein. He was planned to undergo IVC filter placement followed by Ommaya placement later in the afternoon. I noticed the patient started becoming more tachycardic and tachypnea. I notified the physician and used my clinical judgment to advocate for the patient. I did not think the patient was safe enough to leave the unit for the procedure given his symptoms. Soon after he became hypotensive and hypoxic for which I called the rapid response team. He required emergent intubation prior to transfer to the ICU. Portable chest x-ray appeared to show free air under the diaphragms. He had a bowel perforation leading to respiratory failure. Family were called emergently during his acute decompensationI learned how important it is to always advocate for your patient because as nurses we are with the patients most consistently. Strong themes include but are not limited to:Describe the clinical event or situationo Presenting issueo Relevant medical historyo Interventionso Role of the multidisciplinary teamo Family dynamics • Describe how your proficient clinical knowledge, leadership/education skills, and use of evidenced-based practice impacted this specific event and the resulting outcomes• Reflect on the clinical event or situation: o How has this event changed you and your clinical practice?o What might have been done differently to improve the process and outcomes?

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