NURS 8002 Week 11 DNP identity reflection example

From Fixing Problems Faster to Asking Why They Return: A Reflection on Becoming a Scholar-Practitioner

Student Name

College of Nursing, Walden University

NURS 8002: Foundations and Essentials for the Doctor of Nursing Practice

Instructor Name

Month Day, Year

From Fixing Problems Faster to Asking Why They Return: A Reflection on Becoming a Scholar-Practitioner

Where I Started

In my Week 1 introduction, I wrote that I had come to the practice doctorate "to learn how to fix problems faster." I manage a composite outpatient specialty clinic with twelve nurses and medical assistants, and at the time that sentence felt like a strength: I am the person staff come to when something breaks, and I fix it. Eleven weeks later, I would phrase my goal differently. I came to learn why the same problems keep returning after I fix them, and how to change the systems that produce them rather than the individual events. This reflection traces that change through three moments in the course and connects it to the 2021 Essentials domain on personal, professional and leadership development (American Association of Colleges of Nursing, 2021).

Mezirow (1997) describes transformative learning as a process in which adults examine the assumptions behind their habitual ways of thinking and revise them. I will not claim a transformation after one course, but I can point to an assumption I held and have begun to revise: that speed of response is the measure of a good leader.

Moment 1: A Problem Statement Returned

My first problem statement was returned with one comment: "This describes a topic, not a problem." I had written about "patient no-shows in specialty care," a subject rather than a gap between current and desired practice in a defined group. Rewriting it forced me to say what should happen, for whom and what actually happens. In doing so I realized that I had been treating no-shows as something to respond to case by case, calling patients back, double-booking, reminding staff, without ever defining the gap I was trying to close. My fixes had been fast, but they had not been aimed at anything measurable. The rewritten statement named a population, a standard and a distance between them, and for the first time I could imagine knowing whether a change had worked.

Moment 2: Separating Findings From Preferences

The evidence summary was harder than I expected, not because the literature was difficult but because I kept writing what I wanted the studies to say. I had a preferred solution before I began, a nurse call-back program I had seen work elsewhere, and my first draft described every source in terms of whether it supported that program. My instructor asked me to rewrite each summary using only what the authors reported and to move my opinions to a separate section. When I did, the evidence looked different: the strongest studies supported a simpler intervention than mine, and my favored program had little direct evidence. That separation of findings from preferences is, I now think, the core discipline of the scholar-practitioner, and it is one I did not practice as a manager, where my preferences usually became the plan.

Moment 3: One Claim

The synthesis asked me to hold everything I had written under a single claim. My first attempt listed five problems in the clinic, each with its own evidence. Narrowing to one forced a choice I had avoided: which problem matters most, and which can I actually change? Choosing felt like leaving other problems unsolved, which runs against my instinct as a manager. But a synthesis with five claims is five small papers, and a project with five aims is none. Melnyk (2013) places evaluation of results alongside translation as the work the practice doctorate prepares nurses for, and I understand now that evaluation depends on focus. A leader who fixes everything cannot tell what worked.

The choice I made was missed first appointments among newly referred patients, the gap my rewritten problem statement had already defined, because it affects patients at their most uncertain moment, it can be measured with scheduling data the clinic already records and it lies within my authority to change. The other four problems did not disappear. I wrote them into a list for later projects, which turned the discomfort of leaving them into a plan for returning to them. That small act, deciding what not to do now and recording it, is something I rarely did as a manager, where every open problem felt like my failure to act.

What Has Changed, and What Has Not

I now frame practice problems as gaps with a standard, a population and a measure, rather than as events to respond to. I separate what evidence shows from what I prefer, at least on paper; in the clinic, under pressure, I still reach for the quick fix. And I have begun to see my role as building systems that make problems less likely rather than as being the person who resolves them. The domain on personal, professional and leadership development asks nurses to engage in activities that build their capacity to lead and to reflect on their practice (American Association of Colleges of Nursing, 2021). I have met that expectation in the course's assignments. Whether I meet it in the clinic will show over the next year.

What has not changed is my commitment to the staff and patients who rely on the clinic running smoothly. Fast responses will still be needed on hard days. The difference is that I now want to know, after each one, whether the problem was a sign of something that needs a slower, more deliberate fix.

Next Steps

Two commitments follow. First, I will keep a simple log in the clinic for the next three months, recording each problem I fix and whether it has occurred before; recurring problems will become candidates for a DNP project rather than repeated fixes. Second, before proposing any change to my staff, I will write a two-sentence statement of the gap it addresses and share the evidence behind it, so my preferences do not travel as policy. These are small practices, but they are the first places where the course's way of thinking can become my way of working.

References

American Association of Colleges of Nursing. (2021). The Essentials: Core competencies for professional nursing education.

Melnyk, B. M. (2013). Distinguishing the preparation and roles of doctor of philosophy and doctor of nursing practice graduates: National implications for academic curricula and health care systems. Journal of Nursing Education, 52(8), 442-448. https://doi.org/10.3928/01484834-20130719-01

Mezirow, J. (1997). Transformative learning: Theory to practice. New Directions for Adult and Continuing Education, 1997(74), 5-12. https://doi.org/10.1002/ace.7401