Clinical Practice and Nursing

Pamel Reeds Theory of Self-Transcendence

Self-transcendence refers to the ability of a human being to find meaning by being drawn towards someone or something other than themselves. The theory finds its roots from Rogers' Theory of Unitary Beings (Reed, 2009, p.397). The theory puts forth four ways in which self transcendence can be accomplished. The four ways are intrapersonal, transpersonal, interpersonal and temporal (Palmer, Quinn, Palmer, & Fitzpatrick, 2010).

Aim of the theory

The aim of the theory is to provide nurses with a framework for practice and inquiry as pertains to the promotion of well-beings amidst complicated life situations.

Concept

Self -- transcendence: Reed theorizes that people who face life-threatening situations may experience an unusually expanded awareness of their environment and that self-transcendence can be expressed through their behaviors, ideas and perspectives. They become more accepting of death, let go of loss and are open to finding spiritual meaning (Haugan, Rannestad, Garasen, & Espnes, 2011).

Well being: Reed refers to well being as having a sense of wholeness and health as pertains to the one's standards on health and wholeness (Haugan, Rannestad, Garasen & Espenes, 2011).

Vulnerability: Refers to an individual's awareness of their own mortality and their experience of trying events.

Attributes

Caring Presence: Is about the idea of being touching, caring, available and being able to lend spiritual and emotional support (Kliewer 2004).

Search for meaning and purpose: searches for life's ontological significance (Villagomeza 2005).

Transcendence: Involves going beyond one's limitations to gain a greater understanding of the universe and oneself. Transcendence is one of the ways one can experience the world (Armstrong, 2008). Patients may become aware of a higher power and seek intervention through faith (Touchy et al. 2005).

Harmonious interconnectedness: Can be manifest in having a healthy relationship with God, the environment and self.

Model Case

Nurse A takes of a middle-aged patient named John in a neurological unit. John was involved in an accident. Nurse A expresses love, kindness, compassion and hope to her patients. She respects their values and beliefs and attends to their spiritual needs. On a certain day, Nurse A notices that John seems to be anxious and restless despite the medical and physical attention he is receiving. She makes the patient comfortable and offers him a warm cup of milk. John begins to share his feelings about his life and the guilt he has about his drinking habits which led to the accident.

Nurse A commits to continue their discussion and offers that they pray together when he is willing to do so. John seems to be disconnected with God, others and himself. Nurse A offers a listening ear and offers to discuss the spiritual issues that come up.

This is a model case of the attributes the author identifies.

Related Case

Nurse B. appreciates that besides physical needs, the patient has spiritual needs. Nevertheless, she doesn't feel comfortable addressing the spiritual needs. She invites a pastoral counselor to help. The nurse leaves the patient with the counselor and continues with her other duties. The pastoral counselor does not arrive until 4 hours later because he was engaged in the other units. By the time counselor arrives, the patient is now withdrawn and distraught.

Contrary Case

In a case similar to John's, Nurse C. does not spare time to attend to the patient's spiritual needs in any way. Her belief is that she is too busy to attend to such needs when there are more urgent things begging for her attention. To her, spiritual needs are best attended to in a church and not a medical setting.

Antecedents

• Spiritual discomfort calls for giving of spiritual care and not just physical care.