| Course | NR 501 Theoretical Basis for Advanced Nursing Practice |
|---|---|
| Week | 5 |
| Paper type | Theory application write-up |
| Length | About 1,320 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NR 501 Week 5
Reed's Self-Transcendence Theory Applied to One Admission: A Woman With Pancreatic Cancer and a Bowel Obstruction, the Questions the Theory Made Me Ask, and What It Could Not See
Student Name
College of Nursing, Chamberlain University
NR 501: Theoretical Basis for Advanced Nursing Practice
Instructor Name
Month Day, Year
Reed's Self-Transcendence Theory Applied to One Admission: A Woman With Pancreatic Cancer and a Bowel Obstruction, the Questions the Theory Made Me Ask, and What It Could Not See
The Situation, Compressed
The situation took place on the inpatient oncology unit where I work. Details have been changed to protect privacy. Ms. L., a 54-year-old office manager with pancreatic cancer that had spread to her liver, was admitted with a malignant bowel obstruction. Over five days, the team placed a venting gastric tube, controlled her pain and nausea, and held a family meeting at which she chose to stop chemotherapy and go home with hospice. She had been divorced two years earlier, lived alone, and had one daughter, 26, who was working in Germany and arrived on day four. Ms. L. was discharged home on day six with her daughter staying with her.
This paper takes the current chapter version of Reed's self-transcendence theory (Reed, 2023) and applies it to those five days. It is arranged by the theory's concepts rather than by the days, and it records the questions each concept led me to ask, the concept that turned out to be thin, and what happened that the theory did not help me see.
Vulnerability
In Reed's theory, vulnerability is a person's awareness of their own mortality or limits, and it is proposed as the condition that can call forth self-transcendence (Reed, 2023). The evidence of vulnerability in Ms. L.'s admission was plain and came early. On the first night, she told me that she had known since the obstruction started that "this is the beginning of the end." On day two, she asked her oncologist directly how long she had, and heard that it was likely weeks.
The question this concept produced was not whether she was vulnerable, which was obvious, but whether her awareness was something she could use or something that was overwhelming her. I asked her on day two what had been hardest about hearing the news. She said it was not dying but dying alone, before her daughter could come. That answer shifted my attention from her fear of death to her relationships, which is where the next concept operates.
Self-Transcendence, Looked for in Two Directions
Reed describes self-transcendence as an expansion of the self's boundaries in several directions. Because the evidence reviewed in Week 4 suggests that the inward and outward directions may behave separately (Haugan et al., 2013), I looked for each.
Outward. Evidence of outward expansion was strong. On day three, Ms. L. asked me to help her call her former husband, with whom she had not spoken since the divorce, to tell him about her illness and ask him to support their daughter afterward. She also asked a chaplain to help her write a note to her sister. The question the concept produced here was practical: what could I do to make those contacts possible? I arranged a quiet time for the call, held her phone while she talked because her hands were weak, and made sure the gastric tube suction was quiet. Coward (1990) found that women with advanced breast cancer described reaching out to others and letting others help them as part of the same experience; Ms. L. did both in the same afternoon.
Inward. Evidence of inward expansion was harder to find, and I did not find much. When I asked Ms. L. what mattered most to her now, she spoke only of her daughter. When I asked about herself, she changed the subject. I could not tell whether her values had shifted or whether she was holding off her own feelings by caring for others. The theory told me to look, and looking produced a question I could not answer in five days.
Well-Being: The Thin Heading
Well-being in the theory is a sense of wholeness and health in the person's own terms. It is the outcome the theory predicts self-transcendence will be associated with. On this admission, well-being is the heading with the least under it, and I have left it thin rather than filling it with guesses.
What I observed was limited. On day four, when her daughter arrived, Ms. L. cried and then slept for six hours without extra medication, the longest she had slept since admission. On day five she told the social worker she felt "ready." Those are suggestive. But I never asked her directly how she was, in the sense the theory means, and her physical symptoms, her medications and her daughter's arrival changed on the same days, so I cannot say which, if any, of them was linked to how she felt. The theory proposes a relationship between self-transcendence and well-being; this admission cannot show whether it held.
Moderating Factors
The theory proposes that personal and contextual factors can strengthen or weaken the relationship between vulnerability, self-transcendence and well-being. Two such factors were visible. Ms. L.'s physical symptoms were the most obvious: on day one, with uncontrolled nausea and pain, she could not have made the phone call she made on day three. Symptom control came first and made the rest possible. The second was the hospital environment. The unit had one family room, often in use, and visiting was limited after 2100. Her call to her former husband happened in her room, with a roommate behind the curtain. The theory names such factors, but it does not rank them, and in practice the physical ones had to be handled before anything else could happen.
The Residue
Two things happened that the theory did not help me see. The first was a conflict between Ms. L. and her daughter on day five about going home. The daughter wanted her to stay in the hospital, where she felt it was safer, and Ms. L. wanted to die at home. The theory describes the patient's inner and outer expansion, but it has little to say about a family member whose needs pull against the patient's. The social worker, using a family-systems approach, handled that conversation, and she, not the theory, found the way through.
The second was practical: the insurance authorization for the home hospice equipment. It took most of day five, it frightened Ms. L. more than anything else that week, and no nursing theory I have studied would have predicted it or helped with it. It belongs in the account because a theory that seemed to explain the whole admission would be claiming too much.
Against a Plain Account
The last test is whether the theory added anything a competent nurse would not have done anyway. Much of what I did, controlling symptoms, making space for a phone call, involving the chaplain, is ordinary good nursing, and a plain account of the admission would include it without mentioning Reed at all.
The theory added two things. It made me treat Ms. L.'s wish to call her former husband as a central part of her care rather than as a personal errand to fit in around the medical plan, and it made me look for inward change separately from outward, which is why I noticed that I could not find it. Without the theory, I would have recorded that she "coped well" and "reconnected with family." With it, I recorded that her outward connections expanded, that her inward state was unclear, and that the question of her well-being was never asked in her own terms. That is a narrower record and a more honest one, and it points to the thing I would do differently: ask her, early and directly, how she herself was.
References
Coward, D. D. (1990). The lived experience of self-transcendence in women with advanced breast cancer. Nursing Science Quarterly, 3(4), 162-169. https://doi.org/10.1177/089431849000300408
Haugan, G., Rannestad, T., Hammervold, R., Garåsen, H., & Espnes, G. A. (2013). Self-transcendence in cognitively intact nursing-home patients: A resource for well-being. Journal of Advanced Nursing, 69(5), 1147-1160. https://doi.org/10.1111/j.1365-2648.2012.06106.x
Reed, P. G. (2023). Theory of self-transcendence. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (5th ed.). Springer Publishing. https://doi.org/10.1891/9780826139276.0007
The Chamberlain NR 501 Week 5 instructions
The Week 5 write-up has you apply your chosen theory to a situation from practice. Required parts tend to be a brief description of the situation, analysis through the theory's concepts, what the theory helped you see or do, what it missed and APA. Compress the situation to the facts the analysis needs, with details changed. Arrange the paper by the theory's concepts, with evidence and the question each concept prompted. Look for each concept in the situation rather than assuming it is present. Say plainly when a heading comes up thin. Name what the theory did not help you see. Finish by asking whether the theory added anything a competent nurse would not have done anyway.
Inside the NR 501 Week 5 example
The situation section introduces Ms. L., an office manager with pancreatic cancer admitted with a bowel obstruction, over five days. The vulnerability section asks whether her awareness of dying was something she could use. The self-transcendence section looks outward, finding the day three call to her former husband and a note to her sister, and inward, finding that she spoke only of her daughter when asked what mattered. The well-being section reports limited evidence, such as six hours of sleep after her daughter arrived. Moderating factors include symptom burden. The residue section names the conflict about going home and the hospice equipment authorization. The last section credits the theory with two changes in care and admits much would have happened anyway.
Where the points sit in the NR 501 Week 5 rubric
Theory application rubrics in NR 501 usually score a clear situation, accurate use of theory concepts, evidence for each concept, insight about what the theory added, honesty about its limits and APA. Honesty about limits is the row that most distinguishes strong applications, and this paper meets it with a named residue and a test against a plain account. The situation is credited for being compressed with details changed. Concepts score because each heads a section with evidence. Insight earns points because the theory changed two specific things. The thin well-being heading shows careful reading. Coward and Haugan and colleagues connect the application to the Week 4 review. Three references complete APA.
Common NR 501 Week 5 mistakes, and how to avoid them
Applications in which the theory explains every detail are the weakest, because a framework that finds a home for everything has become a way of speaking rather than a tool. Another loss is retelling the situation at length, leaving little room for analysis. Students also assume each concept is present without evidence, ignore what the theory missed or claim the theory caused care that would have happened anyway. If the theory clearly does not fit once you start writing, say so and explain why; that is a finding. Some sections supply a situation, which works the same way. Send your situation and an NR 501 application can be arranged by your theory's concepts.
Get a NR 501 Week 5 example written to your instructions
Send the Week 5 instructions and the rubric, name the theory you committed to, and describe the situation you want used. A custom write-up built to those requirements returns inside 24 to 48 hours and the first is free. Keep your description general when you send it: a patient's own words, and anything your employer holds internally, stay with you.
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NR 501 Week 5 questions, answered
How much of the situation belongs in the paper?
Only the parts a concept will reach, plus enough context that a reader can follow the events. Most drafts arrive with three pages of narrative and one page of application, and the marks are arranged the other way around. A useful discipline is to write the concept headings first, then admit only the details that have somewhere to sit underneath them.
What if the theory clearly does not fit once I start writing?
Report it and carry on. A write-up ending with a precise account of where the theory failed to reach beats one that bends the situation to keep the fit tidy, and instructors read the bend easily. Name the concept that came up empty and the element of the situation nothing accounted for, then say what a better suited theory would have needed to contain.
Can the situation be one my section supplies?
Yes, and some classrooms prefer it, since a shared case lets an instructor compare applications side by side. The work does not change: concepts still supply the headings, the residue still gets its section, and the closing comparison still runs. Where the case is supplied, the write-up gains a sentence saying which details in it the theory never used.
Where can I find a free NR 501 Week 5 sample paper?
The complete Week 5 application of Reed's theory to Ms. L.'s admission, with each concept, the residue the theory missed, the plain-account test and three references, appears on this page.
What did the theory miss in the NR 501 Week 5 application?
A conflict between Ms. L. and her daughter about going home, and the insurance authorization for hospice equipment, which frightened her more than anything else that week.