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

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?

I can't speak for where you work but it most place, it is considered part of a nurse's responsibility.

Grannynurse:balloons:

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I think we have gotten a little bit away from the nsg dx of altered energy field, but I have some thoughts on spiritual distress. Making a referral to clergy may be appropriate, but first we need to assess what is actually going on. Sometimes patients have concerns that they aren't comfortable sharing with clergy. An example is the teenage daughter of a pastor who is angry at God for giving her cancer. Sometimes patients have experiences they consider unorthodox or heretical. I'm not saying that a referral isn't indicated, but that the most important thing is to listen. Not to agree, or argue, or to explain. Just to listen. Then we can suggest a referral, or whatever seems appropriate. (Plus we have to know the religious affiliation or orientation of the patient.) I know there isn't time for listening in all settings. But I think we can spend some "task time" in listening (like when we are doing dressings, procedures etc.).

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I think we have gotten a little bit away from the nsg dx of altered energy field, but I have some thoughts on spiritual distress. Making a referral to clergy may be appropriate, but first we need to assess what is actually going on. Sometimes patients have concerns that they aren't comfortable sharing with clergy. An example is the teenage daughter of a pastor who is angry at God for giving her cancer. Sometimes patients have experiences they consider unorthodox or heretical. I'm not saying that a referral isn't indicated, but that the most important thing is to listen. Not to agree, or argue, or to explain. Just to listen. Then we can suggest a referral, or whatever seems appropriate. (Plus we have to know the religious affiliation or orientation of the patient.) I know there isn't time for listening in all settings. But I think we can spend some "task time" in listening (like when we are doing dressings, procedures etc.).

I agree we have gotten a bit far of field. Spirituality not only deals with a patient's religious beliefs but with his spirit as well. And anger at God may interfer with a patient's ability to communicate with a clergyman. And a non-believer may also have problems interacting with a clergyman but still be in spiritual distress. And while we are busy, like you point out, there is time when giving treatments, to talk with the patient.

Grannynurse:balloons:

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Nursing is and should be holistic in nature. Treating a wound and treating the patient are two different things. However, I think we need to be careful when we start diagnosing patients. This is really in the realm of doctors and is a relatively new process for nurses. "Potential for infection" or "Fluid Volume Deficit" are easily understood and recognized by everyone. They have always been a part of nursing and are now being formally described. I think diagnosis' like "Energy Field Disturbance" are problematic because we cannot even agree on what they mean. Nurses are NOT trained to treat energy fields and we should not attempt to diagnose or treat them! IMHO

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I can't speak for where you work but it most place, it is considered part of a nurse's responsibility.

Grannynurse:balloons:

I work on Orkmok, the third planet in the Zork system....

I'm in agreement with you. Spiritual distress is considered part of nursing responsibility.

My point is this: the hospital administrators are not nearly as concerned with this diagnosis as NANDA is.

As you stated earlier the nursing practice "extends beyond calling his doctor for medication and a priest." So, in order for me to really go in-depth into his distress, (as envisioned by NANDA). I need more time than what is allotted, not to mention more training is phych. I can't say, sorry the admit is going to have to wait, I need to talk to this gentleman about his statement about being mad with GOD. But first I need to do some study of the Catholic faith, because I'm a little rusty on that front. Every one gives lip service to the spiritual well-being of patients, but the bottom line is still the bottom line.

This is not to say nurses shouldn't assess a patients emotional state. Just saying with time constaints and staffing issues, as Danu3 suggests: sometimes diagnosis dealing with emotional state are best left to the experts.

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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:)).

You are right there. I did a rotation with hospice during nursing school. The standard proceedures and patient focus is definately different than a surgical floor. For example, they begin each report in the morning with a prayer then they go directly into discussing the patients emotional state.

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Nursing is and should be holistic in nature. Treating a wound and treating the patient are two different things. However, I think we need to be careful when we start diagnosing patients. This is really in the realm of doctors and is a relatively new process for nurses. "Potential for infection" or "Fluid Volume Deficit" are easily understood and recognized by everyone. They have always been a part of nursing and are now being formally described. I think diagnosis' like "Energy Field Disturbance" are problematic because we cannot even agree on what they mean. Nurses are NOT trained to treat energy fields and we should not attempt to diagnose or treat them! IMHO

Well said, exactly what I would have said (if I were half way articulate.)

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I work on Orkmok, the third planet in the Zork system....

I'm in agreement with you. Spiritual distress is considered part of nursing responsibility.

My point is this: the hospital administrators are not nearly as concerned with this diagnosis as NANDA is.

As you stated earlier the nursing practice "extends beyond calling his doctor for medication and a priest." So, in order for me to really go in-depth into his distress, (as envisioned by NANDA). I need more time than what is allotted, not to mention more training is phych. I can't say, sorry the admit is going to have to wait, I need to talk to this gentleman about his statement about being mad with GOD. But first I need to do some study of the Catholic faith, because I'm a little rusty on that front. Every one gives lip service to the spiritual well-being of patients, but the bottom line is still the bottom line.

This is not to say nurses shouldn't assess a patients emotional state. Just saying with time constaints and staffing issues, as Danu3 suggests: sometimes diagnosis dealing with emotional state are best left to the experts.

I am a practicing Catholic, have more then a nodding acquaintance with Judaism, Buddhism and most Christian religions. And am study Muslim religion. Perhaps the fact that I began my career in NYC, had patients with a variety of religious backgrounds, that forced me to learn more about their individual religions to help them. It is too bad that most seem to think that the demands of their work excuse them from attempting to help a patient with his/her emotional needs. And then wonder why the patient does not follow their directions. I always thought there was more to patient care then just the physical needs. And I always thought a nurse, changing a dressing, could interact with a patient, and meet the emotional needs. Guess I am wrong.

Grannynurse:balloons:

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Specializes in Nursing assistant.
I am a practicing Catholic, have more then a nodding acquaintance with Judaism, Buddhism and most Christian religions. And am study Muslim religion. Perhaps the fact that I began my career in NYC, had patients with a variety of religious backgrounds, that forced me to learn more about their individual religions to help them. It is too bad that most seem to think that the demands of their work excuse them from attempting to help a patient with his/her emotional needs. And then wonder why the patient does not follow their directions. I always thought there was more to patient care then just the physical needs. And I always thought a nurse, changing a dressing, could interact with a patient, and meet the emotional needs. Guess I am wrong.

Grannynurse:balloons:

Could you share a bit more about your educational background?

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I am a practicing Catholic, have more then a nodding acquaintance with Judaism, Buddhism and most Christian religions. And am study Muslim religion. Perhaps the fact that I began my career in NYC, had patients with a variety of religious backgrounds, that forced me to learn more about their individual religions to help them. It is too bad that most seem to think that the demands of their work excuse them from attempting to help a patient with his/her emotional needs. And then wonder why the patient does not follow their directions. I always thought there was more to patient care then just the physical needs. And I always thought a nurse, changing a dressing, could interact with a patient, and meet the emotional needs. Guess I am wrong.

Grannynurse:balloons:

Grannynurse, don't forget we came up in a different period. What we think is common, today's nurses never heard of! I'm a Zen Baptist but work with 40 different cultures. Knowledge is a great thing to have!

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Could you share a bit more about your educational background?

My formal education?

1963 to 1964 San Diego Mesa College

1964 to 1967 Brooklyn State Hospital School of Nursing.

1964 to 1965 Long Island University

1967 Sage College

1969 to 1971 Hudson Valley Community College

1973 to 1976 Long Island University

1981 to 1987 University of South Florida

1996 to 1997 University of South Florida

2000 to 2003 Sage College

I hold a AAS in Nursing, a BSN, A MS. I have taken graduate level courses in rehab, nursing, religion, ethics, modern history to name a few. The reasons for this being a desire to broaden my knowledge base. I general took one course a semester.

Infromal Education

I read a wide variety of non fiction books covering a wide variety of topics. I am currently reading a book written by a Christian conservative, supporting his point of view and what is wrong with the left and Democratic Party.

I have lived in Germany and Japan. I have traveled extensively in this county, Central America and the Far East, being exposed to different cultures and religions. Prior to travel, I have always read about the la

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Could you share a bit more about your educational background?

My formal education?

1963 to 1964 San Diego Mesa College

1964 to 1967 Brooklyn State Hospital School of Nursing.

1964 to 1965 Long Island University

1967 Sage College

1969 to 1971 Hudson Valley Community College

1973 to 1976 Long Island University

1981 to 1987 University of South Florida

1996 to 1997 University of South Florida

2000 to 2003 Sage College

I hold a AAS in Nursing, a BSN, A MS. I have taken graduate level courses in rehab, nursing, religion, ethics, modern history to name a few. The reasons for this being a desire to broaden my knowledge base. I general took one course a semester.

Informal Education

I read a wide variety of non fiction books covering a wide variety of topics. I am currently reading a book written by a Christian conservative, supporting his point of view and what is wrong with the left and Democratic Party. My family has said they fully expect to find me dead, with a book in my hand. I read in bed, when cooking, in the bathroom, on the bus, train, plane, in the car, when not driving, waiting to be seen for an appointment, waiting to pick up my grandchildren at school. When I go out for a meal alone. You catch my drift don't you?

I have lived in Germany and Japan. I have traveled extensively in this county, Central America and the Far East, being exposed to different cultures and religions. Prior to travel, I have always read about the area I am going to visit. Owing to the areas I have worked in and the nature of my work, I have been exposed and read about a number of non traditional religions as well, to learn how they impact on my patients.

I realize I am more widely read then most.

Grannynurse:balloons:

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