N491 Module 7 assignment: Parse human becoming hospice case paper, a full sample

Reviewed by Maren Hollowell, MSN, RN Aspen University True APA form Annotated

A complete N491 Module 7 example in true APA form: a paper applying Parse's human becoming theory to a composite home hospice case, a mother who is ready to die and a son who is not, showing illuminating meaning, synchronizing rhythms and mobilizing transcendence, the nurse's characteristics, implementation challenges and integration with Watson. Margin notes show where each section earns its marks.

1

"I'm Ready, but He Isn't": Parse's Human Becoming Theory in the Home Hospice Care of a Mother and Her Son

Student Name

RN to BSN Program, Aspen University

N491: Concepts and Theories in Nursing

Instructor Name

Month Day, Year

What this page is doingOpening the title with the patient's own words is appropriate for Parse, whose theory centers the person's meaning rather than the nurse's assessment. The rest of the title names the theory, the setting and the fact that the case involves a family, which the transcendence section will depend on. APA 7 student title page.
2

"I'm Ready, but He Isn't": Parse's Human Becoming Theory in the Home Hospice Care of a Mother and Her Son

Most nursing theories ask the nurse to assess a problem and act on it. Rosemarie Rizzo Parse's human becoming theory asks something different: that the nurse be truly present with a person as that person lives the meaning of a situation and chooses a way forward. At the end of life, when many problems cannot be solved, that shift in purpose matters. This paper applies Parse's theory to a composite home hospice case, describes the characteristics the nurse needs to practice it, examines the challenges of implementation, explains how the nurse can support movement toward transcendence, and integrates the theory with Watson's theory of human caring.

What this page is doingThe introduction immediately distinguishes Parse from problem-solving theories, which is the single most important thing to get right about her work. It then lists the five required elements in the order they appear, so the grader can check each off.
3

The Human Becoming Theory

Parse describes the human being as indivisible, unpredictable, and ever-changing, and health as a process of becoming that the person lives according to personal values (Parse, 1998). Three principles organize the theory. The first concerns meaning: people structure the meaning of their situations through language and choices. The second concerns rhythmicity: people live paradoxical patterns, such as revealing and concealing, or connecting and separating, at the same time. The third concerns transcendence: people move beyond the present moment toward possibilities they choose.

Parse translated those principles into three dimensions of practice: illuminating meaning, synchronizing rhythms, and mobilizing transcendence. The nurse practices them through true presence, a way of being with the person that follows the person's lead, without judgment, and without an agenda to change the person (Parse, 1997). The goal of nursing, in Parse's terms, is quality of life from the person's own perspective, not an outcome defined by the nurse.

What this page is doingThe theory is explained through its three principles and the three matching practice dimensions, with true presence identified as the method. Linking each principle to its practice dimension shows understanding of the theory's structure, which is where many papers on Parse lose marks by listing terms without connecting them.
4

The Case

Mrs. H. is a composite patient created for this paper: a 79-year-old retired bookkeeper with metastatic pancreatic cancer receiving hospice care in her own home. She lives with her son, Daniel, 52, who moved back to care for her. Her pain is controlled with long-acting and breakthrough opioids, and she is sleeping more each day. During a visit, while Daniel is in the kitchen, she tells the hospice nurse, "I'm ready, but he isn't. He keeps bringing me smoothies and telling me I need my strength." Later, Daniel asks the nurse privately whether a feeding tube would help his mother get stronger.

What this page is doingThe case is short and centered on a conflict of meanings, not a clinical problem to fix. That is the right kind of case for Parse, because it gives the nurse something to illuminate rather than something to correct. The composite label comes first.
5

Actualizing the Theory With Mrs. H. and Her Son

Illuminating meaning begins with the nurse's response to Mrs. H.'s statement. Rather than moving straight to reassurance or to a plan for talking with Daniel, the nurse invites her to say more: "Tell me what being ready means for you." Mrs. H. explains that she has made her peace, said what she wanted to say to her friends, and is tired of pretending to eat for her son's sake. Speaking it aloud clarifies the meaning for her, which is the purpose of the conversation.

Synchronizing rhythms means staying with the paradox she is living: she wants to let go and she wants to stay close to her son, and she conceals her readiness from him because revealing it feels like abandoning him. The nurse does not resolve the paradox for her but reflects it back, and Mrs. H. says that she wants to tell Daniel herself but does not know how to start.

The nurse practices the same presence with Daniel. When he asks about a feeding tube, the nurse answers the factual question honestly, that artificial nutrition does not usually extend life or add strength at this stage of advanced cancer and can cause discomfort, and then asks what the smoothies mean to him. He says they are the one thing he can still do for her. The feeding tube question was never about nutrition; it was about a son looking for a way to keep caring.

What this page is doingEach of Parse's three practice dimensions appears in order with concrete dialogue, and the nurse's restraint is shown rather than described. The factual answer about artificial nutrition is included because true presence does not mean withholding information when asked; the highlighted sentence is the insight that true presence produced.
6

Characteristics of the Nurse

Practicing human becoming asks specific qualities of the nurse. The nurse must be able to tolerate silence and uncertainty, because the theory does not provide a problem list or a standard intervention. The nurse must set aside the urge to fix, including the professional urge to steer Mrs. H. and her son toward a planned family meeting. And the nurse must genuinely believe that the person is the authority on her own life, which means accepting choices the nurse would not make. Parse (1998) describes this as a way of being, not a technique, and it depends on the nurse's own reflection and self-knowledge as much as on skill.

What this page is doingThe nurse characteristics are specific to Parse and are drawn from the case: tolerating uncertainty, setting aside the urge to fix, respecting the person's authority. Tying them to what the nurse did and did not do with Mrs. H. makes the section concrete.
7

Challenges of Implementation

The theory is not easy to implement. Hospice documentation is organized around symptoms, goals, and interventions, and a visit spent illuminating meaning may leave little that fits those fields. Colleagues trained in the nursing process may see true presence as passive. Research on nurses learning to practice human becoming reflects this: in a synthesis of six studies, nurses described transforming their intentions and experiencing a new kind of joy in practice, but also struggling with change as they let go of familiar ways of working (Bournes, 2002).

The theory's evidence base is also mostly qualitative. A review of 93 studies guided by human becoming found a substantial body of research describing lived experiences such as hope, grieving, and feeling respected, but little that measures clinical outcomes in the way hospice quality programs require (Doucet & Bournes, 2007). A hospice team adopting the theory would need to decide how to document and evaluate it, for example by recording the person's own statements of what matters and whether the plan reflects them.

What this page is doingTwo kinds of challenge are covered: practical (documentation, colleagues) and evidential (mostly qualitative research). Both are supported by sources that are described accurately, including the number of studies reviewed. The section ends with a workable solution, which keeps the tone constructive.
8

Guiding Toward Transcendence

Mobilizing transcendence means supporting the person's movement toward chosen possibilities. For Mrs. H., the possibility she names is telling Daniel that she is ready and releasing him from the smoothies without making him feel he has failed her. The nurse asks how she would like that conversation to happen, and she chooses to do it herself, with the nurse present, the next afternoon. The nurse's role in that conversation is to be there, not to lead it.

For Daniel, transcendence may look like finding a new way to care. When his mother tells him, he asks what he can do instead. She asks him to read to her, as she read to him when he was a boy. Nothing in the clinical plan has changed, yet both have moved beyond the impasse to a way of spending the remaining time that each has chosen. That movement is what Parse means by transcendence.

What this page is doingTranscendence is shown as the person's own choice, with the nurse present but not directing. The ending avoids sentimentality by noting that nothing clinical has changed, which is precisely the point of Parse's theory: quality of life as the person defines it.
9

Integration With Watson's Theory of Human Caring

Parse's theory integrates naturally with Watson's theory of human caring, which also rejects a purely task-based view of nursing and centers the relationship. Among Watson's caritas processes are authentic presence and making room for whatever the person feels, hopeful or painful (Watson, 2008), which closely resemble Parse's true presence and illuminating meaning. Watson adds attention to the healing environment and to basic needs, which balances Parse's reluctance to direct care. For Mrs. H., Watson's theory supports the physical comfort measures and the calm environment of her bedroom, while Parse's theory guides the conversations about meaning. Together they describe a hospice nurse who manages symptoms skillfully and is fully present to the person living through them.

What this page is doingIntegration is shown by naming the specific overlap (presence, expression of feelings) and the specific contribution Watson adds (environment and basic needs), then applying both to the case. That is a genuine integration rather than a statement that two theories are compatible.
10

Conclusion

At the end of life, the most important nursing work is often not solving a problem but helping a person and a family live a situation in a way they choose. Parse's human becoming theory gives the nurse a disciplined way to do that through illuminating meaning, synchronizing rhythms, and mobilizing transcendence. It asks a great deal of the nurse and is difficult to document and measure, but in the case of Mrs. H. and her son it turned a request for a feeding tube into a conversation about love, and that conversation changed their last weeks together.

What this page is doingThe conclusion restates the theory's purpose, names its three practice dimensions, acknowledges its challenges and ends on what it achieved in the case. It is the paper's argument in four sentences, without new material.
11

References

Bournes, D. A. (2002). Research evaluating human becoming in practice. Nursing Science Quarterly, 15(3), 190-195. https://doi.org/10.1177/08918402015003003

Doucet, T. J., & Bournes, D. A. (2007). Review of research related to Parse's theory of human becoming. Nursing Science Quarterly, 20(1), 16-32. https://doi.org/10.1177/0894318406296805

Parse, R. R. (1997). Transforming research and practice with the human becoming theory. Nursing Science Quarterly, 10(4), 171-174. https://doi.org/10.1177/089431849701000409

Parse, R. R. (1998). The human becoming school of thought: A perspective for nurses and other health professionals. Sage.

Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). University Press of Colorado.

How this N 491 Module 7 example is structured

N491 Module 7 typically asks for an APA paper of about 1,250 to 1,500 words applying Parse's human becoming theory to an end-of-life hospice case: how the theory is actualized, the characteristics of the nurse, the challenges of implementing it, how the nurse guides toward transcendence and how it integrates with another nursing theory, with outside sources plus the textbook. Aspen revises courses, so follow your classroom's case and rubric. This example explains the theory through its three principles and three practice dimensions, applies each dimension with dialogue, covers practical and evidential challenges with two research reviews, and integrates Parse with Watson through a specific overlap and a specific difference.

N491 Module 7 questions, answered

What does N491 Module 7 usually ask for?

Commonly an APA paper applying Parse's human becoming theory to an end-of-life hospice case: how the theory is actualized, what characteristics the nurse needs, challenges of implementing it, how the nurse guides the patient toward transcendence and how it integrates with another nursing theory, in about 1,250 to 1,500 words with two outside references plus the textbook.

What does true presence mean in Parse's theory?

A way of being with a person that follows the person's lead, without judgment and without trying to change them. It is how the nurse practices illuminating meaning, synchronizing rhythms and mobilizing transcendence. The sample shows it through what the nurse asks, what the nurse reflects back and what the nurse chooses not to direct.

Does Parse's theory mean the nurse should not give information?

No. When the son in the sample asks about a feeding tube, the nurse answers honestly and then explores what the question means to him. True presence is about not imposing the nurse's agenda, not about withholding facts a person asks for.

Write yours, or have the desk draft it

This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.

Request this one custom, free All N491 module samples All courses