July 2011

This past month was again one of the most challenging parts of the DNP program. Although everything about it is challenging, writing the Project Proposal for my Capstone Project was an arduous task. I am in a much better position now that I am only working part time, but the breadth of the task demands a rigorous scholarly approach into every aspect of it. I have just completed Applied Statistics and Epidemiology and these are two very important aspects of population health and prevention. However, learning about them in the classroom is so much different than applying the principles in actual practice.

My Capstone Project is about implementing a pediatric overweight and obesity preventive program in the primary care setting. I never realized the depth of the involvement I was putting myself into when began the project in a health center in my neighborhood. I knew I was going to create a project that will help the health center in some way. Little did I know how great an impact this project will have especially on the lives of disadvantaged individuals and families in my community who come to the health center for wellness care.

Working with the dietician at the health center in designing the pediatric overweight and obesity preventive program.

As I progressed along the DNP Project Process (Zaccagnini, 2011), I began to realize this is not just a school project I need to complete because I am required to; but also a real life project that has every potential to improve the outcomes for the health center and the youth in my community; a project that will impact the long-term health and quality of life of the children of today. The project requires a collaborative relationship with the stakeholders and other resources that can provide the support and information I need to make the implementation as efficient and effective as possible. The Capstone Project will be a pilot of the program and if determined to be feasible, it will be adopted full scale at all the health centers of the agency.

Again, I would like to encourage those of you interested in embarking into the DNP journey to reflect upon an issue you are passionate about; something that you believe you can do something about and want to do something about. This will make the project more meaningful, enjoyable, and fulfilling. I am halfway through the program and already, I am envisioning myself being involved in public health and prevention. I am excited about the idea and my mind is soaring high about the prospect of it, but there are more challenges to face, more battles to fight, more mountains to ascend. But I am holding fast and keeping my eyes fixed on the price. I need to finish this race that I’ve begun and intend to cross that line. Only then can I say, “I made it!”

Keeping true to my promise to keep a balanced life... I try to enjoy the warm summer days swimming with my kids while they are off from school.

Reference:

Zaccagnini, M. E. (2011). DNP project process model. In M.S. Zaccagnini & K.W. White (Eds.). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing. Sadburry, MA: Jones & Bartlett Learning.

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May 2011

Wow! Last semester was like a roller coaster ride. And I can say out loud with the rest of the class that we made it! Another semester is over… three more to go! I am gracious and grateful that I made it through one tough semester.

"Learning is not compulsary, neither is survival." ~W. Edwards Deming~

As we begin this semester with NR 707 Outcomes Research, I am eager to learn the process, which is an integral part of evidence-based practice. Through this course, I hope to learn how to identify the appropriate methodology, design, and outcomes to measure for my Capstone Project. The process of outcomes research consists of five steps: (1) defining a research question; (2) developing a conceptual model; (3) conducting a literature review; (4) operationalizing the variables; and  (5) developing a research plan (Kane & Radosevich, 2011). Ideally, steps 1 and 2 should have been completed during NR 701 Theoretical Application for Doctor of Nursing Practice. During this course, we were asked to identify a relevant health issue and develop a PICO (P-population, I-intervention, C-comparison, O-outcome) statement, which we are passionate about. We were also asked to identify nursing theory/theories from which we developed a conceptual model for the Capstone Project. Step 3, the literature review was done last semester and steps 4 and 5 will be completed this semester during this course.

I am enjoying every moment right now when the pace is moderate. This gives me some time to attend to other things other than my studies. Last semester was truly a test of time. I wasn’t expecting to be affected the way I was since I am used to hard work. No one said that the DNP Program was going to be easy. When the going got tough (tougher), I often found myself asking what truly prompted me to go for the “terminal degree” in nursing. I could be spending time off from work with my family, doing the things we love to do together instead of being so immersed in learning like nothing else mattered. There have been many times I felt like I needed to just pause and pause for a long time… and I did. I have to ask myself several times if my motivation in the beginning is honest and pure. I knew that knowledge is a gift from God and by nurturing it and allowing it to flourish, I could proudly say to Him that I did not squander his gift but invested and used it well for the good of others.

One skill I am still trying to master is the art of balancing life. When I commit myself to something or to someone, I give 200% of myself. I strive for excellence and perfection because I believe everything and everyone deserves nothing less than the best from me. As God is perfect, so must we be made perfect. And so as I delved into the DNP Program, my expectations for myself were no less. However, I realized soon enough that I am a finite being with limits and boundaries. I found my mind and body unable to keep up with the demands of a full time job, full time student, and full time mother and housewife. I felt my mind and body shutting down to the point of near demise. As much as I wanted to balance my life, there was no way I could do it. I gave time for work, studies, and my family, but left no time for myself. And that was not being wise.

As Henry Miller stated, “Our own physical body possesses a wisdom which we who inhabit the body lack. We give it orders which makes no sense.” This semester, my goal is to strike a balance in my life. I could not afford to deprive myself of some of the most basic needs: sleep, rest, relaxation, exercise, and most of all, prayer and reflection; lest, I may very well just lead myself into an abysmal state of near demise of the mind and body. I will feel and listen to the wisdom of my own body and not take it for granted as I have before. To all students and aspiring students, learn now… we need to “be moderate to taste the joys of life in abundance” (Epicurus).

To part, I would like to share a quote from Antoine de Saint-Exupéry from The Wisdom of the Sands:

“Surely, a man needs a closed place wherein he may strike root and, like the seed, become. But also he needs the great Milky Way above him and the vast sea spaces, though neither stars nor ocean serve his daily needs.”

"We may outrun by violent swiftness and lose by over-running." ~William Shakespeare~ (Image from http://www.googleimages.com)

 Reference:

Kane, R. L. & Radosevich, D. M. (2011). Conducting Health outcomes Research. Sadbury, MA: Jones and Bartlett Learning.

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April 2011

This semester has truly been the most challenging academic experience I’ve ever had in my life (so far). Unlike those who may have entered the program with some experience in big project development, evidence-based practice change, or just with an awareness of what the Capstone Project entails, I don’t. I knew before hand that the program would be rigorous, challenging, and hard. But I never realized the magnitude of this DNP Project and its process until this semester. White and Zaccagnini (2011) talked about the scope of this project as the distinguishing mark of a doctoral work. They said “What distinguishes the doctoral project from the baccalaureate or master’s project is the depth of inquiry, the depth of literature reviewed, the scope of the project, the population served by the project, and the student’s use of solid scientific evidence and theory underpinnings of the project” (p. 453). The projects that we have embarked in are truly the scholarship of application and integration that Boyer elucidated in the new paradigm of scholarship. Unlike the dissertation work that a PhD student engages in, the DNP project is a “real-world” project where the student seeks to create a change in practice to improve the existing condition that affects an identified population. And for this project, the student has no control over the situation. It is what it is. The implementation of an evidence-based intervention as gleaned upon through the systematic literature review underscores one of the essentials of a DNP, which are Clinical Scholarship and Analytic Methods for Evidence-Based Practice (AACN, 2006).

What I also realized is that the DNP project involves a dynamic process. Although it is vital to have a timetable with set completion dates for measurable goals and outcomes, there will be times when unforseen changes occur that warrants a change in the direction of the project or changing the target time for completion. In my case, I find myself having to change my PICO statement because the outcome I initially hoped for has already been achieved at the health center of my affiliation. When I came into the agency proposing to do a project to increase referrals to the Registered Dietician (RD) for overweight/obese children, their leadership started reinforcing this to the staff that in a matter of few months, the number of referrals that the RD is getting has now been overwhelmingly too much for her to manage on her own. So we had to change the PICO to adjust to the needs of the agency.

Be that as it may, time has truly been my greatest enemy and my best friend. Not having enough time, considering work and family, has left me so far behind in terms of completing assignments promptly. In fact I am still completing my systematic review table, among other things. As if I am climbing a very steep mountain, I find the systematic literature review to be the point at which I am almost at the top before reaching a plateau… and then the descent! I believe that once I’ve completed this, everything else will follow (but then again, not without some challenges here and there). The evidence that I will gather from this process will drive and define the project. And so I don’t want to take this process lightly. I really feel accountable for finding the best evidence available because it will affect the lives of many overweight/obese children and their families. Because I truly want to make this project meaningful, useful, and sustainable, I need to devote the time necessary to make this happen. This prompted me to take a big pay cut and go part time in my job. This is the only way I’ll be able to proceed in this program and complete the Capstone Project.

This is the last week of this semester… three more grueling semesters to go! I can’t wait to reach that point of descent after a difficult ascent. I am once again looking forward to a week of break from school. As if my intellectual capacity and my will has been drained dry, I am longing so much to be able to get a few nights of decent sleep, to relax, to reflect, and to be made anew. This season of Easter has truly renewed my spirits and given me hope that after a bad day, a good one comes; that after rain, sunshine; and after despair, hope. Truly, Easter is the spring of our lives that brings us hope, new life, and new beginnings. Come next semester, I hope to start off with a renewed commitment to balance my life; to be good to myself and get enough sleep; and to be more optimistic than pessimistic. After all, this is the Easter Season! Blessed Easter to all!

References:

AACN. (2006). The Essentials of Doctoral Education for Advanced Practice Nurse. Retrieved from http://www.aacn.nche.edu/DNP/index.htm.

White, K.W. & Zccagnini, K.W. (2011). A template for the DNP scholarly project. The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing. In M.E. Zaccagnini and K.W. White (Eds.). Sadbury, MA: Jones and Bartlett Publishers.

 

"Seek comfort in the garden, seek adventure in the wilderness, but seek the truth within yourself."

 

"Happiness is not a matter of intensity but of balance, order, rhythm and harmony." (Thomas Merton). Took some moment to rest my brain and run free, even for just a brief moment.

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March 2011

The race goes on! May God continue to sustain us all through the finish line. When quitting seems to be my only option, I turn to my family and DNP classmates/friends who continue to provide much needed emotional support. But most of all, I turn to God, my source of inspiration and my reason for this pursuit. I hate to paint a picture of doom to those of you out there. Truly, the DNP journey is one that is beset with rigor, but only because of the far-reaching and all encompassing role that a DNP nurse has in a very complex twenty-first century healthcare system. I may have bouts of hopelessness, but as I always say, I am not a quitter. When under the cloud of unknowing and doubt, I withdraw, reflect, pray, and refocus and I press on with a renewed strength and vigor. I can’t express enough how comforting it is to know that we have very considerate and compassionate faculties who understand the difficulty of juggling family, work, and the academic life.

In NR 725, Application to Practice, we are expected to reflect upon the eight essentials of DNP. I would like to share with you my reflection about Evidence-Based Patient Care because this is a very integral aspect of DNP.

 The Institute of Medicine identified the Core Competencies Needed for Health Care Professionals as follows: (1) provide patient-centered care; (2) work in interdisciplinary teams; (3) employ evidence-based practice; (4) apply quality improvement; and (5) utilize informatics (http://books.nap.edu/openbook.php?record_id=10681&page=45). These core competencies and the essentials of DNP education underpin the urgency and cruciality of discovering, integrating, and applying the best evidences to practice.

When I first heard of evidence-based practice, my knowledge was limited to a general notion of it being research findings that when adopted, produce better patient outcomes. I knew it was good, but did not quite understand its implications to my own practice as a frontline nurse until I went back to graduate school. As I continue on in my nursing journey, I realize more how integral evidence-based practice is to the delivery of quality and safe healthcare. As I grow in knowledge, my perspectives begin to take shape as I realized that the components of evidence-based patient-care not only encompass research, intervention, and outcomes, but also the values and perspectives of the patient. As an area most often neglected in considering the best evidences that could improve patient outcomes, this is one of the components of evidence-based practice that I need to pay more attention to.

The DNP education will prepare me to integrate, apply, and evaluate patient-care models that are evidence-based to yield better healthcare outcomes. As a member of the nursing community, I need to establish a collaborative relationship with nurse researchers to advance the knowledge base of the Nursing discipline. As a DNP student, I am only just beginning to appreciate the scholarly work of all nursing colleagues who have sacrificed a great deal for the common cause of improving patient care and advancing the Nursing discipline. My involvement in evidence-based patient care is something to be behooved as a future DNP.

"What do you think of our electronic health record system?" Gathering staff nurses opinion about the electronic health record system at my workplace for my Informatics Major Paper. As a DNP, proficiency in information systems and technology is a must to meet the demands of 21st century healthcare.

If you were following through my posts, you would have already seen the fighter in me that will never choose to give up. I may be too hard on myself, but I expect nothing less because I have been given much. My success in life will never be defined by recognition and status, but in knowing that I have done my best with what was given to me. It is a risk to explore beyond the boundaries of comfort. But I am, after all, a faithful steward of God’s time and talents, so risk and sacrifice will be constant companions through this journey, along with sweet successes and consolations here and there. So to part, I would like to share with you a quote by Mark Twain as cited Mary Anne Radmacher in her book Life Begins When You Do (2011).

Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.

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February 2011

Greetings everyone! It has been very hectic for me these past few weeks. Not that it has never been, but it’s getting more and more intense as the weeks go by. These past few weeks, I have been in constant communication with my mentor/preceptor and the Registered Nutritionist of the agency where I am doing my application to practice clinical hours. I am trying to finalize my PICO (P-population, I-intervention, C-comparison, O-outcome) statement, which will be due the end of this week. I am also trying to start my systematic review of literature to identify the best evidence for my issue, which is childhood obesity.

A picture with my preceptor/mentor. She is the Special Projects Officer at the agency where I am doing my Capstone Project.

Informatics is two weeks away to being over. I have just finished creating a power point presentation on CPOE (computerized physician order entry). For this assignment, we were asked to do a presentation to analyze the application of a health care information system. I am now going to start working on my major paper on a health information system life cycle. For this assignment, I have chosen to write about the electronic health record system in my workplace. After this week and next, I plan to take a few days break before NR704 Epidemiology. Some college classmates are flying from all over the country to Houston to chat, eat, and zumba. I guess everyone needs to unwind from the stress at work and just don’t mind spending a few hundred dollars.

In my last blog, I spoke about AACN’s 8 Essentials of Doctoral Education for Advanced Nursing Practice. I am learning from experience and I want to share with you what I learn as I go along. Those of you out there who are contemplating on which path to take in your nursing profession, it is imperative to be aware that there is an option besides the research-focused PhD nursing program. A lot of clinical nurses want to continue practicing at the bedside or out in the field. The DNP program is a practice-focused doctorate degree that would allow a nurse to do so. A DNP nurse in any health care setting is prepared to apply theory-based and evidence-based knowledge to practice; to improve quality outcomes; and to be a leader in a very complex 21^st century health care system.

I knew before I went into the program that this will be a very intense and rigorous program. But one can never fully realize the extent of it until you are actually in it. It is advisable to go part time in your job if you’re able to. As a full time charge nurse and a mother of three, I am barely keeping up with all the readings, assignments, and deadlines. When I think about it, it is so much easier to quit, but I’m not a quitter. I chose this path in my nursing journey for a purpose that is beyond me. I cannot stress enough the motivation that drove me where I am now, and that is service; nothing more, nothing less. And so I try to focus on all the tasks I need to accomplish one day at a time. I cannot fall apart right now and shatter into pieces. When I think about how much I need to do, I cringe deep inside and hope this is all but just a dream. Others ask how I’m able to do it. I can only say not by my own might, but by God’s grace alone. When I feel overburdened with tasks; when I wish I were spending time with my family instead of reading or writing for school, I close my eyes and retreat to that silent place where God is and draw strength and endurance from Him who is the source of all things.

My two little ones Joshua and Simon camping around my study desk as I study all day and all night on my weekend off.

And so I would like to share some pointers with all of you who are thinking of pursuing a DNP degree. I am hoping that when you get into the program mentally, emotionally, physically, and spiritually prepared, you’ll have a better chance of staying focused on the program and your DNP project.

1. Visit AACN’s website and be informed about the Doctor of Nursing Practice program. (http://www.aacn.nche.edu/DNP/index.htm)
2. Speak with DNP-prepared nurses and learn about their experiences as students and after graduation.
3. Start looking around for a prospective preceptor who will be willing to mentor you for the entire program.
4. Start thinking about your DNP Project or Capstone Project. Think of a health care issue that you are passionate about and see if there’s anything that can be done to address that issue. Start reading peer-reviewed literature about the issue and find the best evidence-based practice.
5. Start thinking about a potential venue where you can do your project. It is advisable that your preceptor be affiliated with that agency or organization so that he/she can facilitate and make the project happen for you.
6. Know ahead of time if that agency, facility, or organization needs an affiliation agreement or a contract because the process takes time.

 If you do these steps before you even start the DNP program, you can avoid the stress of going through all these once the program starts.

Once again, I want to part by sharing with you these beautiful quotes, which are food for the soul.

Fill the cup of happiness for others, and there will be enough overflowing to fill yours to the brim.           -Rose Pastor Stokes

 Today belongs to you. It’s a clean page you can cover with wonderful, creative images and words that will fill every moment with satisfaction.       -Anonymous

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January 2011

I have just finished a case study report for NR 703 (Informatics). I feel a sigh of relief each time I finish the week’s assignments, but I am always looking ahead to the following week. The key is focus, anticipation, and discipline to accomplish on time all that needs to be done.

I have learned a lot of new things about health information technology in NR 703. For the past few weeks, we learned about the foundations of nursing informatics and nursing and health care data and standardized languages. I’ve learned about a lot of IT terminologies I’ve never heard or seen before. Honestly, they intimidated me as I was skimming through the weekly overviews. And I thought applied statistics was out of this world! These jargons jarred my brain for a little bit but after reading, researching, and writing about them, I’ve gotten my equilibrium back.

I have also been busy trying to identify a venue for my application to practice, as well as a mentor or preceptor who will help me achieve my goals and objectives for this program. It would have helped if I had done this before the program started or even during the first semester of the program. Obtaining an affiliation agreement with an agency or organization takes time and is not always easy. But after a week or two, I have finally found the right place for my capstone project. It was stressed to us how important it is that we be passionate about the project. One of my instructors told me that I should not feel like I’m doing to work, but doing something I love to do. I know I love to do any type of work that directly serves those that are most in need. I am blessed to have been lead to the Fort Bend Family Health Care Center where I would be doing a project about childhood obesity among the low socio-economic population of my community.

The release of the American Association of Colleges of Nursing (AACN) Position Statement on the Practice of Doctorate in Nursing in 2004 was followed by release of  The Essentials of Doctoral Education for Advanced Nursing Practice in 2006. I have not come across the essentials until I actually started the program. However, it is imperative for a DNP student to be aware of these essentials. One of my instructors said it is the roadmap of every DNP student. Hence, I would like to discuss briefly the contents of the document to shed some light about the role of a DNP in health care.

Doctorate nursing programs used to be focused more on research and there was no program focused on practice until the inception of the Doctor of Nursing Practice or DNP program. While the doctor of Philosophy (PhD) and the Doctor of Nursing Science (DNS, DSN, or DNSc) degrees focused mainly in the development of nursing knowledge through research, the DNP program prepares a nurse to apply theory and evidence-based knowledge into innovative practice. Whereas PhD programs require a student to have a dissertation, the DNP student is required to integrate advanced knowledge into a capstone project or evidence-based outcomes research to influence a practice change initiative or improve health outcomes (AACN, 2006).

AACN defined the 8 DNP essentials as the foundational outcome competencies and core content of any DNP curricula. Essential I: Scientific Underpinnings of Practice; Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking; Essential III: Clinical Scholarship and Analytical Methods of Evidence-Based;

Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care; Essential V: Health Care Policy for Advocacy in Health Care; Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes; Essential VII: Clinical Prevention and Population Health for Improving the Nation’s Health; and Essential VIII: Advanced Nursing Practice.

A DNP education prepares a nurse to be a leader in the 21^st century health care. This is a response to the Institute of Medicine’s series of reports from 1999 that underpin the fragmented health care delivery system, patient safety issues, health professional education, and leadership for nursing practice (AACN, 2006). The need for transformation in health care in the country has never been as pivotal as it is in the turn of the century.

When asked why I chose to pursue the highest educational nursing degree right after an intense MSN program, I am honest and humbled to say that it is out of my desire to serve. Early during the MSN program, I have realized the Servant-Leadership is my overarching leadership platform because its principles are aligned with my personal values and beliefs. In this token, I hope to be able contribute to the legacy of nursing leaders who have upheld the values of service, social justice, equality, and humanity. It is not an easy road, but one that is beset with rigor, scholarship, commitment, and intense discipline. But I persist to run the race to the end, and persist I must….by the grace of God.

Courage does not always roar. Sometimes, it is the quiet voice at the end of the day saying, “I will try again tomorrow.”                           (Mac Anderson)

“Things that matter most must never be at the mercy of things which matter least.”                         (Johann Wolfgang Von Goethe)

(Images obtained from http://thundafunda.com/33/travel-world-pictures/index.php).

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January 2011

A happy, prosperous, and healthy new year to everyone! As I look back to 2010, I can only count all my blessings. I have a loving and supportive husband, three wonderful boys, helpful parents, a stable job, and a wonderful home. Over the years, I’ve seen all kinds of suffering brought about by illness. I’ve felt the pain and despair of my patients and their families as they try to hold on to their dear lives. When I look around the world today, there are all kinds of contention among nations, within the country, within the communities, within families, and within oneself. I am thankful to God for giving me the inner peace and joy amidst all these.

I am also grateful that I’ve made it through the first semester of the DNP program. During the winter break, I tried to catch up on all the lost hours of sleep, another thing to be thankful for. It was wonderful to be able to sleep not having to worry about deadlines and assignments. To me, having a few weeks of decent sleep was the best Christmas gift this year. I was also able to run a few laps with my husband as I planned. Close friends from New Jersey and Florida came to spend Christmas with us in Texas and that was fun and refreshing. I tried to savor every minute of the winter break, as it will take me until next Christmas before I can get another decent sleep.

Before the second semester started, I scanned through the course syllabus for NR 725 (Application to Practice) and my thoughts began swirling around. I tried to push it to the back of my mind, but it’s like a restless kid that won’t stop nagging me. As I look ahead to 2011, I can only say it will be hard and fast. NR 725 is scheduled in conjunction with NR 706 (Capstone Project). As a future DNP, one of our roles is the application of theory to practice. At the end of the program, I must be able to integrate all the concepts learned and must have applied them to my capstone project.

 Unlike my other classmates who already have a venue for their clinical practice and capstone project, I am still trying to identify a place and a population for my capstone project. I could have done this during the last semester but was not able to due to time constraints. I have finally spoken with my preceptor during my MSN who agreed to be my preceptor/mentor. However, she is waiting to speak with the VP of her facility to see the likelihood of a project. The faculty has been very supportive and helpful in giving me options and ideas. The key is to do a project for which I am passionate about. One of the faculties told me that it has to be something I would enjoy doing and not something that will make me feel like I’m working. So at the moment, this is at the top of my priority list.

During this week’s discussion for NR 706, the following are some of the questions we are asked to talk about: “What prompted your decision to return to school for a DNP degree? Where do you see yourself practicing and what will you be doing differently?” As for me, it is more for lifelong learning. After MSN, I just realized how much knowledge is a gift. As a gift from God, I need to nurture it and invest on it for the good of others. I know I have the skill to lead because I am a good follower. I am a human being just like anyone else. I go through the same joys and pains that everybody goes through. The only difference lies in the circumstances surrounding our lives. I see myself working with and for the people as a nurse leader, whatever role that may be.

This semester, I am also enrolled in NR 703 (Informatics).  Informatics has grown tremendously not just for nursing, but also for the entire health care system as a response to the report of the Institute of Medicine To Err is Human released in 1999. In the report, about 98,000 people died in the hospitals alone as a result of preventable medical errors. The use of health information technology makes health care delivery more efficient and effective, and eventually save lives.

This will be a very interesting semester, as all the rest will be. I just hope and pray that I’ll be able to accomplish at least all my goals for this week. I can only take it one week at a time and try to get as much sleep as I possibly can.

To end, I would like to share these words of inspiration:

Keep your heart free from hate, your mind free from worry, live simply, expect little, give much, scatter sunshine, forget self, think of others (Norman Vincent Peale)

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December 2010

This is the last week for our class in Applied Statistics.  Some colleagues asked if this course would be of any use to my practice. I would have asked the same question had I not pursued higher nursing education. Now that I have made it through this tough course, I can straightforwardly say “yes.” As a future DNP, my roles would encompass theory and research evaluation and application as described in the American Association of Colleges of Nursing’s Position Statement on the practice of DNP. Having the knowledge I have learned in Applied Statistics would definitely prepare me for this role.

Read... highlight... read... highlight... read... highlight... snoooooozeee...

Other than learning about various concepts of applied statistics, I also realized that the virtual classroom is no different than the brick wall when it comes to learning. I’ve heard others say that there’s no match to being educated in the classroom; that on-line education is less superior to the traditional classroom. For me, it is a matter of personal preference. Some students need to have somebody to guide them through, while others learn best independently. The on-line structure also has advantages, especially for those who are working full time and have families. It gives the flexibility that the traditional program could not offer. However, an on-line student needs to be self-disciplined and responsible to meet deadlines of such a fast-paced program.

Again, I could not stress enough how quickly time went. In the last two months of this course, my classmates and I have bonded in a special way. Perhaps because this course was such a tough one, we needed each other’s support in understanding instructions for assignments, concepts, and interpretation of data. I can almost picture the faces of my classmates and identify their personalities just from our on-line communication and discussion. It has been a pleasure to be in this class and to have expert instructors who are not only considerate, but flexible as well.

Just like the Advent for the birth of Jesus, every phase of our lives is a patient waiting for the fruits of our labor. As for me, I am hoping to reap was I sowed for this DNP program in early 2012. My final hurdle for this class is a case study that needs to be submitted before midnight this coming Sunday. I am so glad that I finished all the assignments, laboratories, and exercises for the last two weeks of this course three weeks ago, when I had a long stretch of days off from work. I am having friends and their families coming to stay with us for the Christmas holiday and they will be arriving from New Jersey and Florida this Friday. I knew then I could not scramble over these last few assignments at a time when I also need to prepare for my guests arrival. Nonetheless, I am proud to say, “I made it!”

I will definitely savor every moment of the few weeks I have of break from school. I will try to make it up for my kids and watch as much TV shows and DVDs with them. I will also try to run with my husband who’s been begging me to run with him for the past four months that I was in school. I will try to catch up on the many hours of sleep I lost. But most of all, I need to spend time to reflect upon all the good things that God has blessed me with; my family and friends, my home, my job, my education, and my life. As the clock ticks and the pages of life turn, I want God to know that I have done my best in all circumstances. As time flies, I want to know that I am headed towards the destiny He’s set for me. Have a joyous Christmas and a prosperous new year to you all!

My eldest son Ariel performed for their school's winter orchestra concert, where he played as a 2nd violinist.

“Time flies. It’s up to you to be the navigator” (Robert Obrien)

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November 2010

As the season of Advent begins, so does Fall finally makes its presence known. Both seasons teach us patience and hope; as Advent brings with it the anticipation of our Savior's coming, Fall makes us hopeful of new life bursting forth on Spring.

Fall has finally beset Texas as leaves of the trees are finally turning into deep hues of orange and red. It is week 6 of Applied Statistics! Where did time go? Seems like that’s the common theme among on-line students. Indeed, time drifted by so swiftly that I have to take a moment to reflect on what had come and gone. Over the last few weeks, we tackled seemingly difficult topics, yet in essence are quite basic. I was introduced to the concepts of frequency distribution, central tendency, variability, shapes of distribution, relative standing, correlation, probability, Pearson’s r and inferential statistics, Z-score, Cohen’s d or effect size, t-test (parametric test), chi-square (non-parametric test), and this week, I get to meet ANOVA test. What I find interesting about statistics is that it is quite intuitive. There is also a certain amount of subjectivity in statistics, because interpretation of data or the choice of statistics is dependent upon the interpreter of the data or the researcher. Nonetheless, basic principles still abound.

I said just a while ago that these topics are seemingly difficult, yet in essence are quite basic.  At the initial glance, what lies ahead of us is usually intimidating; a usual human reaction to something unknown. Yet knowledge gained through learning is empowering that by knowing, we gain a sense of security and assurance that we can understand, if we only try to learn about it. After all, life is all about knowing and learning… about life, ourselves, the people we love, the people around us, our world, and our God.  We cannot cease to learn, or we cease to live. And once we have learned about a seemingly intimidating topic, we realize things follow certain basic patterns. The ebb of life is a pattern of ups and downs, of coming and going. Once we realize this, we can be more courageous is facing our future; in learning about something new. Every encounter in life becomes an “aha!” moment… a “déjà vu” moment as if we have been here once before… that we have known it all along.

I have always believed that life is matter of choice. We become what we choose to be. We reach where we choose to go. Although destiny is in the hands of God, the choice is ours to make. We can traverse the path He destined for us, we can go a different way, or remain where we are in the status quo; where life slowly withers away into nothingness. Although our intellect is a gift from God, learning is a matter of choice and free will. We can choose to remain in our small limited knowledge of life, or we can choose to expand and be as vast as the universe beyond. There is infinity in life that even a lifetime isn’t enough to learn all about the wonderful and amazing facts about it.

If you have read my biographical posting, I mentioned that I have never liked learning when I was younger. I was a dreamer then, who always dreamed of things that I might never have. I dreamt of becoming who I may not have been created to be. I lived in a fantasy world where things are beyond my grasp. But when I realized that God has created me in His image and equipped me with all I need to face life, I began to live in the here and now, where things are real… where I can touch and feel life and the truth. Since then, my desire to learn about life and the truth has become even stronger, that nothing seems to quench my thirst for knowledge. I grab all the opportunities there are out there trying to learn everything and as much as I can. As Johann Wolfgang Von Goethe once said, “If you wish to advance into the infinite, explore the finite in all directions.”

This DNP journey was a difficult choice for me. It meant sacrifice and giving up a lot of things. But I cannot ignore the inner promptings for higher learning. My intellect is a gift from God and I want to invest it for a greater cause that is yet to be unfolded. Just like the wise servant who invested the gold coins his master left him, I want to be able to face my Master knowing that I have fully invested the gift He has bestowed upon me. Applied Statistics intimidated me in the beginning, as much as Finance, Economics, and Accounting did in my MSN program. But just as the ebb of life follows a certain pattern of ups and downs, coming and going, sciences also follow the basic laws of life, gravity, and physics. There is certain intuitiveness in statistics, just as there is in any other sciences. There is nothing that can intimidate us more than our own fear of the unknown. Yet if we open ourselves to all the possibilities, we realize that every encounter in life is an “aha!” moment… a “déjà vu” moment that is reminiscent of the certainty in life amidst the uncertainty of this world.

 Learning is awe inspiring and the more I learn, the more I see the pulchritude of life and the magnificence and splendor of the Creator. And so to end, I would like to share a couple of quotations that I hope will inspire you as much as they have inspired me. I love quotations because they are food for the soul. They inspire me to challenge myself and I love sharing them with others.

A gentle tug of the heartstrings, an urging from deep within, the whisper of sweet inspiration is how all great achievements begin. (Unknown author).

"Our souls are like pools of still water upon which the spirit's rains fall sending out tiny ripples of waves that whisper our destiny's call." (Unknown author).

Today I am inspired to go beyond the boundaries of my weakness, to challenge the walls of my limitations, and believe in endless possibilities. (Unknown author).

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November 2010

We are now in week 3 of NR 702, which is Applied Statistics. I dreaded this course because I have never been good with numbers. The first week was the worst for me. I was so apprehensive that I will never be able to understand the symbols and language of statistics. Browsing through the pages of my textbook, I told myself, “What in the world is this?!” I was in the panic mode as time is of the essence. I needed to post in the discussion forums by 11:59 pm every Wednesdays, and submit weekly exercises and laboratories by 11:59 pm every Sundays. Weekly activities constitute reading specific chapters from the textbook, listening to on-line lectures regarding the topics for the week, article readings, and reviewing recommended websites, such as the CDC to get information and data for weekly discussions and assignments.

At the end of the first week, my anxiety level started to decline. With expert, very supportive, and considerate instructors, I am slowly gaining confidence in myself that I am capable of understanding an area that I dreaded the most: numbers, numerical symbols, and mathematical formulas, but not without their guidance. Our instructor stated in the beginning of our course that Applied Statistics for this program is focused more on developing DNPs’ abilities to interpret and use data for improving practice, and not so much on calculation. At least this was a consolation for me. With less anxiety, I am able to process statistical concepts and gain some basic understanding of when statistical data are appropriate to use… but still with some degree of difficulty. I can definitely say there is a strong inverse correlation between anxiety and ability to learn. 

My greatest dilemma is when it is my weekend to work and when I have to work Mondays and Tuesdays. I scramble to meet Wednesday and Sunday deadlines, and so I always end up staying awake for 24 hours or more at least once to twice a week. Working full time, being a wife and mother of 3 boys, and pursuing a doctorate degree on-line is like plunging into the deep waters of the ocean. I knew even before that it is not going to be easy. I may find myself gasping for air or freezing in the cold waters of the ocean. When people ask me how I do it, I can only say “By God’s grace alone.” For indeed, all I have is His, including my talents, skills, intellect, and will. He is my inspiration, my strength, and my hope. With God, all things are possible. I am thankful that I have a very supportive husband and parents. Without them, it would be almost impossible for me to face the challenges of the DNP program.

After staying awake for 48 hours to finish my Praxis Model Paper for NR 701 (Theoretical Applications for DNP), I finally got to celebrate my youngest son's 7th birthday with my family. To my left is my husband Raymond, then our eldest son Ariel. In the front from right to left is Joshua and Simon, the birthday celebrant.

The service oriented MSN program of Regis has inspired me to be a volunteer ESL teacher in my parish at Sugar Land, TX for the entire academic calendar year. To my right is my partner Brenda, and to my left are our students from Mexico, Egypt, China. Seated in the front from right to left are our students from Iran and Korea.

I would like to part with a short poem I wrote about life. I hope you find a glimpse of inspiration that will nudge your hearts to learn and to serve.

I was given my intellect that I may learn about life;

I was given my thoughts that I can reflect about life;

I was given wisdom that I may discern the Truth;

I was given love that I may learn how to share the Truth;

I was given strong, yet gentle hands,

So that with all that I have learned and reflected about about life,

I can serve the Giver by serving the people He love.

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