Running head: CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 1 CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 10 Concept Synthesis Paper: Personal Nursing Philosophy Yordanka Milanes South University 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. 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. Nursing Meta-paradigms in Morse’s Theory o.

1. Running head: CONCEPT SYNTHESIS PAPER: PERSONAL
NURSING PHILOSOPHY 1
CONCEPT SYNTHESIS PAPER: PERSONAL NURSING
PHILOSOPHY 10
Concept Synthesis Paper: Personal Nursing Philosophy
Yordanka Milanes
South University
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

2. 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.
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

3. 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.
Nursing Meta-paradigms in Morse’s Theory of Suffering
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.
Health
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

4. 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
Environmental comprises external and internal factors that
surround a patient. It is the general characteristic through which

5. 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
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
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

6. 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
Emotional suffering is a consequence of enduring. The

7. 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.
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
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

8. 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

9. 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.
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.
References
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 Scholarship, 48(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

10. & 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
Century, 15(3), 33-38. doi:10.1515/pielxxiw-2016-0026.
Running head: CONCEPT SYNTHESIS PAPER: PERSONAL
NURSING PHILOSOPHY 1
CONCEPT SYNTHESIS PAPER: PERSONAL NURSING
PHILOSOPHY 10
Comment by MS: Correct APA format.Good job.

11. 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

12. 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

13. 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

14. 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.

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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 Scholarship, 48(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.

24. (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
Century, 15(3), 33-38. doi:10.1515/pielxxiw-2016-0026.
Sheet1Grading for this assignment will be based on answer
quality, logic/organization of the paper, and language and
writing skills, using the following rubric.Points: 70Assignment
4:
PresentationCriteriaUnacceptableFairProficientExemplaryBelow
70% F70-79% C80-89% B90-100% A1. Create a 12-slide
presentation. Follow the outline on pp. 343–346 for the critical
slides of your presentation and their placement.Did not submit
or incompletely created a 12-slide presentation. Did not submit
or incompletely followed the outline on pp. 343–346 for the
critical slides of your presentation and their placement.Partially
created a 12-slide presentation. Partially followed the outline on
pp. 343–346 for the critical slides of your presentation and their
placement.Satisfactorily created a 12-slide presentation.

25. Satisfactorily followed the outline on pp. 343–346 for the
critical slides of your presentation and their
placement.Thoroughly created a 12-slide presentation.
Thoroughly followed the outline on pp. 343–346 for the critical
slides of your presentation and their placement.Weight: 70%2.
Clarity, writing mechanics, and formatting requirementsMore
than 6 errors present5-6 errors present3-4 errors present0-2
errors presentWeight: 20%3. 3 ReferencesNo references
provided.Does not meet the required number of references;
some or all references poor quality choices.Meets number of
required references; all references high quality choices.Exceeds
number of required references; all references high quality
choices.Weight: 10%Weight: 7%1e. Revise the Competition
section based on the feedback you have received.Did not submit
or incompletely revised the Competition section based on the
feedback you have received.Partially revised the Competition
section based on the feedback you have received.Satisfactorily
revised the Competition section based on the feedback you have
received.Thoroughly revised the Competition section based on
the feedback you have received.Weight: 7%1f. Revise the
Marketing Plan & Sales Strategy section based on the feedback
you have received.Did not submit or incompletely revised the
Marketing Plan & Sales Strategy section based on the feedback
you have received.Partially revised the Marketing Plan & Sales
Strategy section based on the feedback you have
received.Satisfactorily revised the Marketing Plan & Sales
Strategy section based on the feedback you have
received.Thoroughly revised the Marketing Plan & Sales
Strategy section based on the feedback you have
received.Weight: 7%2a. Describe the ways in which your
company is committed to being a good corporate citizen.Did not
submit or incompletely described the ways in which your
company is committed to being a good corporate
citizen.Partially described the ways in which your company is
committed to being a good corporate citizen.Satisfactorily
described the ways in which your company is committed to

26. being a good corporate citizen.Thoroughly described the ways
in which your company is committed to being a good corporate
citizen.Weight: 7%2b. Discuss how your company’s activities
will affect the environment and identify the steps you will take
to mitigate any negative impacts.Did not submit or
incompletely discussed how your company’s activities will
affect the environment and did not submit or incompletely
identified the steps you will take to mitigate any negative
impacts.Partially discussed how your company’s activities will
affect the environment and did not submit or incompletely
identified the steps you will take to mitigate any negative
impacts.Satisfactorily discussed how your company’s activities
will affect the environment and did not submit or incompletely
identified the steps you will take to mitigate any negative
impacts.Thoroughly discussed how your company’s activities
will affect the environment and did not submit or incompletely
identified the steps you will take to mitigate any negative
impacts.Weight: 7%2c. Determine any health issues / claims
related to the product you are making, whether negative or
positive. Suggest the strategy your company will use to mitigate
any negative issues, and to ensure any positive claims are
true.Did not submit or incompletely determined any health
issues / claims related to the product you are making, whether
negative or positive. Did not submit or incompletely suggested
the strategy your company will use to mitigate any negative
issues, and to ensure any positive claims are true.Partially
determined any health issues / claims related to the product you
are making, whether negative or positive. Partially suggested
the strategy your company will use to mitigate any negative
issues, and to ensure any positive claims are true.Satisfactorily
determined any health issues / claims related to the product you
are making, whether negative or positive. Satisfactorily
suggested the strategy your company will use to mitigate any
negative issues, and to ensure any positive claims are
true.Thoroughly determined any health issues / claims related to
the product you are making, whether negative or positive.

27. Thoroughly suggested the strategy your company will use to
mitigate any negative issues, and to ensure any positive claims
are true.Weight: 7%2d. Suggest your company’s plan, through
advertising, distribution, and / or other methods, to target and
reach only appropriate market segments.Did not submit or
incompletely suggested your company’s plan, through
advertising, distribution, and / or other methods, to target and
reach only appropriate market segments.Partially suggested
your company’s plan, through advertising, distribution, and / or
other methods, to target and reach only appropriate market
segments..Satisfactorily suggested your company’s plan,
through advertising, distribution, and / or other methods, to
target and reach only appropriate market segments.Thoroughly
suggested your company’s plan, through advertising,
distribution, and / or other methods, to target and reach only
appropriate market segments.Weight: 7%3. Clarity, writing
mechanics, and formatting requirementsMore than 6 errors
present5-6 errors present3-4 errors present0-2 errors
presentWeight: 15%4. For year one, revise and submit the
Income Statement, Cash Flow Projections, and Balance Sheet
sections from the “Business Plan Financials” MS Excel template
(see: Course Required Files in Week 1).Did not submit or
incompletely, for year one, revised and submitted the Income
Statement, Cash Flow Projections, and Balance Sheet sections
from the “Business Plan Financials” MS Excel template (see:
Course Required Files in Week 1).Partially, for year one,
revised and submitted the Income Statement, Cash Flow
Projections, and Balance Sheet sections from the “Business Plan
Financials” MS Excel template (see: Course Required Files in
Week 1).Satisfactorily, for year one, revised and submitted the
Income Statement, Cash Flow Projections, and Balance Sheet
sections from the “Business Plan Financials” MS Excel template
(see: Course Required Files in Week 1).Thoroughly, for year
one, revised and submitted the Income Statement, Cash Flow
Projections, and Balance Sheet sections from the “Business Plan
Financials” MS Excel template (see: Course Required Files in

28. Week 1).Weight: 15%
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