As the title implies, this post is about gratitude. It is timely in the sense that it is the end of the year, and I have so much to be grateful for. Particularly, this will be a reflection on my whole DNP journey at Illinois State University, and to express my gratitude to the multitude who got me to the finish line.

This story was a little over two years in the making. Well, even longer if the researching of where to go, how long will it take, and how much would it cost will be factored in. I am a planner, so of course, I won’t go charging on an endeavor without fully knowing what I am getting myself into. I weighed options, the biggest consideration of which is to ensure that I am able to juggle school, work, and home responsibilities without missing a beat. And I am glad that after consulting so many, and praying hard for so long, I decided on attending ISU’s Mennonite College of Nursing. Fun fact, it was the first college of nursing accredited by the National League for Nursing. Just how cool is that?

Before I go down that rabbit hole, let me get back to my tale. My future esteemed professor interviewed me before admission to the Graduate School. It was not an easy interview by any means. However, I chose to be true to myself. I stated that I just wanted to make a difference in nursing be it in the actual practice, innovation through informatics, and influencing future generations of nurses through mentorship. I always believed that it is part of my calling to pass on my love of learning to others.

I got my admission letter, and as they say:

The rest is history – and boy, what a history it has been!

The Journey Begins

Not only did I get an admission letter, but a surprise of a lifetime!

         

As it turned out, that was just the beginning of an exciting, and at times, challenging academic journey. First uphill battle? Conquering graduate level Statistics class! It was very difficult, to say the least! However, I am eternally grateful to my professor for being patient with me because I was able to apply my learnings in my final capstone project and manuscript. And of course, there is more Math to do when I took my Epidemiology class.

Those early classes prepared me to dream boldly, thinking that I could actually make a difference. I envisioned improving the readmission rates among our sepsis patients, a persistent concern in our organization. I was genuine in my vision, supported by my literature synthesis, that it earned me the distinct honor to chosen as the first Asian to become the GradBird scholar.

A Fork on the Road

However, as I have stated in my “My DNP Journey: From Red, Red Wine to Red GradBird” post, that proposal was not meant to be. Honestly, I felt defeated for a moment. Nevertheless, I did not allow that to define my quest to make a difference in our patients’ lives. I moved on, and thankfully, was able to find emergency and cardiology stakeholders who were supportive of my switching to implementing a chest pain initiative. If the initiative becomes successful, it will be a win from an organizational perspective! Personally, though, it was an homage to my parents and my brother who all succumb to cardiac issues.

Implementing our proposed chest pain initiative enabled me to collaborate with colleagues outside of my usual professional circle. Our emergency and cardiology subject matter experts revised the existing workflow. Librarians helped us find relevant literature that support our evidence-based practice proposal. Data and financial analysts crunched numbers that defined what the problem is and the potential improvement our initiative may provide. Epic analysts automated electronic health record tools and created secure chat group to streamline documentation and clinical communication without compromising patients’ privacy. Emergency and cardiology experts reviewed early versions of the manuscript and recommended edits.

All those collective efforts allowed me to present our results during the ISU Research Symposium day and our organization’s Nursing Research Conference.

       

Another Bucket List Checked

Disseminating our results was not only limited to poster presentations. Another course requirement was to submit our manuscript to nursing journals. This opportunity brought me back to my early days as our high school paper’s editor-in-chief. My young, teenage brain earned me regional and national awards in journalism. However, those former awards pale in comparison to the potential of being published in a journal of nursing. As expected, it was an uphill battle! The first journal I submitted my manuscript to did not find my article to be aligned with their audiences. That definitely bruised my ego, but thanks to the encouragement of my faculty advisor, I dusted myself up and continued the process. Thankfully, it was accepted for publication after completing the requested revision. It is currently available online, and here’s a the screenshot of the title.

Not Just About Sepsis and Chest Pain

While I am super proud of what we have accomplished as far as my proposed projects were concerned, my academic course was not just about sepsis and chest pain. My Changing Healthcare Systems project was improving our retail pharmacy utilization for continuity of care and patient safety. On the other hand, my Financial and Resource Management class made me understand staffing, FTEs (full time equivalents), and other financial resources needed to operate a unit, a healthcare site, and an enterprise. Grateful that my professors found my work for both as satisfactory.

                    

Another Chapter Closes

My two-year DNP academic journey may have concluded with our graduation. However, work continues. Truth be told, there is more work to be done! We will be fine-tuning our cohesive workflow in improving care provided for our chest pain patients. More than meeting their initial and emergent needs, we aim to enhance the course of their post-discharge needs through a more streamlined transitions of care process across different settings. We propose to leverage available technologies to enhance care. I can’t wait to incorporate our pathway into a clinical decision support system, do some predictive analytics using large language models, and explore the use of artificial intelligence in preventing major adverse cardiac events. Just these thoughts thrill this certified geek for life. Seriously though, these ideas are of course greatly influenced by the HEART pathway implemented within our organization. I am personally grateful to Dr. Mahler and Dr. Pearson who have been very supportive of our local initiative. Here is a glimpse of their aspirational initiative:

https://school.wakehealth.edu/features/research/heartpathway

Grazie a Tutti

Speaking of gratefulness, I am eternal indebted to my professors at ISU, especially to my faculty advisor. She guided me from my initial difficult steps of switching capstone initiatives up to the final edit of my manuscript. In the same token, I am also grateful to my mentor who has been supportive of me and my professional growth since the early days of my Master of Science in Nursing – Informatics classes. They were my twin pillars who helped me get over all the challenges I faced and overcame during this DNP sojourn.

I am also thankful to my stakeholders from the emergency, inpatient and outpatient cardiology, imaging, case management, revenue cycle, and quality departments without whom I could not have implemented my initiative. Shout out too, to my analyst colleagues: data analysts, application analysts, and financial analysts. You provided me with pre- and post-data and information technology tools which were instrumental in innovating the streamlined workflow. My clinical informatics friends helped me compare notes with differences in chest pain management from several sites, provided me with encouraging words when the going got tough, and some just lent me a listening ear when I felt like venting out. Meanwhile, my leaders were very understanding and provided me with opportunities to keep my work-life-school balance and stay sane. A few DNPs in my organization were very generous with their time in guiding me how to navigate this very challenging journey. I am forever grateful to them for that. Hopefully, I get to return the favor by paying it forward to a graduate school mentee in the future.

On a personal note, I am thankful for my ever supportive family. My Apencitos cousins, aunts, uncles, nieces, and nephews have always been proud of me from day 1, and provided me with the much needed spiritual intercession. The same could be said of my other aunts (cousins of my Nanay and my Tatay) and a few cousins who knew that I was in school. We had so many family challenges during the duration of my DNP journey, but having them on my corner made every challenge bearable and manageable. I am grateful also for the support of a few friends who knew that I was in school. Thank you all for your willingness to read and correct my assignment drafts.

As with my every achievement (work and school), I dedicate this to my Nanay, my Tatay, and my brother, Toto, who all succumb to heart related issues. Although they are no longer here, I could only picture how proud they must have been. This, too, is a feather on their cap as much as it is on mine. At the same token, my youngest brother is my staunchest ally. He remains to be my voice of reason, and provides me with much needed clarity when I become overwhelmed and nearly frustrated. Thank you, Toots!

The ones who I really owe a lot are my husband, Ranie, and my dog, Mico. I cannot even remember how many times I forgot to cook rice or shorten Mico’s walks because I need to finish an assignment. Despite my keeping them at the back seat at times, Ranie still fed me with whatever I request him to cook and Mico still gave me his happy tail wag as long as I have a few minutes to massage him. They were my sounding board when things didn’t go as planned. That was why they were both there cheering me on during my graduation – yes, Mico, was in the arena, too!

Finally, I give the Highest Glory to Jesus Christ, my Lord and Savior! I am where I am because of Him. I hope He will continue to make me an instrument of His Healing to many more lives now and in the days to come. Caritas Christi urget nos!