My early research explored how children’s picture books could be used to support psychological resilience and recovery.

How do different cultural worlds make sense of the same ethical question? What happens when ideas like autonomy, family, duty, and death intersect differently across societies? 

I wrote stories that helped children make sense of medical experiences, stories that explained what was happening to their bodies in language that felt kind, safe, and empowering. That work taught me that nursing is deeply holistic, something that cares for the mind as much as for the body. It also awakened my curiosity about how people find meaning and comfort in care, and how communication itself can become a form of healing. 

Quite by chance, I recall learning that advance directives had been legalized in Shenzhen, China. This was astonishing to me because, in my parents’ generation, even mentioning the word death was considered unlucky, let alone planning for medical treatment in one’s final days. The deep cultural taboo surrounding death—the long-standing tradition of family-centered decision making, the lack of mature legal protections, and the prevailing belief that clinicians must always “save” rather than allow natural dying—made advance directives intensely fraught in China. Such conversations were almost unthinkable.

Yet, the same concept—advance directives—sits comfortably in the United States, where a relatively robust legal framework and a cultural emphasis on individual autonomy make such practices more widely accepted. Observed side-by-side, I became fascinated by the contrast. How do different cultural worlds make sense of the same ethical question? What happens when ideas like autonomy, family, duty, and death intersect differently across societies? 

It sparked my interest in how end-of-life decisions unfold across cultural contexts. It led me to wonder how people in various societies talk about dying, dignity, and the right to choose their own path—and to study it. 

Now, my work focuses on how cultural factors influence people’s engagement with advance care planning. Concepts such as advance directives, living wills, culture, and paternalism intertwine in complex ways, and I find joy in navigating that intellectual landscape.

End-of-life care is fascinating to me. Socrates said that philosophy is about practicing death again and again, and, in a way, learning about end-of-life care feels the same. It’s like practicing how to understand and face death, over and over.  

Nursing gives me the freedom to think deeply about these questions and, at the same time, the grounding to act. Because as a nurse, no matter how abstract my questions become, they always return to something real: helping patients in the world as it is. And that, to me, is the most beautiful part of this garden of reflection I have stepped into, where thought and care grow side by side. 

Tang, a mentee of assistant professor Jessie Gibson, earned both a baccalaureate and master’s degree in China. She is a second-year PhD in nursing student. 

NURSING NARRATIVES is a regular feature for UVA School of Nursing students that provides them with a space to express their thoughts. Initially funded through a two-year, $24,000 Jefferson Trust grant, the recurring feature is now fully supported by the School of Nursing and part of each issue of VNL.