situation frequently may be so dire that the meaning of one's life must be considered within the context of one's immediate existence as opposed to a more abstract postulation of the long-term meaning of life. Again, the advanced practice nurse frequently must care for patients whose immediate situations appear to them to be hopeless. Frankl (1984) wrote that: "Even the helpless victim of a hopeless situation facing a fate he cannot change, may rise above himself, may grow beyond himself, and by so doing may change himself. He may turn a personal tragedy into a triumph" (p. 147).
Frankl (1984) contended further that meaning in life is ever changing; thus, human life always is in a state of transition. Life's meaning under such circumstances, according to Frankl (1967) may be discovered through performing acts, experiencing values, and suffering. According to Frankl (1967), when individuals are confronted with inescapable or unavoidable suffering, such as an incurable illness, they are ready to suffer under the condition that the experience will have meaning. Thus, the experience of suffering permits them to actualize the potential meaning of their lives. Suffering, according to Frankl (1984) no longer is perceived as pain once meaning is found by an individual. This concept is highly relevant for the advanced practice nurse who is caring for terminally ill patients, gerontological patients, and patients experiencing excruciating pain.
The essence of Frankl's (1984) logotherapy is that one's life's meaning can be discovered by self-transcendence, by moving beyond concern for the self and focusing on other people and social and spiritual values. To do otherwise, such as a direct focusing on pleasure and happiness, according to Frankl (1984) will lead to an existential vacuum. By contrast, self-transcendence leads to personal fulfillment. Frankl (1967) emphasized creativity as a source of self-transcendence and meaning.<...