A Week in Clinical Practice: Reflections of an Advanced Practice Nurse


Throughout the past week, I had the privilege of immersing myself in clinical practice as an advanced practice nurse. This essay seeks to provide a comprehensive overview of my clinical experiences during this period, highlighting both the challenges and successes I encountered. Specifically, I will focus on a patient assessment, delving into the signs and symptoms observed, the assessment process, and the subsequent plan of care. Furthermore, I will explore at least three potential differential diagnoses with rationales, along with the health promotion intervention that was implemented for the patient. Lastly, I will reflect on the invaluable lessons gleaned from this week’s clinical exposure, emphasizing their potential benefits for my future practice as an advanced practice nurse.

Clinical Experience and Challenges

During the week, my clinical experience revolved around an outpatient department, which exposed me to a diverse patient population, each presenting unique health concerns. One of the prominent challenges I encountered was the need to balance efficiency with comprehensive care delivery. The constant flow of patients demanded swift decision-making, putting my clinical skills and knowledge to the test. However, with the unwavering support of the healthcare team and my commitment to efficient time management, I effectively navigated through these challenges, ensuring each patient received the attention and care they deserved.

Assessment of a Patient

One patient, Mr. Johnson (pseudonym), a 45-year-old male, sought medical attention with complaints of fatigue, unexplained weight loss, and a persistent cough. The assessment process entailed gathering his medical history, family history, and conducting a thorough physical examination.

Signs and Symptoms (S&S)

Fatigue: Mr. Johnson reported experiencing overwhelming tiredness and a notable decline in energy levels, significantly affecting his daily activities and overall quality of life.

Unexplained Weight Loss: Over the past three months, he had unintentionally lost approximately 15 pounds, despite no significant changes in his dietary habits or exercise routine.

Persistent Cough: Mr. Johnson suffered from a persistent dry cough, particularly worse at night, and occasionally accompanied by chest pain.


Based on Mr. Johnson’s presenting symptoms, a comprehensive physical examination, and his medical history, I considered the following potential differential diagnoses:

Differential Diagnosis: Pulmonary Tuberculosis (TB) Rationale: TB can present with symptoms like a persistent cough, unexplained weight loss, and fatigue, especially in individuals with a history of exposure to the bacterium Mycobacterium tuberculosis (CDC, 2021).

Differential Diagnosis: Chronic Obstructive Pulmonary Disease (COPD) Rationale: COPD is characterized by a chronic cough, fatigue, and weight loss, particularly in long-term smokers or those exposed to respiratory irritants (GOLD, 2020).

Differential Diagnosis: Lung Cancer Rationale: Unexplained weight loss, a persistent cough, and fatigue are common in lung cancer cases, especially in patients with a history of smoking or other risk factors (ACS, 2022).

Plan of Care

To confirm the diagnosis, I ordered a series of diagnostic tests, including sputum analysis, chest X-ray, and a complete blood count. Additionally, I promptly referred Mr. Johnson to a pulmonologist for further evaluation and specialized care.

Health Promotion Intervention

While awaiting the test results and specialist consultation, I emphasized health promotion and education to empower Mr. Johnson to make positive lifestyle changes. I provided counseling on smoking cessation, underlining its impact on respiratory health and the risk of developing chronic conditions like COPD and lung cancer. Furthermore, I encouraged him to adopt a balanced diet and engage in regular physical activity to enhance his overall well-being and counteract fatigue.

Key Learnings for an Advanced Practice Nurse

This week’s clinical experience instilled several crucial learnings that undoubtedly hold tremendous value for me as an advanced practice nurse. Firstly, I recognized that effective time management is integral to delivering high-quality patient care in a fast-paced clinical environment. Prioritizing tasks based on patient acuity and fostering seamless collaboration with the healthcare team enabled me to optimize patient outcomes without compromising on the quality of care.

Secondly, I understood the significance of active listening and effective communication in patient assessments. By attentively listening to patients’ concerns, I gained essential information that guided my diagnostic process, leading to the formulation of tailored care plans catering to each patient’s unique needs.

Thirdly, I appreciated the power of interdisciplinary collaboration in patient care. Working in close conjunction with physicians, specialists, and other healthcare professionals provided diverse insights and approaches to patient management. This collaborative approach yielded improved patient outcomes and a more comprehensive provision of care.

Lastly, I recognized the pivotal role of health promotion and patient education in preventing and managing chronic conditions. Equipping patients with knowledge about healthy lifestyle choices empowered them to actively participate in their healthcare journey, fostering positive health outcomes and greater patient engagement.


In conclusion, my clinical experience over the past week offered me valuable insights into the challenges and triumphs that come with being an advanced practice nurse. The assessment of Mr. Johnson and the subsequent plan of care exemplified the significance of evidence-based decision-making, interdisciplinary collaboration, and health promotion interventions.

As I embark on my journey as an advanced practice nurse, I am committed to integrating these learnings into my practice, aiming to provide patient-centered, evidence-based care that addresses the unique needs of each individual under my care. By prioritizing health promotion, embracing active listening and interdisciplinary collaboration, and adhering to effective time management, I am confident that I will evolve as a compassionate and proficient advanced practice nurse, positively impacting the lives of my patients and contributing to the advancement of healthcare at large.


American Cancer Society. (2022). Key statistics for lung cancer. Retrieved from https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html

Centers for Disease Control and Prevention. (2021). Tuberculosis (TB). Retrieved from https://www.cdc.gov/tb/default.htm

Global Initiative for Chronic Obstructive Lung Disease. (2020). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Retrieved from https://goldcopd.org/2020-gold-reports/

World Health Organization. (2018). Health workforce requirements for universal health coverage and the Sustainable Development Goals. Retrieved from https://www.who.int/hrh/resources/health-observer24/en/