Nursing diagnosis "altered energy field"

Altra, BSN, RN · Jan 17, 2006

One of my favorite nursing school instructors once threatened to put any care plans submitted to her containing this dx straight into the trash can ... :rotfl:

To answer llg's point ... no, I don't scoff at pts' spiritual, religious or philosophical beliefs & practices which may be employed as adjuncts to standard, accepted medical practice. What makes me very uneasy is the thought of nurses "crossing the line," so to speak, into this territory in their role as professional nurses. IMO, it could marginalize our profession.

I have not looked at any of the links provided by VickyRN & Siri ... will explore those later.

paphgrl · Jan 17, 2006

The problem that I have with TT and the NANDA diagnosis is that there is no valid research that proves the "energy field" exists in any peer reviewed publications that use valid scientific methodology (ie controlled, double blind objective research.)

A scholarly publication does not necessarily mean that valid research technique is used. We, as nurses, should use evidence based research in our practice.

For this reason I do believe that the "energy field" diagnosis threatens the legitamacy of our profession.

Also, because a practice is "alternitive" doesn't necessisarly mean it is holistic.

danu3 · Jan 17, 2006

Thanks for the information and clarification.
Danu, do nursing students really have to learn TT? I haven't heard of the programs here requiring it.
I'm more of the scientific mode of thinker myself. But if there are nursing diagnosises pertaining to the spiritual condition of the patient, it is not a stretch for me to consider this one either, though I probably won't practice it.

No, not that I know of. I have trouble with this diagnosis because it does require special training in TT. If I am not train in TT, how in the world am I going to make the diagnosis. As for the spiritual diagnosis, nurses do have some (although minimum) training in the area, at least at the level of regonizing "spiritual distress" and then you can call in the Chaplaincy or something. With the way this new energy diagnosis is written, if I understanding right from reading it, I can't just call in someone train in TT because I myself have to do some energy stuff to diagnose the patient (e.g. the instructions given in this diagnosis) to have an energy problem.

With the spiritual distress diagnosis, I can figure that out in the patient even if I am a atheist and I just call in the appropriate people. With TT (as it is written up in the diagnosis), I have to believe in the energy concept in order to diagnose while with the spiritual distress, I can remain an atheist (atheist can have spiritual question also, I know that).

It just seemed like this is really odd... more like a political move to me. The way it is written is like if there is a new nursing diagnosis like "Deficient, Relationship with God". And the nursing action would be to "guide" the patient in prayers to establish/reestablish relationships. Actually I could probably use the energy diagnosis and put in my own brand of religious believes in there without too much trouble.

Tweety, BSN, RN · Jan 17, 2006

Sorry Danu.

There are many nursing diagnosises that are over my head, and I simply do not use them. (Actually, I don't use NG in my practice period, I'm just talking interventions here.)

I don't think just because a NG exists that we have to buy into their belief.

Tweety, BSN, RN · Jan 17, 2006

The problem that I have with TT and the NANDA diagnosis is that there is no valid research that proves the "energy field" exists in any peer reviewed publications that use valid scientific methodology (ie controlled, double blind objective research.)
A scholarly publication does not necessarily mean that valid research technique is used. We, as nurses, should use evidence based research in our practice.
For this reason I do believe that the "energy field" diagnosis threatens the legitamacy of our profession.
Also, because a practice is "alternitive" doesn't necessisarly mean it is holistic.

I agree, and thus have the same reservations, but I don't feel as strongly that it undermines the profession.

Is there really any scientific proof in faith based NG's?

Tweety, BSN, RN · Jan 17, 2006

I don't scoff at alternative modalities, just believe that they ought to be researched and incorporated into evidence-based practice.
As for spiritual care and praying, that does not require my participation as a nurse.

TT has been researched and found to be beneficial. The same as prayer is beneficial. One has a hard time proving that prayer helps, but there is evidence that some patients benefit, as there is some evidence that patients benefit from TT and benefit from placebos. The mind-body connection can be powerful.

I agree, though research and a line has to be drawn somewhere.

Just because this diagnosis exists doesn't mean you have to participate either.

Jolie, BSN · Jan 17, 2006

TT has been researched and found to be beneficial. The same as prayer is beneficial. One has a hard time proving that prayer helps, but there is evidence that some patients benefit, as there is some evidence that patients benefit from TT and benefit from placebos. The mind-body connection can be powerful.
I agree, though research and a line has to be drawn somewhere.
Just because this diagnosis exists doesn't mean you have to participate either.

I guess I'm not doing a good job of making my thoughts clear here. I firmly believe that the "laying on of hands", "therapeutic touch", massage, etc. are of great benefit to patients, and too often lacking in the nursing care of most patients.

What I question is the notion that any of this is related to a practitioner's manipulation of an "energy field". THAT is what I want to see researched and substantiated and incorporated into evidence-based practice.

Instead of developing new and questionable nursing diagnoses that support the referral of a patient to a TT or Reiki practitioner, why not advocate for adequate nurse:patient ratios that allow the NURSE to perform hands-on care?

grannynurse FNP student · Jan 17, 2006

I guess I'm not doing a good job of making my thoughts clear here. I firmly believe that the "laying on of hands", "therapeutic touch", massage, etc. are of great benefit to patients, and too often lacking in the nursing care of most patients.
What I question is the notion that any of this is related to a practitioner's manipulation of an "energy field". THAT is what I want to see researched and substantiated and incorporated into evidence-based practice.
Instead of developing new and questionable nursing diagnoses that support the referral of a patient to a TT or Reiki practitioner, why not advocate for adequate nurse:patient ratios that allow the NURSE to perform hands-on care?

And why can't a nurse do both, support TT and advocate adequate nurse:patient ratios. I do not see one being mutually exclusive of the other.

Grannynurse:balloons:

VickyRN, MSN, DNP, RN · Jan 17, 2006

New nursing diagnoses, 2005

Imparied Religiosity

Readiness for Enhanced Religiosity

Risk for Dysfunctional Grieving

Risk for Impaired Religiosity

Sedentary Lifestyle

Revised diagnoses, 2005

Dysfunctional Grieving

Energy Field Disturbance

Risk for Spiritual Distress

According to NANDA (2005, p. vii), "The new and revised diagnoses reflect increased awareness of the importance of spirituality and religion in health and illness as well as growing global concerns surrounding sedentary lifestyles."

NANDA International. (2005). Nursing diagnoses: Definitions & classification. Philadelphia: NANDA International.

VickyRN, MSN, DNP, RN · Jan 17, 2006

References cited in the official NANDA book (see above) to support "Disturbed Energy Field:"

Macrae, J. (1988). Therapeutic touch: A practical guide. New York: Knopf.

Newshan, G., & Schuller-Civitella, D. (2003). Large clinical study shows value of therapeutic touch program. Holistic Nursing Practice, 17, 189-192.

Nurse Healers Professional Associates International, the official organization of Therapeutic Touch. 3760 S. Highland Drive, Salt Lake City, Utah 84106; http://www.therapeutic-touch.org .

Jolie, BSN · Jan 17, 2006

And why can't a nurse do both, support TT and advocate adequate nurse:patient ratios. I do not see one being mutually exclusive of the other.
Grannynurse:balloons:

If scientific evidence proves the existence of an energy field, and the benefits of manipulating it, then I'm all for it. Until then, I don't believe it is proper for nurses to engage in unproven therapies. Our status as respected healthcare professionals lends credence to treatments that may be, at best, expensive and useless, and at worst, harmful if they are substituted for truly effective therapy.

grannynurse FNP student · Jan 17, 2006

(I don't understand why you chose to attack my response. Please refrain from doing so again.)

I'm sorry if you view my post as an attack. To use a sixth graders poor attempt to put down TT is one founded in a non-scientific approach. And you did do just that. And if you had done a little more research, you would have found:

1. the sixth grader didn't do her own research, which was highly questionable

2. several adults did, which was also not very scientific

3. their attempt was an extremely poor one.

4. the sixth grader's mother was a member of a known quack organization, whose own research is highly suspect.

All I suggested was that one look into the research that has been done, both in support and against the validity of TT. There are several articles, which used the scientific model to validate, the use of TT. And while I do not have the titles of the articles or journals handy, a review of the literature will provide them.

Grannynurse:balloons: