Contributor: Lyn Durnell

Enlightenment on what makes us think and act the way we do leads to self-discovery into what perhaps was ingrained in us as children. As a young girl, I remember my mom teaching me the importance of how to properly carry myself. My mom told me to never talk about myself to other people, rather just let other people talk about themselves. She was always aware of how she presented herself to others and always wanted to appear strong and perfect. It took me a long time to realize that my mom was trying to protect herself by building this protective wall around her, but instead it prevented her from forming close connections and happiness. It has been six months since my mom died following months of confusion, depression, anxiety which led to a tragic fall. As I reflect on the last few years of my mom’s life, I am discovering how her life could have been enhanced and more fulfilled if she had expressed to people her emotional pain, including her doctors and nurses. During my grieving process and looking back on my mom’s struggles, I was reminded of Pamela Reed’s theory of self-transcendence and the importance of a person’s ability to achieve well-being through the stages of life. There are people, such as the case with my mom, that need help in achieving this level of transcendence.

Pamela Reed’s middle range nursing theory defines self-transcendence as a person’s ability to expand self-boundaries to connect with themselves, others, and their environment (Khait, Sabo, & Shellman, 2020). Self-transcendence is a developmental theory as a person moves from one stage of life to another and experiences life events (Fiske, 2019). Vulnerability is a key concept in Reed’s theory of self-transcendence as it is defined as being aware of one’s mortality or when experiencing difficult life events. These concepts of transcendence by expansion of our personal boundaries in ways to enhance a sense of well-being are important for people to achieve to move through what Reed calls the process of innovative change necessary throughout our lives. The capacity to expand boundaries depends on the individual and their circumstances. My mom was unable to adapt to aging which could be in part to fear, lack of vulnerability, anxiety, and depression.

The components of the self-transcendence theory resonate as I watched my mom being unable to achieve well-being and peace in her life. She was loved by her family and reminded she was worthy, but she was unable to connect with herself, others, and the world around her. This inability to transcend and expand her personal boundaries and lack of vulnerability prevented her from working successfully through the stages of life. My mom was unable to release her past and through the years she continued to succumb to depression and anxiety as she held on to unhealthy memories and self-limiting beliefs. As she entered her older years, she felt invisible and even near her death she expressed her lack of purpose in life. It is a tragic story yet one we can learn from as nurses. My mom put her faith in doctors and nurses, which were multiple missed opportunities for intervention. Her healthcare providers focused on prescribing medications to numb her complaints of chronic pain. Probing questions to delve deeper into my mom’s problems could have at minimum made her feel seen and heard.

Reed speaks of expanding boundaries by connecting with oneself, others, the community, and to a spiritual higher being. Nurses can help facilitate this by providing and encouraging resources including meditation, support groups, and connecting with nature. Spiritual connection can be what the individual believes in and refers to seeing that there is a power higher than ourselves. Transpersonal relates to finding purpose and a spiritual connection. In a meta-analysis among older adults, the most important aspect for older adults was being able to talk about what was on their mind (Haugan et al., 2022). My mom lacked social connections and retreated into self-imposed isolation. Besides her family, the only connections my mom had were with her healthcare providers.

Nurses can impact patient outcomes by taking a holistic view when talking to their patients by asking questions that allow a patient to be vulnerable. The theory of self-transcendence reminds me of a quote by Henry Miller: “One’s destination is never a place, but a new way of seeing things.” This is a powerful reminder that achieving overall well-being requires the ability to navigate the changes throughout life and acquire coping mechanisms to shift your mindset to a positive realm. Nurses that are aware of this for themselves and for their patients can help facilitate their patient’s journey when this adaptation is difficult for the patient to achieve on their own.

References

Fiske, E. (2019). Self-Transcendence Theory and Contemplative Practices. Holistic Nursing Practice, 33(5), 266-272. https://doi.org/10.1097/HNP.0000000000000340

Haugan, G., Demirci, A.D., Kabukcuoglu, K., & Aune, I. (2022). Self-transcendence among adults 65 years and older: A meta-analysis. Scandinavian Journal of Caring Sciences, 36, 3-15. https://doi.org/10.1111/scs.12959

Khait, A.A., Sabo, K., & Shellman, J. (2020). Analysis and Evaluation of Reed’s Theory of Self-Transcendence. Research and Theory for Nursing Practice: An International Journal, 34(2), 170-187. https://doi.org/10.1891/RTNP-D-19-00015
Miller, H. (1957). Big Sur and the Oranges of Hieronymus Bosch. New Directions.

About Lyn Durnell

Lyn Durnell MSN, RN is a PhD student at Texas Woman’s University in Houston, Texas. Her area of focus is on women’s health and gender ageism. She currently works in access and reimbursement as a patient advocate to ensure health equity for all patients. She is an advocate for change and the impact nurse engagement with patients can have on patient outcomes.