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

Thanks for the info rngreenhorn. But you have got to explain to me what this

"vacant/hole/spike...wave...tingling/dense/flowing" thing is?

I think that is just description of the energy field (am I right?). It is like describing a person's breathing - shallow, rapid, and 24/min.

Oh, and I have to add this to our list of ways of assessing : pragmatism.

I think you make really good points because I believe that this discussion has become, and should become: how do we determine what is valid, true or even just efficacious. Is that a word?

Probably to most pragmatic variable we want to look at is - is it consistently effective? If it is, are there other methods just as effective or more effective (I am ignoring the economic factor just to keep it simple).

For example, if you look at the details in the nursing diagnosis (many many posts back, someone posted the details), a big part of it is to establish "therapeutic" alliance with the patient. Actually that is the first thing a nurse is suppose to do according to that diagnosis. Interesting experienment (they may have done it already, don't know) would be to do everything the alter energy diagnosis said excetp the specific TT stuff (I don't mean you need to do some sham TT kind of thing; I mean just skip the TT stuff). Would the results be the same?

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I don't believe in ghosts but my friend does. She also believes people can talk to the dead and channel messages to loved ones. I can't prove they don't exist and she can't prove they do. I really don't care unless she tries to tell me that channeled messages from dead loved ones can help you psychologically. And that there should be a nursing process to take advantage of channeling or a nursing diagnosis to describe it. Or that I just have a closed mind to it since it has been "proven" on the Maury Povich and Montel Williams shows. Maybe ghosts exhist but they have no place in a science based language like nursing diagnosis...and neither does TT or energy fields! IMHO

Actually there are all those paranormal stuff in psychology which is suppose to be "science". Do ghosts belong to relm of science? Or do they belong to the relm of philosophies/cosmology/religions? Just becaue I don't believe your world view, am I "close" minded. Now I do think there should be respect between people who have different views (which I think most people would agree).

How would you handle a nursing diagnosis like "spirtual distress" (I think tweety mentioned it)? Should that be in the nursing diagnosis? Is there a difference between a generic "spiritual distress" and something specific like the channeling example you gave? As I mentioned before, I do think there is a difference. But what are your thoughts?

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Thanks for the info rngreenhorn. But you have got to explain to me what this

"vacant/hole/spike...wave...tingling/dense/flowing" thing is?

Oh, and I have to add this to our list of ways of assessing : pragmatism.

I think you make really good points because I believe that this discussion has become, and should become: how do we determine what is valid, true or even just efficacious. Is that a word?

Let me see if a can explain this. A nursing diagnosis contains: a definition, related or risk factor, and defining characteristics (subjective and objective). Once you have the diagnosis you can plan the interventions to acheive a desired outcome.

So lets use "failure to thive" as an example. The definition: a progressive functional deterioration of physical and congnitive nature.... (Taber's Clyclopedic Medical Dictionary 19th Ed, pg 2612). The related factors are things that lead to "failure to thrive" e.g. major illness, depression, fatigue etc. The defining characteristics: subjective would be things we can't measure or things the patient states e.g. "I just don't feel like eating, I'm just so depressed I don't feel like eating any more." Then objective characteristics would be something we can measure: weight loss, inadequate intake, weakness, decreased participation in ADL's etc. Once we decide the patient indeed has these things, we can plan our intervention accordingly e.g. talk to the physician about getting an antidepression med, offer foods the patient would be more likely to eat, maybe a feeding tube etc.

So, with that background, back to the questions at hand: What is "vacant/hole/spike...etc." (This is where I have a problem with this diagnosis.) The objective defining characteristics according to Taber's is "Temperature change (warmth/coolnes); Visual changes (image/color); Disruption of the field (vacant/hole/spike/bulge); Movement (wave/spike/dense/flowing); Sounds (tone/words)." As far as I'm concerned the only thing objective that I can diagnose is "warmth" and "coolness" i.e. body temperature. So, how in the hell am I to assign this diagnosis if I am not able to feel the energy disturbance? Anyway, I don't blame you for being confused. I certainly am.

I should ad a disclaimer. I have never studies TT, or tried TT, so maybe I could feel a "spike" with some education....

Anyway, hope that clears it up a bit.

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I'm not sure what is meant by "spiritual distress". Ineffective coping makes sense to me as does most of the NANDA diagnosis. I really think we can throw out the esoteric diagnosis' in favor of realistic ones based on what we can see, hear, feel and smell.

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I'm not sure what is meant by "spiritual distress". Ineffective coping makes sense to me as does most of the NANDA diagnosis. I really think we can throw out the esoteric diagnosis' in favor of realistic ones based on what we can see, hear, feel and smell.

I think "spiritual dispress" is a valid diagnosis. We as nurses treat or diagnose a patient's response to medical intervention: we are concerned with physical and emotional outcomes. For example, if a devote Catholic who goes to mass every week has a heart attach and suddenly stops studying scripture, stops going to mass, becomes hostile, and exclaims one day "Damn, why did God do this to me." These are all things we can assess and plan interventions for (Within our scope of practice). For example, we could contact the patients preist, we could talk to the doc and get some anti-depression meds, we could dicuss his medication regimen with him, we could give him information for support groups etc.

That said, this is all well and good in the "fantasy world" of NANDA. In reality, I'm to damn busy hanging nitro drips, starting IV's, changing beds, taking off doc's orders, taking VS etc, to be planning an indepth care plan concerning the patients spiritual well being. This fact however doesn't make the diagnosis invalid... I have to agree with you, I'm not a big fan of the esoteric diagnosis.

PS please excuse the poor grammar and misspelled words.

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I think "spiritual dispress" is a valid diagnosis. We as nurses treat or diagnose a patient's response to medical intervention: we are concerned with physical and emotional outcomes. For example, if a devote Catholic who goes to mass every week has a heart attach and suddenly stops studying scripture, stops going to mass, becomes hostile, and exclaims one day "Damn, why did God do this to me." These are all things we can assess and plan interventions for (Within our scope of practice). For example, we could contact the patients preist, we could talk to the doc and get some anti-depression meds, we could dicuss his medication regimen with him, we could give him information for support groups etc.

That said, this is all well and good in the "fantasy world" of NANDA. In reality, I'm to damn busy hanging nitro drips, starting IV's, changing beds, taking off doc's orders, taking VS etc, to be planning an indepth care plan concerning the patients spiritual well being. This fact however doesn't make the diagnosis invalid... I have to agree with you, I'm not a big fan of the esoteric diagnosis.

PS please excuse the poor grammar and misspelled words.

While you may be busy with your nursing tasks, isn't one of those nursing task addressing your patient's spiritual needs. And by spiritual needs I mean your patient's emotional needs. As a practicing Catholic, when anyone suddenly question's why "God is doing this to me", he is having not only a crisis of faith but his emotional well being is severely distored. And as a practicing nurse, you have an obligation that extends beyond calling his doctor for medication and a priest.

Grannynurse:balloons:

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Is spiritual distress related to religion? If so, is it not better addressed by clergy? Does this mean that agnostic nurses cannot treat these patients? What is in this pseudo-diagnosis that is not covered by ineffective coping?

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While you may be busy with your nursing tasks, isn't one of those nursing task addressing your patient's spiritual needs. And by spiritual needs I mean your patient's emotional needs. As a practicing Catholic, when anyone suddenly question's why "God is doing this to me", he is having not only a crisis of faith but his emotional well being is severely distored. And as a practicing nurse, you have an obligation that extends beyond calling his doctor for medication and a priest.

Grannynurse:balloons:

You got a good point there.

So, I guess the next question would be: Is the nursing job description as prescribed by NANDA, state boards, nursing organizations and text books compatible with the realities of floor nursing in todays hospital culture and staffing?

If not who should change?

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Is spiritual distress related to religion? If so, is it not better addressed by clergy? Does this mean that agnostic nurses cannot treat these patients? What is in this pseudo-diagnosis that is not covered by ineffective coping?

I love the term pseudo-diagnosis.

However, from what I can figure these two diagnosis are different. Ineffective coping is just an over all inability to cope. I guess you could use this diagnosis on an atheist. But "spiritual distress" would be more specific to someone who is in distress related to his/her own personal diety. I do think, however, there is some over lap there.

And yeah if you are my patient and are is spiritual distress you would probably be better served if I contacted your clergy, rather than me attempting some theraputic communication with you.

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I love the term pseudo-diagnosis.

And yeah if you are my patient and are is spiritual distress you would probably be better served if I contacted your clergy, rather than me attempting some theraputic communication with you.

As far as my understanding goes with spiritual distress, any nurse can detect it base on the nursing diagnosis description (it does not matter if you are an atheist). In terms of action, often on the floor (I would assume base on my limited observation), the chaplaincy service would be called. If you happened to have the time and you are of similar faith tradition, you may be able to do something. If not, the safest route is to call the chaplaincy or find out if the person needs to get connected back to his/her faith community and try to contact that faith community.

It is a case in my opinion of knowing when to call in the specialist, whether the specialist be a doctor, a social worker, a therapist, a chaplian, a whomever.

Another related example is the Eucharist (communion) for a person of the Catholic faith. For a number of Catholics, having communion at least weekly is very important. If they don't have it, they would go under "spiritual distress". So a priest would be call. A related personal example, one of my uncle was dying and just won't go. There is something that seemed to be holding him back but he can't communicate. My mother finally asked him does he want communion (he is Protestant) and there were a drop of tears flowed from his eyes. They gave him communion and a few hours later, he died. I would place my uncle's example as spiritual distress and a good nurse will be able to detect it (even though s/he is an atheist) and take appropriate action by again, calling in the right people to help.

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You got a good point there.

So, I guess the next question would be: Is the nursing job description as prescribed by NANDA, state boards, nursing organizations and text books compatible with the realities of floor nursing in todays hospital culture and staffing?

If not who should change?

Good question. The problem is that nursing is so varied as it can be outside the hospital too. Even in the hospital environment, it can be very varied. For example, compare ER nursing to Psych nursing. With ER nursing, my guess is that you will not have that many opportunites to deal with the spiritual side of things as you have with some areas like psych nursing. The spiritual side, I think you usually need time to have the opporutnity for the patient to bring it up. From what I read on this site, beside psych nursing, other nursing areas that have more time to get to know the patient and family are areas like hospice nursing or certain kind of oncology nursing or rehab nursing. When one has the time to know the patient, spiritual issues can pop up and nurses has a role in it if the nurse is going care for the whole person (put the chaplaincy number on speed dial:)).

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Is spiritual distress related to religion? If so, is it not better addressed by clergy? Does this mean that agnostic nurses cannot treat these patients? What is in this pseudo-diagnosis that is not covered by ineffective coping?

Spiritual distress is not related solely to religion. An individual who expresses a lack of hope, a purpose in life, lack of courage, guilt, refuses interaction with friends and family, is suffering from spiritual distress. Spiritual distress is not only religious in nature but it also affects one's own spirit.

Grannynurse:balloons:

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