In the quiet rhythm of care, five letters help make sense of it all: ADPIE—assessment, diagnosis, planning, implementation, and evaluation.
What if a dream could be cared for in much the same way?
Dreams, too, arrive with vital signs. They ask to be assessed when the path is uncertain, diagnosed when something goes wrong, planned when the way forward becomes clearer, and carried out even when doubt lingers at the edges.
For Ms. Jazz Excell M. Remedio, RN, becoming a top 10 passer of the Philippines Nursing Licensure Examination (PNLE) was not simply an outcome to be recorded. It was the result of a journey shaped by setbacks, adjustments, and faith.
Perhaps, like a patient under careful watch, a dream doesn’t reveal its whole story at once. It unfolds in signs, responses, and small recoveries with each revealing about the course ahead.
Assessment: Establishing the Baseline
Before a nurse could care, she must first assess. She listens to every pulse, observes every sign, and gathers details where the patient stands.
Jazz’s first assessment was not of a patient. It was herself.
In 2022, returning from the world of screens and digital modules to four-cornered classrooms and crowded corridors meant learning how to be a student all over again. The transition came twice: stepping back into the classroom while leaving high school behind and taking her first steps into Nursing.
She chose this path with a deep desire to serve others, to become a voice for her patients, to hear the stories behind the names and conditions written on charts. With her family’s unwavering support and a dream she believed God had planted in her heart, she found the determination to pursue it.
But wanting a dream is far from knowing where to begin.
The pandemic did more than turn bustling corridors into silence. Once an active, “pasikat” student, Jazz found herself becoming quieter and less certain of how to connect with others.
For years, even as college passed her by, she felt there were still pieces of herself that remained unseen. Then, she found singing. What began as a way to express what words could not slowly became her own language—a way to be heard without having to say much at all. It carried her to second place in The Voice of VSU, but beyond the recognition, it helped her rediscover a voice she thought she had lost.
“I really love singing because that is how I express myself. Mao to, mailhan rako sa nursing kung mukanta ko,” she shared.
Confidence did not return overnight. But, her willingness to keep trying remained constant. When confidence faltered, faith gave her something to hold on to—not simply as something she believed in, but as something she chose to live by.
And before nursing asked her to care for others, her own journey first demanded her to retrieve her voice once more as she took a step forward.
Diagnosis: Identifying the Challenges
In nursing, diagnosis gives meaning to the signs. It identifies what needs to be addressed before care can begin.
For Jazz, the weight of nursing became clear early. The standards were high, and her instructors pushed them beyond simply passing, knowing every lesson was preparation for the responsibilities they would one day carry.
“First year pa lang na-feel na namo ang pressure nga murag ugma… diretso board exam nami,” she recalled with a laugh.
But the pressure eventually found its mark. By third year, Jazz faced what she described as the “darkest moment” of her life. During midterms, only two classmates passed. Jazz was not among them. A week before her birthday, she received her first singko.
For a moment, it felt like a verdict. With home in Bohol and school in Leyte, the distance only made the weight harder to carry.
With encouragement from her older brother, Jazz slowly gathered her scattered courage and finally told her parents. Instead of the disappointment she feared, they met her with reassurance and prayer, reminding her that one failure could not define her entire course.
“The race is not yet over, so you can still do your best,” they reminded her with faith.
The setback may have shaken her, but it did not break her faith. If anything, it grew firmer. She chose to keep going, even without knowing what lay ahead.
Planning: Setting the Course of Care
After diagnosis comes a plan. For Jazz, another chance meant change.
During her first semester, she admitted that she had been too relaxed with her priorities, sometimes choosing her favorite series over studying. Failure made her rethink what truly mattered.
As her goals became clearer, so did the need to redefine her priorities. She could not afford to go through the same struggle again. This time, she knew she had to give her best in everything she did.
“Next time, dili nani mahitabo Jazz. Do not make yourself go through the same struggle again.” she told herself.
But her goal did not end with simply passing. She wanted to become a nurse who looked beyond charts, listened to her patients, and understood the lives behind their needs. She wanted to be with people, witness their struggles firsthand, and understand what it truly meant to respond to them.
“The Filipinos really deserve na serve-an nato… hatagan nato ug healthcare that they deserve,” she shared.
She also knew what needed to be improved: communicating, one of her weaknesses, and knowledge, because compassion alone could not carry the responsibility of caring for another person. It had to be matched with willingness and readiness.
Her goal was no longer simply to finish. She was charting a course toward the nurse she hoped to become—prepared not only to care, but to serve.
Implementation: Carrying Out the Interventions
Plans mean little until put into action. For Jazz, implementation meant stepping into PNLE even when she did not feel ready.
It was November when the PNLE schedule shifted from May and November to February and August. Doubt was contagious, spreading through the batch. After feeling that their goal was too far to reach, a decision to take the examination on latter date had been made. Their department adjusted schedules and workloads, while their dean and registrar helped make the process possible. “I am so grateful sa amoang department…they did not fail their promise,” she recalled.
After the decision, their weeks remained demanding, with 12-hour RLE shifts to leave room for them to prepare. By the last week of April, they had begun reviewing.
With time, what once felt difficult had slowly become familiar. The lesson that once gave her a “singko” was now one she found easier to understand. Concepts became clearer, lessons more manageable, and learning became something she began to enjoy.
Months passed by in a blink of an eye, then came July: their graduation. While the ceremony marked the end of a student's life, it did not include the end of their preparation. They continued, before and after the graduation. Together with diplomas, they also carried what they had learned in the classroom.
Yet, as graduation approached, one question remained: Would she remember enough?
“Mao gyud na ang need na dawaton nimo, inig take sa PNLE—you will never be prepared, I will never be prepared.”
Then came the examination.
The night before, fear kept her turning through her notes, scanning one page after another as if something might still be missed. Eventually, she stopped. There was nothing more she could do but face what she had pre
Then they proceeded to the testing center, at University of Cebu Main Campus - Jones Building. She was met by the crowd, a crowd that shared the same goal. “Wow, kani nga mga tao, we have the same dream—to pass the board exam,” as she remembered the moment.
At the testing room, surrounded by people carrying the same dream, the weight of the moment finally settled in. “Lord, if this is for me, you would help me. Maghimo jud kag miracle.”
The first day tested her nerves. By the second, the unfamiliarity began to fade. When it ended, relief came first, still followed by the inevitable what-ifs.
Yet, Jazz knows she is not alone facing the battles. Her faith, family, friends, batchmates, the Nursing Department, and St. Louis Review Center had been the hands that steadied her along the way.
All that remained was the wait.
Evaluation: Assessing the Outcome
Evaluation is the final moment of looking back: What worked? What changed? What was learned?
Then, the results came out.
Like a diagnosis piercing every scattered symptom into a one clear picture; the sleepless nights, quiet struggles and moments of doubt that carried her there. Everything she had carried, led to one finding: her name among the PNLE passers, and within the Top 10.
It was more than what she had prayed for. For once, the outcome spoke for everything she had endured.
Along the way, Jazz learned to put her heart into what she does and let her work give glory to God. On every examination, she would write “For God’s Glory”—a small reminder of whom she was doing it all for. Beyond the lessons nursing taught her, she found another kind of wisdom in God’s words.
But perhaps one of her gentlest lessons was learning to care for herself, too.
For someone whose course continually asked her to go beyond, Jazz described herself through the word “transcendence”—to keep going, to know when to be gentle, and to still believe, “...I can go beyond that,” she said.
Looking back, if she was able to take the same path again, she would do it again, without a doubt. Initially, she dreamt of becoming a DOST scholar and planned to take Medical Technology. But before she could even take a step forward, the road immediately turned and led her into another path, to Nursing instead.
“Imagine if I did not pursue this, asa kaha ko ron?” she mused.
Her course was never a flat line. Like a heartbeat on a monitor, it rose and fell through failed examinations, shaken confidence, sleepless nights, and moments when questioning her path seemed easier than continuing. Yet perhaps that was the point: a line that moves is a sign of life. Every rise and dip meant she was still here, still fighting, still moving forward.
Maybe that's what her story leaves behind: a journey is not a perfect rhythm, but one that keeps tracing its way across the monitor. The dips were never the end. Always, there is another beat, another chance to continue.
Like the nursing process, perhaps a dream only needs to be assessed one step at a time.
And for Jazz, as the path finally makes sense, she met it with faith that carried her farther than she thought, purpose kept her moving, and love was there all along. As what she often emphasized:
“...with love, everything follows.”