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What are your nursing education and clinical experience, year of practice, job position, professional growth and development, and career ladder?

Running head: CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 1

CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 10

Comment by MS: Correct APA format.Good job.

Concept Synthesis Paper: Personal Nursing Philosophy

Yordanka Milanes

South University

Please read my suggestions in your paper, get Morse’s publications below, REWRITE and resubmit by Thursday midnight. This will help you work on Project 3.

Concept Synthesis Paper: Personal Nursing Philosophy

An understanding of nursing practice is made easier with a personal philosophy. Various theories have consequently been developed with the aim of defining practice concepts in this field. In specific, this paper focuses on Morse’s theory in nursing practice. The paper explores the author’s personal nursing autobiography in relation to Morse’s concepts of enduring and emotional suffering. In relation to Morse’s theory, the study discusses the four meta-paradigms namely person, health, nursing, and environment. Nurses who apply the identified concepts within the four meta-paradigms in personal philosophies attain positive outcomes.

Nursing Autobiography

My childhood desire was to serve and care for the needy people. Nursing was my target ambition, and now, I am in the profession. Throughout my role as a nurse practitioner, I have displayed acceptable standards of practices that achieve patient comfort and wellness. In reference to Morse’s concepts of enduring and emotional suffering, I serve with compassion and empathy with the aim of enhancing patient comfort and wellness. Having worked in the field of primary care, my zeal to exercise professionalism has consistently restored patient anguish and suffering. So as to achieve positive outcomes, I exhibit efficiency and effectiveness whenever dealing with patients. With frequent trainings that I undergo, I have developed a positive tendency of making influences on patients. More commonly, I try to advise them in line with Morse’s theory with the aim of facilitating their recovery and wellness. Comment by MS: Great. This paragraph presented your passion and inspiration in nursing profession.

It is paramount that I have advanced in my nursing philosophy. When handling patients, I specifically try to understand their needs, be it psychological, emotional, or even physical. In particular, this approach enables me to make personal contacts with affected patients in a bid to counter any associated enduring or emotional suffering. It is critical that my focus is based on paying special attention to suffering patients. It is essential that I employ nursing experience to address extreme cases. Against changing techniques in the healthcare setting, I have a philosophy of endeavoring to incorporate new ideas to enhance healing and comfort strategies. My aptitude to embrace diversity makes it easier for me to interact with all manner of patients irrespective of their backgrounds. In as much as I am proactively involved in nursing, I will always seek to equip myself with new knowledge to develop strategies for attaining emotional peace. My eagerness to integrate both preventive and curative measures is seen as fundamental in yielding positive patient outcomes. Comment by MS: Excellent. This paragraph included factors that guide your decision making and nursing care. Who are you? You need to present yourself as a nurse and a future FNP. What are your nursing education and clinical experience, year of practice, job position, professional growth and development, and career ladder?

Nursing Meta-paradigms in Morse’s Theory of Suffering Comment by MS: As you mentioned, you need to focus on the definitions of metaparadigms from Morse’s theory only.Please redo this section, before working on Project 3. If Grace (2017) cited Morse’s work, Grade is a secondary source. Therefore, the citation for a secondary source is (as cited in Grace, 2017).

Nursing meta-paradigms serve to demarcate one discipline from the other, while identifying critical concepts from within a particular theory. As already stated, the four nursing meta-paradigms include person, health, nursing, and environment (Grace, 2017). It is critical that these four serves to provide a model for information sharing in relation to Morse’s theory. Notably, the four meta-paradigms are each defined in relation to Morse’ theory of suffering.

Person

The person constitutes the first nursing meta-paradigms. In view of Swezey (2017), the person is the specific person diagnosed with a given condition or illness. Family members and the community equally play crucial roles as far as support to the ‘person’ is regarded. In reference to Morse’s theory, the piece provides detailed procedures that are significant in the treatment of a given patient. As such, it is easier for nurses to recognize the degree to which a patient is suffering with the aim of providing care to avert associated suffering. With Morse’s guide, nurses are able to differentiate between enduring and emotional state of suffering, thereby offering best interventions. In the assessment of Grace (2017), it is the responsibility of nurses to ensure patients are relaxed through applying holistic approaches that yield positive results. Morse’s prospect of exploring diverse cultures in healthcare helps nurses in making adjustments when handling patients with distinct cultural backgrounds. Comment by MS: You need to focus on Morse’s definitions of this concept. Comment by MS: According to Morse’s …Need at least one primary sources. Morse (2001) defined environment as the person’s surroundings while they are going through the suffering phase whether it be their place of business, home, or in society and how they are managing throughout the course of the day. The nursing aspect of the theory of suffering involves how to care for the client who is suffering in ways other than medicinal. Morse (2001) explains that when a patient is in pain, there is no way to completely eliminate it without anesthetizing them, and as nurses we need to understand more fully how to effectively institute non-pharmacological interventions to reduce the amount of pain or suffering that one is experiencing.

Health Comment by MS: Need to focus on its definition from Morse’s.Example:Morse relates that a person’s health is not well when going through emotional enduring and emotional suffering. For a person to move on they must complete the emotional enduring and suffering necessary to move on to their reformulated self (Morse, 2001). Health as a concept doesn’t have to be a physical ailment but can be the emotional devastation that they are feeling. A person who is dealing with the death of a loved one, or loss of hope, can be going through emotional enduring and emotional suffering, just as they might with a physical illness. Morse (2001) relates that the theory of suffering will not complete until the person is ready.

Health is a critical concept that constitutes the nursing meta-paradigms. Morse’s theory defines health as a form of wellness that a particular patient enjoys (Swezey, 2017). According to Swezey (2017), health encompasses the general well-being of an individual. Although the primary genetic make-ups are the predisposing factors that determine the state of a person, there are secondary factors that an individual interacts with, thereby elevating the risk of a disease arising. For nurses to achieve patient health, it is critical for them to understand vital signs in relation to given suffering and pain. In some situations, the issue of health is perceived as an element that has a threat to an individual’s integrity and wholeness. It is essential that Morse’s theory provides clear insights that are aimed at improving and restoring a patient’s health. Therefore, an implementation of specific health interventions readily helps nurses to reinstate patient health.

Nursing

The meta-paradigm of nursing is centered in care provision. Principally, the nursing component involves delivery of quality and safe healthcare services to patients with optimal health outcomes (Grace, 2017). It involves actions that are taken by healthcare provider upon the arrival of patients. Good nurses employ therapeutic interventions to make appropriate judgments. In relation to Shams et al (2013), the aim of proactive nurses is to protect, promote, and preserve human comfort that touch on patients. In order to improve patient experience, it is appropriate for nurses distinguish states of suffering as exhibited by patients. It is equally crucial that nursing encompasses an implementation of interventions that alter a given patient’s perception regarding an existing medical condition. The practice of nursing practitioners to adhere to Morse’s theory would be fruitful. Notably, Morse’s theory emphasizes on the need for them to apply appropriate guidelines in responding to patient illnesses that are complex. With this approach, nurses easily stabilize patients’ conditions, thereby addressing endurance and emotional suffering.

Environment Comment by MS: Focus on Morse’s definition.The definition by your theorist of your theory.For example;Morse (2001) defined environment as the person’s surroundings while they are going through the suffering phase whether it be their place of business, home, or in society and how they are managing throughout the course of the day. If you use a secondary source, please cite it correctly,Example, Morse (2001) stated, “The environment consists of internal and external stressors” (as cited in Tetrault & Nyback, 2010, p.6). The environment in which we practice has a lot to do with how our patients respond. Patients handle internal and external stressors differently. Stressors are often noted with a patient’s body language. Patients who are wimbling between emotional enduring and emotional suffering are not ready to fully embrace suffering and cannot see there is life and happiness after the stressor. As nurses we must guide them in their unrest, knowing which state they are in and responding appropriately.

Environmental comprises external and internal factors that surround a patient. It is the general characteristic through which all aspects of individual lives evolve. The health of a person is significantly affected by the environment with respect to the manner of interaction with other participants (Parahoo, 2014). Therefore, it is essential that patients readily interact with the environment. In order for them to achieve a high level of wellness, it is critical that they make interactions that reduce stress in relation to internal and external factors. Given that the environment normally causes suffering, each and every individual is necessitated to overcome stress in every possible way. The cultural, social and economic aspects equally constitute environmental factors that are crucial to patients’ well-being (Van Graan et al., 2016). Notably, Morse’s theory highlights the specific approaches that caregivers should explore in attaining emotional comfort within healthy environments for patients and families.

In general, it is imperative to argue that an individual’s health is managed through positive behavioral practices in promoting good health. In order to improve the health and well-being, there is a need to modify environmental factors to align them to patients’ physical, social, and spiritual desires. Environmental modification enhances the reduction of stress that may inhibit recovery. Therefore, the practice of nursing does not only involve care, but the understanding of factors that affect health and well-being.

Practice Specific Concepts Comment by MS: You need definitions from Morse’s theory, please read the suggestions below and rewrite this section. This will help you work on the Project 3.Project 3 will include a definition of each concept from Morse’s theory only, because it focus on ONE theory.

Besides the four meta-paradigms, it is essential to explore practice specific concepts as described by Morse’s theory. There are two important concepts of the Morse’s theory, these are enduring and emotional suffering (Swezey, 2017). To better enlighten the reader, this study analyzes the two concepts by Morse’s theory. Because of their direct relationship, the impact of these concepts on patients is overwhelming.

Enduring Comment by MS: Concept Synthesis/Analysis is exploring/clarifying the meaning of your concept to understand the foundation of theory development (Wills & McEwen, 2014) by identifying all theoretical definitions of each selected concept, including the definitions from your selected theory, dictionary, and other literature review. Note: For your final assignment (Project 3 – Nursing Theory Analysis), you will focus on the definitions of concepts based on your selected theory. You did a great job with exploring several meanings of this concept.However, please focus on the definition of this concept from Morse’s theory.Example, Emotional EnduringEnduring concept consists of attributes, or characteristics, that are common to all instances of enduring: (1) maintaining control of self, (2) living in the present moment, (3) removing oneself from the situation, and (4) being aware of the danger or consequences of emotional disintegration” (p.607). Enduring is coming from the Latin word “to last” and refers to the person’s ability to journey through a great physical or psychological condition and hold on to their self in the process (Morse & Carter, 1996). Merriam-Webster (2018b) defines enduring as lasting or durable. Enduring has various level of intensity. According to Morse (2001), people who are enduring are focused on the present, their body movements are robotic and expressionless in verbalization. Enduring phase is when a person perceives a threat or potential harm to self; this harm could be fear, pain or devastating illness (Foss & Naden, 2009). It is in the enduring phase that we can keep moving forward. Persons do often have emotional outbursts during the enduring phase, this is the escape of built up energy. The enduring behaviors are a normal response to allow for coping.

The concept of enduring has wide applicability in the health care arena. In view of Swezey (2017), enduring comprises three categories, namely enduring to survive, live, and die. According to Swezey (2017), enduring takes place in reaction to a threat that encompasses the integrity and comfort of an individual. Enduring can be explained as the containment of emotions (Merriam Webster Dictionary, 2018). In the patient context, Explore Dictionary (2018) defines enduring as a practice that entails bearing without resistance. The Cambridge Dictionary (2018) describes enduring as long lasting. The Urban Dictionary (2018) defines enduring as putting up with something. Nurses should therefore reduce the effects of patient endurance.

Based on the highlighted definitions, it is evident that enduring has an impact on patient wellness. More common is the fact that individual emotions are blocked, making it difficult to handle health care situations. Owing to the severity of emotions, patients are not relieved by keeping the emotions to themselves. When such threats are extremely severe, affected individuals tend to act like robots, with clear life disconnections. Therefore, Morse’s approach in relation to enduring would mean that patients become stable enough to focus their energy on remaining strong, regardless of existing conditions or illnesses (Swezey, 2017). In handling affected patients, nurses are demanding to exercise caution with the prospect of reducing existing levels.

Patients with effective, enduring practices exhibit reduced emotional eruptions. Those that have problems attaining endurance can apply destructive behaviors with the aim of curtailing their heavy minds. For instance, individuals are strongly advised to engage in physical exercises, participate in out of control laughing, and do puzzles to overcome endurance (Swezey, 2017). When feelings inside an individual are allowed to emerge, his/her endurance has interfered with, an outcome that leads to deep depression, incident sorrow, and sometimes anger. On their part, patients and their families are demanded to display practices that dispel enduring and emotional suffering, as a way of remaining healthier and well.

Emotional Suffering Comment by MS: Need a definition from Morse (your theorist).Example, Emotional Suffering According to Morse (2001), emotional suffering is the phase in which patients deal with the internal or external factor causing the distress and see there is hope and possibility beyond the despair, pain or tragedy (as cited in Butts, 2018). According to Merriam-Webster (2018) suffering is the endurance of pain, misery, and/or distress. Suffering is a phenomenon that can be seen both on the inside and outside, dependent on the context of the disease (Encarnacao, P., Costa Oliveira, C., & Martins, T., 2018). The person who is having the emotional suffering is sad and unhappy (Morse, 2001). Morse goes on to imply that those who are emotionally suffering recognizes true loss and change. Posture changes such as slumping, head down and looks of devastation can indicate that the person is going through emotional suffering. Moving from enduring to emotional suffering is not done until the person is able to accept their loss.

Emotional suffering is a consequence of enduring. The connection between enduring and emotional suffering reveals that an individual move from the former to the latter when situations become worse. The need for affected individuals to build emotional strength would therefore be critical. According to the Merriam Webster Dictionary (2018), emotional suffering is described as a state of unpleasant reaction that results in fury or humiliation. Emotional suffering is defined as the act of expressing or having strong feelings (Cambridge Dictionary, 2018). The Collins English Dictionary (2018) describes emotional suffering as a state of extreme pain, sorrow, or distress. According to the Vocabulary Dictionary (2018), an individual in emotional suffering is one in distress and trouble. It is observed that all the definitions barely mean the same thing; a state of distress. Comment by MS: Great job with exploring more meanings of this concept. Concept Synthesis/Analysis is exploring/clarifying the meaning of your concept to understand the foundation of theory development (Wills & McEwen, 2014) by identifying all theoretical definitions of each selected concept, including the definitions from your selected theory, dictionary, and other literature review. Note: For your final assignment (Project 3 – Nursing Theory Analysis), you will focus on the definitions of concepts based on your selected theory.

These definitions highlight the need for patients to overcome emotional suffering. In whatever situation patients find themselves in, it is important that they find ways that dispel any form of emotional suffering. In relation to Morse’s theory, caregivers have the responsibility of managing emotional suffering in patients. They can achieve this through guidance and counseling regimes that manage emotional stress. The ability for nurses to engage affected patients would yield positive outcomes, hence general wellness for affected persons. According to Swezey (2017), ‘the reformed self’ is congruent to tackling emotional suffering. Understanding the concept of emotional suffering helps nurse practitioners develop the ability to engage in self-regulation measures that restore emotional comfort. The need for patients to practice stress handling regimes would help in improving their status with the prospect of wellness and comfort at hand.

Proposition Statements Comment by MS: These assumptions should be address by Morse (theorist) not by other authors, unless they cited Morse’s works. If Swezey (2017) cited Morse’s works, the citation for a secondary source should be (as cited in Swezey, 2017). Swezey wrote this section for school of nursing, not an author of the reliable book. Example,an assumption of suffering that is seen in healthcare and in everyday society is that physical pain. It is the cause of suffering. If pain is reduced, suffering will be reduced as well (Morse, 2001). Sufficient and reliable sources will help you write a good paper. Please get Morse’s publications below: (posted in your reference section)

In professional nursing practice, attaining endurance and emotional suffering are fundamental issues. According to Swezey (2017), these are the concepts that guide the nursing practice, the values and beliefs that underpin health care delivery, and the assumptions carried by nurses in demonstrating progress. They therefore form the basis of the concepts as displayed by Morse. The need for nurse practitioners to adhere to these assumptions would be essential during practice. In a bid to regulate endurance and emotional suffering, professional nurses should be guided by these assumptions:

1. A person is worthy of respect. This assumption coincides with the principle of equity in nursing, where all patients are viewed as equal. As such, every patient should be treated with the necessary care, respect, and consideration as any other patient (Zarzycka, Ślusarska, Dobrowolska, Deluga, Trojanowska, & Bartoń, 2016).

2. The patient wants to be a part of the healthcare planning process. This assumption is useful in ensuring willingness by the nurse to offer care to individual patients, as a willing recipient of healthcare. (Bryant-Lukosius et al., 2016)

3. The patient has the liberty to make decisions about his/her health and well being. As part of the concept in health and health promotion, every patient should be permitted to make own decisions and that given a choice should be considered in health and wellbeing.

4. The environment plays vital roles in the health of a person and can be modified to attain better health outcomes.

5. Promotion of health prevents emotional distress in individuals. The promotion of health is regarded as a significant undertaking that prevents emotional distress in connection to the concept of endurance (Bryant-Lukosius et al., 2016). The notion that preventive measures are more likely to be successful and effective than curative ones best explains this assertion.

Clinical Example

Sometime back, I was assigned to handle a 45-year-old female patient. She was suffering from a mental illness. Clearly, this patient could not pay attention, and her emotional stress was overwhelming. My role in stabilizing this patient was critical. It is notable that I tried to talk to her in a gentle way with the aim of calming her emotions. In line with Morse’s concepts, I gave her the freedom to express herself as she was part of the healing process. From her confession, I realized that she lacked a serene environment to calm her emotions. After giving her medication, I ensured that she fully relaxed in a bid to stabilize her unsettled mind. In the end, her wellness and comfort were restored. When she left for home, I reiterated the need for her to make peace with everybody as a way of handling enduring and emotional suffering. It is critical that the patient recorded immense improvements in a span of two weeks. Notably, her level of emotional comfort had risen steadily. Comment by MS: Great job with a case example.Please study conceptual framework below to help you understand how to apply Morse’s concept to patient care.Escape from enduring, recognition (see below), and awareness are relevant to enduring concept. Please review the article below:Tetrault, A., & Nyback, M. (2010). Supporting the Suffering Patient in the Stage of Enduring- A Theoretical Reflection on Suffering as an Essential Part of Nursing. Retrieved November 5, 2016, from https://www.novia.fi/assets/filer/Publikationer/Serie-A-Artiklar/Supporting-the-suffering-patient_1.2010.pdf Comment by MS: Good job with nursing practice. Example, As described by Morse (2001) that enough suffering helps to reformulate a person and to set goals to achieve an enhancement learned through the suffering (Georges, 2002). Nurses incorporate along with family members to provide them support and recognize the level of suffering of a family member. Empathy, listening, and talking are some of the strategic forms that can be offered during the stage of suffering (Tetrault & Nyback, 2010).

Conclusion

A personal nursing philosophy necessitates effective healthcare approaches. Accordingly, the paper addresses a personal autobiography in connection with Morse’s concepts of enduring and suffering. As revealed in the study, the four meta-paradigms of nursing, namely person, health, nursing, and environment, are essential in attaining patient comfort and wellness. The paper further analyzes the two concepts as highlighted in Morse’s theory. The study equally analyzes five preposition statements as displayed by Morse’s theory of suffering. Essentially, nurses who apply the identified concepts within the four meta-paradigms in personal philosophies attain positive outcomes.

Please get Morse’s publications below and get other reliable and relevant sources.

Please study and add the following figure in your Project 3;

References Comment by MS: You need to have at least ONE primary source (Morse’s works)

Bryant-Lukosius, D., Spichiger, E., Martin, J., Stoll, H., Kellerhals, S. D., Fliedner, M. De Geest, S. (2016). Framework for evaluating the impact of advanced practice nursing roles. Journal of Nursing Scholarship48(2), 201-209. doi:10.1111/jnu.12199.

Cambridge Dictionary. (2018). Retrieved from, https://dictionary.cambridge.org

Collins English Dictionary. (2018). Retrieved from, https://www.collinsdictionary.com/dictionary/english

Grace, P.J.. (2017). Nursing ethics and professional responsibility in advanced practice.3rd ed.Boston, MA: Jones & Bartlett Learning.

Merriam Webster Dictionary. (2018). Retrieved from, https://www.meriam- webster.com/dictionary

Parahoo, K. (2014). Nursing research: Principles, process and issues. 3rd ed. London: Macmillan International Higher Education.

Shams, A., Bahmanziari, N., Kordi, A., & Pourentezari, M. (2013). Patient’s satisfaction and their problems in emergency department of Alzahra hospital. Journal of Health- System Research, 112.

Swezey, N. L. (2017). A Nurse’s Perspective on Janice Morse’s Praxis Theory of Suffering – CUNY Academic Commons. Retrieved from Hunter Bellevue School of Nursing website: https://commons.gc.cuny.edu/papers/60044/

Urban Dictionary. (2018). Retrieved from, https://www.urbandictionary.com

Van Graan, A. C., Martha, J., & Williams, M. P. (2016). Clinical judgement within the South African clinical nursing environment: A concept analysis. Journal Home, 21(1), http://dx.doi.org/10.4102/hsag.v21i0.932

Vocabulary Dictionary. (2018). Retrieved from, https://www.vocubulary.com/dictionary

Zarzycka, D., Ślusarska, B., Dobrowolska, B., Deluga, A., Trojanowska, A., & Bartoń, E. (2016). Empathy in nursing. Assumptions, practice and its empirical determinants. Pielegniarstwo XXI Wieku / Nursing in the 21st Century15(3), 33-38. doi:10.1515/pielxxiw-2016-0026.