Uncertainty can be difficult to manage because of its dual aspects, however. As Brashers (2001, p. 291) points out, "In some instances, people may want to reduce uncertainty because they find it threatening. At other times, uncertainty allows people to maintain hope and optimism." Although Mishel recognized that uncertainty can be not just negative but positive, her framework focuses primarily on the negative side of uncertainty, ignoring the fact that in some cases, a patient's only positive outlook lies in uncertainty (McCormick, 2002, p. 128). A patient uncertain of whether he has cancer can be highly stressed by that uncertainty. Likewise, if he knows he has cancer and is uncertain of the outcome, he can be stressed. Even if his cancer is in remission, uncertainty over whether it may recur or not can be stressful. On the other hand, a patient that has received a grim prognosis may find that the only hope he has lies in uncertainty-the uncertain hope that he may miraculously recover; for this patient, uncertainty is both desirable and potentially therapeutic. Thus, although Mishel's theory addresses an important aspect of

McCormick, K.M. (2002). A Concept Analysis of Uncertainty in Illness. Wiley InterScience. Journal of Nursing Scholarship, 34(2), 127-131. Retrieved on January 1, 2010 from: http://www3.interscience.wiley.com/cgi-bin/fulltext/118929729/PDFSTART

Bonadonna, R. (2003). Meditation's Impact on Chronic Illness. Holistic Nursing Practice, (Nov/Dec), 309-319. Retrieved on February 1, 2010 from: http://ovidsp.uk.ovid.com/sp-2.3/ovidweb.cgi?WebLinkFrameset=1&S=FMJDPDMBEIHFJJIOFNELIHBGJAKAAA00&returnUrl=http%3a%2f%2fovidsp.uk.ovid.com%2fsp-2.3%2fovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.15.16%257c0%257c00004650-200311000-00006%26S%3dFMJDPDMBEIHFJJIOFNELIHBGJAKAAA00&directlink=http%3a%2f%2fgraphics.uk.ovid.com%2fovftpdfs%2fPDHFFNBGIHIOEI00%2ffs043%2fovft%2flive%2fgv021%2f00004650%2f00004650-200311000-00006.pdf&filename=Meditation%27s+Impact+on+Chronic+Illness

In the student's own medical history, a childhood operation was a traumatic event requiring a seven-day stay in the hospital without the comfort of home and parents, and the impact of uncertainty was all negative and fear-based. The difference that the ward nurse made in supplying comforting hugs and a vision of the future in which recovery would be complete was dramatic. The nurse was, in fact, the only thing that made the situation tolerable, and her kindness has never been forgotten.