Nursing diagnosis "altered energy field"

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"Altered energy diagnosis"

Do you support this NANDA diagnosis? Or do you feel that this diagnosis threatens the legitamacy of our profession? Nanda still stands behind it. What are your thoughts?

paphgrl

Specializes in Nursing assistant.
The philosphy of the school of nursing I'm attending for my RN to BSN is that nursing is both an art and a science (they are a Christian school). As I mentioned earlier, I am more science oriented. I think it we're totally scientific, then we're leaving out something..I'm not sure what, but nursing wouldn't seem as personable or holistic to me if it was only science.

Let me say again, I am by no means a NANDA fan.

great point

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I am sorry grannynurse, I have been teasing alot about this. I will try to turn to a more rational approach.

Are you really? You follow this response with a joke that is clearly meant to be a put down on TT. I do not know if TT is a valid nursing tool or not. I had a positive experience with a nurse skilled in TT but it by no means won me over to TT. TT and other alternatives to traditional medicine and nursing are frequently dismissed using derogatory terms. Such dismissiveness does not won people over to one's point of view. In fact, it frequently inspires those who have some questions to come to the defense of the theory in question, such as myself. There have always been things, in this world, that cannot be easily proven or disproven using the scientific method. Does this mean that we dismiss everyone else theory? If we do, we will lose a great deal because what cannot be proven scientificlly today, may well be provable tomorrow.

The use of Nursing Diagnose is used primarily by nursing students. It is also used to clarify nursing actions. It is not meant to be a purely evidence driven diagnostic code, hence the inclusion of TT. Whatever or not one uses it in their practice is up to them Those that do would appreciate the same amount of respect that is demanded by evidence base practitioners.

Grannynurse:balloons:

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Specializes in LTC, assisted living, med-surg, psych.
Not to start another "fire" but if this was in reference to Danu's post... :specs:

No, it was in reference to another post.......I was posting at the same time as danu3, and he got there first. Sorry about the timing, I was afraid somebody would think that, and I'm glad for the opportunity to clarify my statement.

:imbar

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Specializes in Nursing assistant.
Are you really? You follow this response with a joke that is clearly meant to be a put down on TT. I do not know if TT is a valid nursing tool or not. I had a positive experience with a nurse skilled in TT but it by no means won me over to TT. TT and other alternatives to traditional medicine and nursing are frequently dismissed using derogatory terms. Such dismissiveness does not won people over to one's point of view. In fact, it frequently inspires those who have some questions to come to the defense of the theory in question, such as myself. There have always been things, in this world, that cannot be easily proven or disproven using the scientific method. Does this mean that we dismiss everyone else theory? If we do, we will lose a great deal because what cannot be proven scientificlly today, may well be provable tomorrow.

The use of Nursing Diagnose is used primarily by nursing students. It is also used to clarify nursing actions. It is not meant to be a purely evidence driven diagnostic code, hence the inclusion of TT. Whatever or not one uses it in their practice is up to them Those that do would appreciate the same amount of respect that is demanded by evidence base practitioners.

Grannynurse:balloons:

Sorry granny nurse, I will quit kidding around. I am sorry if I hurt your feelings.

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Specializes in Med-Surg.
Sorry granny nurse, I will quit kidding around. I am sorry if I hurt your feelings.

I took notice of your jokes and took them for what they were: jokes. However, I didn't think they were altogether appropriate if you don't mind me saying now even though I didn't say anything at the time. But you've acknowledged that, apologized and I'm o.k. with that and appreciate your good attitude and apology about the jokes. :)

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Specializes in MDS coordinator, hospice, ortho/ neuro.

"altered energy field" sounds like a static cling issue to me. I understand the Reiki thing, which is not to say I believe in Reiki. I wouldn't be surprised if there is something to the magnetic field research, and some of the other alternative therapies, but "altered energy field" sounds like something that would take entirely too long to explain to a state surveyor, even if I could back it up with anything substantial.

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Sorry granny nurse, I will quit kidding around. I am sorry if I hurt your feelings.

While I accept your apology, my comment is not about my feelings. It is about the propensity of those who cannot accept something to put it down in such derogatory terms. If you do not agree with the possibility of TT, then say so and try backing up your position with some solid evidence. It is not necessary to use some of the terms I've seen here. Nor is it necessary to allude that believers are not on solid footing because they cannot prove it scientifically.

Grannynurse:balloons:

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i agree, i think the nursing diagnosis is a crock.

however, they are trying to accomplish just what you're saying " we should use our own language to describe what we do and what we aim to help our patients accomplish...."

i think the intent is good. that is, to have a standard language where nurses can communicate with each other regardless where you are from. this could help especially if you float a lot or if you are a travel nurse. i mean, if each hospital have different labels for the same/similar nursing action, it is a bit of a headache. this is actually a generic problem in most field. for example, a minor example in computers, most companies call a "mouse" a "mouse" but ibm calls it a "pointing device" (don't know if they still do).

what would be nice is actually not a nursing language but a health care language. at a minimum a common langauge between doctors and nurses. maybe even include social workers, and chaplains (in hospital or hospice environment). if a patient has cancer, everyone in health care working as a team has different roles to play and all of them are important. it would be nice to have a common language between the different professions as this can potentially enhance communications and maybe even reduce red tape.

i don't think they claim that their diagnosises are scientific in nature....just that the interventions are things that nurses can do. for example "from wikipedia, the free encyclopedia.

the nursing diagnosis readiness for enhanced spiritual well-being is defined as an "ability to experience and integrate meaning and purpose in life through a person's connectedness with self, others art, music, literature, nature, or a power greater than oneself." (anonymous, 2002, p. 68) and was approved by nanda in 2002." is not science.

do you have a source where nanda claims to put scientific labels on their ng's and claim they are science?

that is true that they do not claim nursing diagnosis as scientific (although it may involve science in many of the diagnosis). at least that is my understanding.

best is to look at the horses mouth so to speak:deadhorse (ok, beating the dead horse is the closest i can find; can't find anything with horses mouth).

look at http://www.nanda.org/html/about.html where it says "...the desired outcome of the association's work is to provide nurses at all levels and in all areas of practice with a standardized nursing terminology with which to:

  • name client responses to actual or potential health problems, life processes, and wellness;
  • document care for reimbursement of nursing services;
  • contribute to the development of informatics and information standards, ensuring the inclusion of nursing terminology in electronic health care records; and
  • facilitate study of the phenomena of concern to nurses for the purpose of improving patient care.

nursing terminology is the key to defining the future of nursing practic..."

i never thought about nursing reimbursement with billing and insurance before, but that is a point of consideration. within the context of our discussion, guess it would fall under "potential health problems".

"potential health problems" can be at the biological level, psycho-social level, or spiritual level which nurses are trained at. nursing is the only profession i know of who are trained at the bio-psycho-social-spiritual level. we do have the ability to talk to the doctors, the social workers, and the chaplain as we know their languages and we know when to call them. i look at them more as specialist (doctors being a specialist at the biological level (maybe psychiatrist is an exception), social workers are specialist at the psycho-social level, and chaplains are specialist at the spiritual level).

the controversy for the "energy field" is whether it is a "potential health problems" or not (rather the alteration of it). since it is such a controversy with both sides showing studies supporting their own side, i personally do not think it is time to have such a nursing diagnosis. when things calm down a bit and we have enough evidence to get some kind of concensus, then we can decide.

actually take a quick look at http://www.nanda.org/ it says "...standardized vocabulary affects all of your concerns as a nurse, including: social/spiritual aspects of care, purchasing, budgeting/funding, positive outcomes, holistic, accurate communications, reimbusement, risk management, software..." i don't know if they have a special section on holistic/wholistic stuff, if they have, i don't have any problem with tt in there. actually instead of holistic/wholistic, it should be something like complementary would probably be better.

here is a reference from an old nursing book - "fundamentals of nursing" 6th ed (2000) by kozier, erb, berman, burke. look at page 292 on nursing diagnosis "...nursing diagnosies describe a continuum of health states" deviations from health, presence of risk factors, and areas of enriched personal growth... the domain of nursing diagnosis includes only those health states that nurses are educated and licensed to treat. for example, nurses are not educated to diagnose or treat diseases such as diabetes mellitus; this task is defined legally as within the practice of medicine. yet nurses can diagnose and treat knowledge deficit, ineffective individual coping, or altered nutrition, all of which may accompany diabetes melltitus... a nursing diagnosis is a judgement made only after thorough, systematic data collection."

those of you who has a more recent version or other textbooks, be interested what they say also. it will be educational. again, it does not have to be scientific to be in the nursing diagnosis.

actually a question that comes up reading this from the textbook, would tt be more appropriate be in medicine and not nursing?

as mentioned by another poster, what happened if a nurse diagnose alterned energy field and another nurse next shift is not train in tt? or is this a stepping stone for the tt people to force tt training on all nurses whether they believe it or not? we already have people posting who said they took tt and at least one said s/he don't really feel the energy field. so would that nurse be disqualified because s/he can't see the aura or feel the energy field?

this is quite different from something like spiritual distress because if we look at the detail description, any nurse regardless of his/her faith tradition (or lack of faith tradition) has the ability to diagnose it and the ability to carry out intervention. the way the alter energy field is written, it would similar to spiritual distress where it is recommended specifically that a nurse should use prayers from the judeo-christian bible which it does not do fortunately. with some minor modification, you can replace tt with other energy traditions like reiki (sp? i mentioned that earlier), so why so specific?

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...My theory is that one outcome of chronic pain is psychological distancing and isolation. When you can make that connection, it some what ameliorates the discomfort by releasing some of the stress in that area, increasing the persons capacity to cope.

In other words, pain puts us in a knot, and understanding helps untie it.

I do not believe this action alters any energy.

We are physical, pschological and spiritual beings. I believe that each aspect of our being impacts the other...

In the nursing priority 3 under the intervention of the Alter Energy Field diagnosis, it says "... Fundamental focus of TT is on healing and wholeness, not curing signs and symptoms of disease"

It seemed to imply that conventional medicine just cure the signs and symptoms of disease which is not accurate. Take appendicitis, if the energy field exist, there probably is a major disturbance in the field. Now how can TT heal it? To be fair, I don't think TT claim to heal things like apendicitis (if I am wrong, let me know). To "cure" this disease, you have to go under the knife. When the operation is sucessful, you are not "curing signs and symptoms" of appendicitis, you took care of the root problem. Now there are other human aspect that needed to be healed after the operation especially if the person do not have a good supportive community.

TT, at the risk of oversimplying it, says the fundamental cause of illnesses is the energy field in our human body being out of wack. Or if you want some high sounding words, the bio energy field is not in homeostasis.

The things is that, how do we know that? Assuming the exisitence of this field, is it possible that illness causes the disturbance of the energy field instead?

Your personal example of the patient is a good example actually... if we have a device that can measure the energy field, your patient might have it "altered". But by being a presense with a caring heart, your patient is better and if we have the ability to measure the field, it might have gone back into balance. In this scenerio, the altering of the energy is actually one of they signs (we measured it objectively with a device) that the patients have and are we just "curing" the signs?

The signs and symptoms... another thought... another reason TT is controverial is that the ability to detect alter energy field which is suppose to be a sign (something that is suppose to be on the objective side) is highly debatable. Do we have studies where you have mulitple practitioners detecting energy field on the same patients and they all come up with similar conclusions (as to where the energy inbalance is)? In another word, is it something like taking the temperture (fairly consistent accross nurses), or is it like looking at the color of urine (where potentially the descriptioin could be more variable), or is it something like doing a psychiatric diagnosis (where there are quite a bit of varibility sometimes even given DSM IV)?

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...

You have inspired me, I'll be signing off to go study now......

I hope this thread inspires you to have a passion on many different nursing subjects. However, I sincerely hope this thread does not inspire you to become a statistician as we need more nurses, not statisticians. :)

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If this were a true discussion about TT or any alternative medical treatments or nursing diagnose, for that matter, one would expect it to be more enlighten intelligent, rather then being dismissed as a pile of ---- by its detractors, discussion. The discussion appears to center on the belief that unless something can be proven by scientific research, it cannot possible exist and therefore is not deserving of our recognition or respect. And there appears to be a focus that nursing is a science. One wonders if this focus is not present, in an attempt to win the approval of the hard science believers, such as physicians. I fear that some will now attempt to prove or even state that their belief in science is not an attempt to influence others, although it would be a misstep, IMHO. Those that are true believers in the hard science, evidence based theory only, would best remember that what they hold true were not always provable using the hard scientific method. All one has to do is read about the detractors of a Viennese physician who advocated the washing of hands between examining laboring mothers and post delivery mothers. He did not know nor could he prove the existence of bacteria or cross contamination. And he suffered through more then his share of detractors but hard science eventually caught up to prove his theory correct.

Grannynurse

You brought up a few good points.

Evidence base approach is important. But a good question is - what should be evaluated by evidence base approach and what should not? So should TT be evaluated by evidence base approach or not? Why or why not?

I think any biological treatment should go through the evidence base approach as that is where science really shine.

Now for psycho-social related treatment, I would cut it a little bit of a slack since they are not hard sciences. They are "soft" science and doing evidence base approach stuff is a lot harder. However lots of time, it can be and should be done. Just look at the serious mental health area, we have all these theories that turned out to harm not only the patients, but the families of the patients (e.g. the schizophrenic mother). But with evidence base approach, it is at least better now (at least it got rid of the schizophrenic mother theory).

For spiritual stuff, I think evidence base approach can be questionable depending what you are trying to test. If you try to test how effective is prayers, that is questionable (it also have some theological problems depending on one's faith tradition also) because how do you test a being that is suppose to be higher than you? I mean it is like a lab rat trying to run experinment on the researchers (actually there was a cartoon that did exactly that). If you test something like whether connecting the patient back to his/her faith community will decrease anxiety or something like that, that is ok

So for TT, it really depends on what level it is at. If it claims to be a biological treatemt and not a spiritual kind of thing, then yes, 100% evidence base approach. The reason is that we need to know if TT is

something like Ignaz Semmelweis (1818-1865) who instituted hand washing (as you mentioned) or TT is something like the spontaneous generation theory proposed first by Aristotle (the energy concepts is extremely old, like spontaneous generation theory) which eventually get disproved by Redi (1626-1697), Spallanzani(1729-1799), Pasteur (1822-1895).

About focusing nursing to be a science (a hard science) to be more prestigious, I think that is true. But it is not in nursing only, it is in many academic fields. "Social Science" is a good example as it used to be called "Social Studies". The thing is that nursing historicall do suffer, let's use a nursing diagnosis, "Self-Esteem, Chronic Low". Being "scientific", having the ability to go to grad school (even a Ph.D.) all do to one extent or another booters the profession's image and self-esteem. And having a BS instead of BA in nursing or an AS instead of AA in nursing is alone that line probably. Or maybe not... since nursing do require quite a bit of science.

However, I think (I could be wrong) even the most hard core evidence base nurses knows nursing is a bio-psycho-social-spiritual profession. Now we may be strong or weak at different levels but all of us have some kind of training in all the areas.

As for comparing TT to Semmeiweis, there are similaritie and differences. One similarity is that TT and the theory behind hand washing are new to the mainstream and not only new, it is quite a ridiculas concept to the mainstream. Another similarity is that in both cases, the mainstream do laugh in a not so kind ways at the alternative theory.

One difference is that TT has decades to prove their case. In Semmeiweis, he does not have that luxury. Lister (1827-1912), a contempory of Semmeiweis actually convince his fellow doctors to change their minds later.

Another difference is that science did what it is suppose to do, it changed the minds of doctors with the hand washing case because you have enough evidence to convince even those who laugh at you. With TT, such evidence do not exist. There are plenty TT studies, but they do not have the evidence to convince the mainstream. The mainstream is not always wrong, sometimes they are right.

In the alternative area, stuff like foot reflexology is just not convincing. But accupunture in pain, there are enough evidence that it is becomming mainstream (at least for certain pain management). TT is probably somewhere in between the two. So let's wait and see.

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Here is a personal perspective:

In about 1980, when I was in graduate school, I attended a one week workshop in Therapeutic Touch. It was taught by a nurse. At the time, I was very open to the possibility of TT and had done some background reading.

I really tried, but I have have no luck with TT at all. I can't see auras, although I accept that some people can. I tried to reduce my (then ) infant's daughter's fever with TT, but was unsuccessful, even with Tylenol on top of TT.

If I pass my hands over someone else's body, I can't feel any energy field. However, I do notice that I am quite aware of subtle changes in heat. The other person is also aware of the heat of my hands, and I've been told that it feels "wierd".

So, I am open-minded, but skeptical. If I, as a reasonably motivated and accepting nurse can't assess energy fields, I'm not totally comfortable with the nursing diagnosis of altered energy field. I am a supporter of nursing diagnosis, but I think the diagnoses should be usable by all nurses with the appropriate background.

This reminded me actually of when I was taking Aikido (which deals with energy stuff a lot). Everyone in the class can "extend" their energy it seemed, and I remember there is a great pressure for me to conform and say the same thing.

Don't know how many of us remember our psych class where it talked about Solomon Asch experiment on conformity (the line test). That was a powerful experiment where it shows the power of conformity. The interesting thing was all you need is one person to break rank, the the power of conformity goes down.

I don't know, do you feel lots of pressure to conform?

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