I remember the day clearly – sitting in a convenience store parking lot after buying a pack of pencils on my way to my first day of nursing school. I had no idea what I was getting myself into. Or, perhaps more realistically, I had no idea how ill-prepared I really was. As a mediocre high school student who got by with the bare minimum, I was rudely awakened when faced with the realities of nursing school. During my first semester, I was placed on academic probation and was dismissed from the nursing program I was enrolled in until I improved my GPA and became eligible for readmission. In one semester, I managed to raise my GPA from 2.1 to 3.0 and was readmitted into the nursing program with the next class. This was a great lesson in learning how badly I truly wanted to be a nurse. I saw a fork in the road – I could choose to buckle down and work for what I was passionate about, or I could settle, change my major to something objectively easier, and forget about nursing altogether. I struggled with this decision for months, wondering if I would ever become a nurse at all.
Little did I know, this would not be the end of my journey of failures on my way to where I am today. After completing the third year of what should have been a two-year nursing program, I failed the NCLEX – the significant exam that all nursing graduates must pass to become licensed. Once again, I was faced with a decision: Go back to the drawing board and reimagine how I was preparing for this exam, or turn my back on it all and move on with life. This was one of the lowest points of my professional life and forced me to undertake deep introspection to decide where I wanted my life to go.
Deciding that I was not done with nursing was one of the best decisions I have ever made. The trials and failures along the way have shaped me into the provider I am today as a nurse practitioner. Without the lessons I learned from these two turning points, I would not have been able to survive and thrive in such a rigorous degree program like the doctor of nursing practice. My hope in writing this piece is to share some of these “quality improvement interventions” that I learned along the way, which may help others in their personal and professional journeys.
Stay grounded. Faith, physical fitness, and spending time in nature are all great strategies to stay grounded, remember where you come from, and look forward to where you are going.
Surround yourself with perspective-givers. I found it important to surround myself with others who can provide me with perspective, mostly older and more experienced friends and colleagues. Sometimes it is hard to see the forest for the trees.
Develop a preoccupation with failure. In the same way there is only light and the absence of light, there is only success and the absence of success. Failure is a measuring stick used to gauge the magnitude of success.
Develop a quality improvement plan. Identify what went wrong and determine how you can fix it. Whether it’s developing a better study routine, learning to say “no” to maintain a balanced plate, or implementing interventions to stay organized, take the time to develop a plan of action.
Be kind to yourself. Calm seas never made a good sailor. There will be times in life where nothing seems to go according to plan. Make a new plan and realize you have the ability to accomplish what is at hand.
I once heard a colleague say that quality improvement science is a dynamic non-event. There are often multiple iterations in quality improvement projects that lead to the prevention of patient harm, such as falls or the development of pneumonia. However, personal quality improvement is a dynamic event. There may be numerous iterations in our journey to reach a life we can live with.
Dale Pearce is a nurse practitioner.
