Disturbed Energy Field

menetopali · Mar 18, 2009

Pardon, but what extension of faith pertains to concentrating to alter energy fields of the human body?
I've been a certified reiki practitioner for years. While the premise behind it may be different than therapeutic touch, the goals and outcomes are usually very similar: to locate and ease pain or discomfort that traditional medicines aren't effectively treating.
It isn't a replacement for treatment or a cure; it is a supplemental therapy that often brings patients great comfort.
Do you have similar feelings toward acupuncture, acupressure, or color therapy? Music therapy? Light therapy? These were all things deemed questionable at best, quackery at worst, yet found to yield some positive results.
I'm very interested to hear why you think this is faith-based.
Best,
Southern

the premise of "therapeutic touch" is the detection of an "energy field" that cannot be demonstrated to exist. that inability to demonstrate the "energy field" exists (and the demonstration by a 5th grader that practitioners who purport to 'manipulate this field' could not actually detect the field in a randomized trial) requires that we take a leap of faith akin to that found in religion. i am aware of no other controlled study to evaluate whether "therapeutic touch" is more or less effective than a comparable intervention of close proximity and soothing voice spoken to a patient. as such the diagnosis of "disturbed energy field" is wholly inappropriate, perhaps "ineffective coping" would be more appropriate in documentation with "faith support" as the intervention?

light therapy - notably in the treatment of seasonal affective depressive disorder has shown a demonstrably positive effect.

color therapy has been repeatedly demonstrated since the mid-19th century to improve mood (Nightingale, 1864), whether it is through some weird "energy field" or simply a biochemical response to changing scenery (more likely in my opinion) has not been demonstrated to my knowledge but it has had better outcomes than placebo.

music therapy - has shown demonstrable effect and this effect is in fact used in industry to good effect

acupuncture & acupressure - i have not seen clinical trials for so i'm not able to comment on this versus placebo.

reiki - is a practice that i am entirely unfamiliar with no will provide no opinion either way

i don't object to using therapeutic touch or any other paranormal / religious practice that brings comfort to a patient if that is the wish of the patient. again, faith can have a tremendous effect on healing (that has been demonstrated repeatedly in the literature). while the individual practice of faith should be encouraged, it is not the role of a health care provider to impose there faith on others. Rogerian beliefs approach those of other new age groups, cults, and religions in that they require acceptance based on faith in the leader of the movement without critical examination of the claims being made.

what i object to is (1) calling something a science when it fails to meet the rigor for a science based claim, and (2) attaching profession that strives to use the best evidence to a practice with no evidence beyond the placebo effect to support it

amarilla, RN · Mar 18, 2009

the premise of "therapeutic touch" is the detection of an "energy field" that cannot be demonstrated to exist. that inability to demonstrate the "energy field" exists (and the demonstration by a 5th grader that practitioners who purport to 'manipulate this field' could not actually detect the field in a randomized trial) requires that we take a leap of faith akin to that found in religion. i am aware of no other controlled study to evaluate whether "therapeutic touch" is more or less effective than a comparable intervention of close proximity and soothing voice spoken to a patient. as such the diagnosis of "disturbed energy field" is wholly inappropriate, perhaps "ineffective coping" would be more appropriate in documentation with "faith support" as the intervention?
i don't object to using therapeutic touch or any other paranormal / religious practice that brings comfort to a patient if that is the wish of the patient. again, faith can have a tremendous effect on healing (that has been demonstrated repeatedly in the literature). while the individual practice of faith should be encouraged, it is not the role of a health care provider to impose there faith on others. Rogerian beliefs approach those of other new age groups, cults, and religions in that they require acceptance based on faith in the leader of the movement without critical examination of the claims being made.
what i object to is (1) calling something a science when it fails to meet the rigor for a science based claim, and (2) attaching profession that strives to use the best evidence to a practice with no evidence beyond the placebo effect to support it

I agree that insufficient research has been done, though I think there is an easy explanation as to why: attempts to conduct trials have a primary intent to validate, (rather: discredit), the human ability to detect energy fields, putting the trial practitioner's 'ability' under the microscope instead of first using diagnostic tools and biotechnology to first explore and validate, (or discredit), 'energy', 'energy fields', and the like.

Finding a pool of comparable practitioners without skewing the results of the trial would be difficult at best. Beliefs, methodology, and technique vary greatly among energy practitioners. Understandably, few practitioners will stand up to be openly mocked, picked apart and likely humiliated. The calls for participants I have personally seen have been from private individuals and organizations seeking to discredit the practice entirely, (also understandable, as I doubt energy practitioners and the modality of same rank high on research inquiries with regards to modern medicine.) Without funding, relevant interest, participants and a reasonable purpose...

nothing is learned, for better or worse.

I remember reading about the little girl's study you mentioned, and it brings up a few important points. First, her mother (a RN) was an active member of a group questioning the use of Therapeutic Touch. Her daughter prepared a study actively aimed at discrediting TT, (hardly unbiased, really, to set out to prove something untrue.) I can't speak to the pool of practitioners, (don't know any specifics), but I do have a comment about the technique:

I'm not surprised at all that practitioners could identify the position of her hand less than half of the time.

Now, while some may think this means that practitioners cannot detect energy fields, it is absolutely subject to interpretation given one's knowledge of the subject. As a practitioner myself, I'm not sure I could have identified the position correctly either, given that she was a healthy young girl. In my practice, I 'see' (with eyes closed) flashes of color and get a feeling (usually a sick one - a wave of heat or the like) when my hands pass over the 'bad' area. If someone has an 'all-over' illness, the feeling is intense and can be found if hands are placed over the heart area.

Others 'see' differently. Some people touch. Some people 'look'. Some people feel. This is partly why I have trouble defining this (the ability to detect or alter energy fields, not 'energy' itself) as a strict science. I'm also not sure it can easily be taught; I know I have taught others and had some wonderful, gifted students, and some not so much, who just couldn't grasp it. Finally, this is also the reason why I never 'worked' as a practitioner, (was much more a personal interest, stemming from childhood), because progress can vary due to practitioner/client suitability. There have been people I've had difficulty reading, (who others 'read' easily), and some I've come up crystal clear with that others were drawing a blank. Needless to say, I only 'read' people I could help, and this is why I volunteer time instead. You'd be surprised to know how popular this is with hospice.

Regarding diagnosis, I do agree that ineffective coping would be a preferred alternative, (and I don't agree that the OP should have chosen this diagnosis for her patient without being a TT practitioner herself.) That being said, I was under the impression this diagnosis is not readily or ordinarily used outside of those participating in TT as part and parcel of care.

Correct me if I'm wrong, but I also was under the belief that patients chose to receive TT. Though I can tell you firsthand that it's near impossible to 'read' someone who doesn't want to be read, (emotional stress, anger, and the like make it more difficult to sort what you're seeing, like a big jumble), I absolutely believe that all interventions and treatment should be by choice.

I think there is much to be learned about the body and our abilities. Have you seen this?

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/05/26/BAG510QDVT.DTL

I'll be interested to see what happens, though I'm honestly more interested in the science behind what happens in the body during illness or trauma than ability to detect same. For example - the dogs who can sense epileptic seizures before they happen or detect cancer by smell? WOW. I'd love to know what is happening inside that is acting as a signal, (just as I'd love to know where my colors and feelings come from when 'looking' at someone sick.)

Best,

Southern

TheSquire, DNP, APRN, NP · Mar 18, 2009

OSouthern,

What exactly is this energy? What is its fundamental particle under the Standard Model? What instruments can be used to detect or measure it?

The Rogerian model is a great way to get across the concept that a patient is a whole person who lives in their own environment and not just a diagnosis on a sheet. However, that's all it is and should be viewed as - a concept. The energy field does not actually exist. It cannot be quantified, measured, or reliably detected in any sort of standardized setting. It is not there. If you have issues with the means used to try to detect such energy fields in the posts mentioned above, then you also undermine the movement of both medicine and nursing towards evidence-based practice, which relies on such studies to tell us what works and what does not. In order to do that, we must reject the magical thinking represented by things like Reiki, Therapeutic Touch, and other "energy field" based alternative treatments.

RedCell · Mar 19, 2009

I was looking through my Doenges nursing dx book, and there is a NANDA dx of Disturbed Energy Field as evidenced by objective things like waves, spikes, color changes, or holes in the pt energy flow. What the heck?! :icon_roll I wrote it in as a possible dx on my final care plan, my teacher was cracking up.

There is nothing OBJECTIVE about waves, spikes, color changes, or holes in a patient's energy flow. Unless you can show respectable and nonbiased research that says otherwise, this is no better than my Uncle Juana Bier slinging crack rock and snake oil down in Compton claiming that is will cure any and all ailments. That is why your teacher laughed.

amarilla, RN · Mar 19, 2009

OSouthern,
What exactly is this energy? What is its fundamental particle under the Standard Model? What instruments can be used to detect or measure it?
The Rogerian model is a great way to get across the concept that a patient is a whole person who lives in their own environment and not just a diagnosis on a sheet. However, that's all it is and should be viewed as - a concept. The energy field does not actually exist. It cannot be quantified, measured, or reliably detected in any sort of standardized setting. It is not there. If you have issues with the means used to try to detect such energy fields in the posts mentioned above, then you also undermine the movement of both medicine and nursing towards evidence-based practice, which relies on such studies to tell us what works and what does not. In order to do that, we must reject the magical thinking represented by things like Reiki, Therapeutic Touch, and other "energy field" based alternative treatments.

As I wrote previously, research has not focused on the heart of the issue: exploring and validating/discrediting the notion that the body has energetic properties. Rather, studies like the one mentioned previously sought to discredit a human's ability to detect the field of another in a single event from a small pool of practitioners. Kindly, I'll wait for more advanced technology than a single trial with a stated intent to discredit the practice entirely, particularly with what I've seen and experienced firsthand over the years.

I have no need to 'undermine the movement of medicine and nursing toward evidence-based practice'; rather, again, I hope to see more research and trials refining the nuances of how energy work produces results, (whether they be found to result from a placebo effect or not.) One small-scale trial concerning perceived practitioner ability by a nine year old girl isn't concrete proof that energy work does not have positive benefits; neither are anecdotal stories of such benefits realistic to implement therapies or further integrate energy work into treatment. Real, unbiased research is needed, (preferably not funded by quackwatch. Seriously.)

Dismissing alternative treatments undermines exactly what I find exciting about science (and medicine, for that matter): exploring, revising, adding, subtracting, refining and learning. You're absolutely right: I'll take pushing the boundaries over staid rigidity any day! We don't know everything there is to know, and I won't pretend we do.

Best,

Southern

Atheos · Mar 19, 2009

When a nursing diagnosis is given it states, in nursing language, a nursing problem that those colleagues have identified. This particular problem, Disturbed Energy Field, is used by the nurses who practice Therapeutic Touch so they have a way to document what they assess and are doing for their patients. Can we have respect for those colleagues who are helping those patients not to belittle and laugh at them? We all also know that this diagnostic documentation is required by federal law in all hospital and LTC charts when federal reimbursement is being received by these facilities. For some practitioners it is also how they get paid. All the nursing diagnoses have matching computer number codes and many independent nurse practitioners use nursing diagnoses for billing purposes as well as documentation.

Can you prove that these so called nurses have indeed OBSERVED a disturbed energy field?

What are it's measurements. Better yet, what form of energy is it? Can you prove that they see it. Are they the only ones that can see it or can I see it with my Third Eye? Do I need to be more open minded and open up my Chakra to allow my Chi to flow?

Look, I don't want to be disrespectful but if this kind of nurse comes to see me she better bring Ms. Cleo as well.

This ain't science. It might be religion but it's not science. I'm kinda embarassed that it's there too. Geez.

ETA:

A the number one indicator of a proper scientific experiment is that it is repeatable by a third party. Period.

If only 'special' people can 'see' this energy field then the odds of it being bunk are rather high. Though that doesn't mean it's impossible I have to admit.

Daytonite, BSN, RN · Mar 19, 2009

documenting a phenomenon that is not independently observable, independently testable, and part of accepted practice borders on fraud. if the facility is receiving federal funds for such services then there re serious church-state issues as that implies federal monies are being used to fund religious practices. if an individual wants to hire somebody to perform religious healings, faith healings, voo-doo, therapeutic touch, or the like - fine. again, i have no problem with someone who believes in these things but they are clearly faith-based. i am deeply offended that such faith-healing concepts are attached to profession that i am a part of. i have been very respectful of the practices of faith others bring into the care of patients and that patients bring into the hospital setting, but they are practices of faith, not science. as practices of faith they have no place in a diagnoses (medical or nursing).

You do not understand documentation requirements. Medicare requires care plans in the charts of all patients when a facility receives federal funding for any patients that facility services. It does not mean that all of them must receive this funding. So, any and all patients in these facilities, even if they pay their bills in cash, must have a care plan in their charts. I have worked in facilities that admitted wealthy celebrities and poor people alike. Of course, the celebrities went to a different part of the hospital and all kinds of goofy things went on with their care at times--and it was documented. If they pay for it, who cares?

menetopali · Mar 19, 2009

i am well aware of the need, and importance of, appropriate documentation. "disturbed energy field" is not appropriate documentation any more than "possessed by demons" or "lost soul". the billing issue comes from using a diagnosis that is a religious belief instead of an honest assessment of a patient's disease process or state of being. within a narrative "disturbed energy field" or "manipulated energy field" has no meaning, what is more appropriate would be: "spiritual leader at bedside with crystals" or "tribal shaman at bedside performing healing chants" or "priest at bedside praying with patient and family" or "therapeutic touch practitioner at bedside waving hands over pt". each of these document the observed activity and none profess belief in the underlying faith which the practice is based on. after any of these religious acts it would be appropriate to document the pt status - increasingly agitated, calm, no change observed, decreased pain reported, etc. when you move a religious practice into the realm of a diagnosis two things happen - first credence is given to the practice as if it were scientifically accepted (i acknowledge that this mixing of science and religion was common practice through much of history) and second it places the profession that supports such a diagnosis based in superstition or faith in the untenable position of claiming to use evidence based practice while subscribing to faith healing.

pinkiepie_RN · Mar 19, 2009

I am a believer in reiki and therapeutic touch, although it's nothing that I would bring into nursing practice unless on a volunteer basis or if I were certified in TT or reiki and intervening as a religious/spiritual support. That said, I think if you don't believe in it, simply don't use it as a nursing diagnosis. Obviously NANDA sees fit that it be an official dx and if TT nurses use it, then great. If you don't see a use for the dx, that's appropriate too.

menetopali · Mar 20, 2009

the fact that NANDA sees fit to use it is the professional embarrassment when we try to say that nurses follow evidence based practices.

Koyaanisqatsi-RN · Mar 20, 2009

You do not understand documentation requirements. Medicare requires care plans in the charts of all patients when a facility receives federal funding for any patients that facility services. It does not mean that all of them must receive this funding. So, any and all patients in these facilities, even if they pay their bills in cash, must have a care plan in their charts. I have worked in facilities that admitted wealthy celebrities and poor people alike. Of course, the celebrities went to a different part of the hospital and all kinds of goofy things went on with their care at times--and it was documented. If they pay for it, who cares?

Wow, you completely missed the point of the post you quoted, and I'm not sure you even read it at all.

the fact that NANDA sees fit to use it is the professional embarrassment when we try to say that nurses follow evidence based practices.

This is the crux of this whole issue. On the first day of my RN program, all of my instructors took special care to discuss how nursing is evidence based practice, and that we are 'no longer the doctor's handmaidens'. This is all well and good, but when I see nurses advocate this garbage of 'disturbed energy field' and then have the audacity to complain about not being taken seriously by doctors or the public, I can feel little sympathy.

If we want to be evidence and science based, that's a good thing. But let's not half-ass it and include ridiculous, untestable, fluffy garbage such as 'disturbed energy field' as part of the nursing diagnosis.

Valerie Salva, BSN, RN · Mar 20, 2009

as with religious belief, faith, or the placebo effect, can do wonders. that doesn't mean it isn't helpful, but it isn't science and "disturbed energy field" has no more place in diagnosis than "possessed by demons". while "therapeutic touch" may help the former and "exorcism" may help the latter, neither is science. Faith is a powerful thing and can be put to good or ill, it can help or hinder the healing process, and it has a profound effect on the function of the body. i'll happily stipulate all of those points, but faith in something is not based in reality - on the contrary it is by it's very nature a belief in something without proof. use it if you or your patients feel better with no objection from my corner, but don't pretend that its science or based on any theory in the scientific meaning of the word.

Agreed.

However, I feel is was poor judgment for NANDA to accept this NDX. It makes us look rediculous.