Paciencia is a unique hunting rifle. It has a three-round magazine, but boasts higher damage than the regular variant, as well as higher item HP. Its main advantage over the standard variant is its extremely high critical damage, which is an astounding 110 points, equal to the anti-materiel rifle. Due to its bonus critical chance, critical hits will be more common. It also has a 3.5x magnification when looking down the rifle's iron sights, equivalent to a top-tier scope. However, like many unique weapons, Paciencia cannot be modified using standard hunting rifle mods.
In appearance, it is less makeshift than regular hunting rifles. The pieces of metal and duct tape holding the barrel in place are absent as the barrel is in no state of disrepair, the stock is not damaged, and the wood is in far better condition. A Mexican flag is also wrapped around the stock for use as a makeshift cheek rest. There also appears to be score marks just under the receiver, most likely a killcount.
Paciencia can fire a total of about 1,745 standard rounds, the equivalent of 582 reloads, from full condition before breaking.
Paciencia, along with the anti-materiel rifle, has the highest critical damage output in the game.
Paciencia, unlike the anti-materiel rifle, can be equipped with hollow point rounds. When this unique hunting rifle is equipped with hollow points, its critical damage is higher than the anti-materiel rifle's against most unarmored/lightly armored targets. With Better Criticals and HP rounds, it can even surpass the Anti-Materiel rifle against highly armored targets.
With all available critical damage bonus perks Better Criticals, (Just Lucky I'm Alive, and Stealth Girl) HP rounds outperform both AP and JSP rounds for critical hits against targets with up to 57 and 37 DT respectively. With a high enough critical chance HP rounds outperform in DPS as well (with critical damage bonus perks). For a target with 25 DT, HP rounds have a higher DPS than AP and JSP rounds as long as critical hit chance is at or above 17% and 35% respectively.
Paciencia access to HP rounds allows it to beat out the anti-materiel rifle and YCS/186 for 1 shot damage output with a staggering 2544 damage for a sneak attack headshot to an unarmored opponent on normal difficulty with all relevant damage perks (Better Criticals, Just Lucky I'm Alive, Bloody Mess, the Lonesome Road perk, and Lord Death (Rank 3)).
Behind the scenes
In Spanish/Portuguese, Paciencia means "Patience". According to Joshua Sawyer, it is named so "because you have three shots, so you had better make them count."