Cur Autem (latin translation for “the why”) Friedrich Nietzsche said it best, "If we have our own why in life, we shall get along with almost any how." Now upon first read, you may be wondering what this has to do with your position as a nurse. In fact, you may question how this even relates to you as a person. But I assure you that many aspects of your life as a nurse, and in general, is predicated on your sense of meaning and the application of this meaning to the various aspects of your life. Which in turn, offers you the paradoxical why that so many need to lead a purpose driven life. If Viktor E. Frankl, a published psychiatrist and author of the book titled, “Man’s Search for Meaning”, and also a man who had endured torture, famine, and tyranny to the most inexplable extent, can find meaning in the nothingness that being a prisoner of the Nazi regimen endowed, then I am confident that you can too. Frankl wrote that almost every aspect of a man’s life can be taken away, except for the human freedom of choice. He said that despite all the suffering, he would often see men give away the last of their food rations to others who needed it more. Demonstrating that one’s attitude can be preserved even in the greatest extremes of suffering, and out of it, meaning and purpose can be derived, that is sacrificing despite circumstance and reason, and nourishment as the latter. Frankl then went on to publish about a type of existential analytic therapy coined Logotherapy, which can be described as a therapeutic approach in which the derivation of meaning in one’s life is the goal and transcendence the means. But I digress. Those who were suffering, often stripped of every last piece of their Being, right down to the core, found purpose in their existence. This is a very powerful sentiment. That the vestige of human freedom of choice, to do good, can be preserved in suffering and as a result, what appeared to be an existence in which living meant torture and starvation could be one of meaning and purpose. Recognizing this idea, we can not ignore the fact that meaning derived from purpose is all that matters, even in the extremes endured by Frankl. Similiterque in Caelo Speramus (latin translation for “in reflection we trust”) While the nursing profession itself does not have to endure the same misfortunes of that of Mr. Vikor Frankl to find meaning, we do, however, have the moral responsibility to find meaning in the suffering of others. As a nurse, we have the responsibility of a liaison of sorts; that is comprised of a healthcare professional, a shoulder to cry on, a person to provide comfort to patients & families during illness and in death. This translates to boundless opportunities to improve upon yourself and your approach to practice. If it took one experience as a prisoner in the Nazi regimen for Mr. Frankl to contribute to the psychoanalytic process, then by comparison, nurses should have the capacity to move mountains by way of the suffering that we witness on a daily basis. And indeed, many do. While not on the same stratum of the tyrannical regimen that Adolf Hitler operated, illness, tragedy, and death of patients and their families certainly does bring plenty to the table. Those handwritten sentiments from the families of deceased patient’s indicating their appreciation for all the members of the team, the hard work and care demonstrated to make the final moments of their mothers or fathers life a dignified one is just one of many examples of this. But what does the path to finding meaning look like? How can we emulate what the malnourished prisoners of war did in our practice? Well the answer is an obvious one, however, is something that the everyday hustle and bustle of life gets in the way of. This my friends, is the wondermants of reflective practice. So much of healthcare is predominantly empiric in nature, however the practice of nursing is one in which art can cascade with the healing process. Take in, process, and disperse your metaphysical understanding of what you see and how it makes you feel. Put these feelings into words, categorize them and develop yourself and your approach to practice. Allow that dying patient, surrounded by loved ones, or perhaps the opposite, alone and withering away unaccompanied, impact your approach to that Form 1 patient who is indecisive about life and death and unsure if life is worth the suffering it brings. ... Without reflection, there is no thought. Without introspection towards the woe’s that our profession endures, we can not derive meaning or purpose to justify our roles as nurses, but even more troubling, as Beings. The most desolate of places to be is inside an Existential Vacuum in which what you ought to do is dictated by others, which is deadly game of conformism, or what you do is for others, which is contrary to the governing bodies perception of autonomous practice. Final thoughts; So much of what we read in the nursing literature related to our practice, whether it be our “ways of knowing”, which is eloquently cloaked by the empirics incessant need to categorize and label, but can be easily described as an underpinning of what we do and how we go about it. Or the nurse-client relationship as guidelines as to what ought to be done and boundaries demarcated by the ethical parameters of our practice; is based on choice. Our choice, as nurses to transcend the boundaries of what could be, or choose to just let be. Interesting Read for those who are curious to explore the existential aspect of nursing: Udo, C. (2014). The concept and relevance of existential issues in nursing. European Journal of Oncology Nursing, vol. 18, 347-354. http://dx.doi.org/10.1016/j.ejon.2014.04.002 1462-3889/ References:  Frankly, V. E. (1946). Man’s Search for Meaning: Revised and Updated. New York: POCKET BOOKS.