Nursing diagnosis "altered energy field"

[paphgrl]

"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

[SFCardiacRN]

But you can always deny that a chair is not really a chair even if you can feel it under your butt!

I can objectively see a chair. I can chart it's characteristics. I can tell if it is safe to sit on or not. I can measure it's dimensions and recommend any repairs that might be needed. The diagnosis of energy field has none of these.

[SFCardiacRN]

I dont know where that dx came from, but it sounds completely out of whack with the kind of Western medicine practiced here in the US. It almost seems like an attempt for Nanda to be cutting edge or PC or something?

It came from a small group of aggresive nurses in commitee that would not shut up until it was included. Unfortunately, the NANDA commitee majority caved in to these loud mouthed wackos.

[rngreenhorn]

From a purely practical approach: outside of this forum, nursing school, textbooks, and websites, I never hear about this diagnosis. I've never had a physician write an order for TT, never had one write "pt appears to have an 'alteration in his energy field'" in the progress note, never seen it in any of our care plans, never seen a nurse diagnose "altered energy field", never had a patient ask for TT.

So just wondering where it is being used? How prevalent is this diagnosis in nursing? Where does a patient go to be diagnosed with this affliction? Is this something that is being taught and used by your standard floor nurse? Is there an "altered energy field" question on the NCLEX? Or do only advanced practice nurses use it?

I know NANDA is pushing for socialized medicine, is it also pushing for our tax dollars to pay for alternative type modalities?

And finally totally off the subject: Danu you should check in and let us know you are OK.

[phoenix33]

So just wondering where it is being used? How prevalent is this diagnosis in nursing? Where does a patient go to be diagnosed with this affliction?

Hi There rngreenhorn,

I just returned from lunch with a friend who is a ARNP in a Rheumatology practice here in Florida. The physician she works with is an allopathic MD who is open to other modalities and allows her to perform healing touch sessions as well as raindrop technique (totally different)in the office on clients who are willing and can pay. There are many patients in that office who benefit from this modality and, as you may have already noted, it is used as a COMPLIMENTARY therapy, not an alternative. Medications are still prescribed as needed.

BTW there are HT practitioners who are reimbursed by insurance for this service. I also know a HT instructor who travelled to California last year to teach basic techniques to staff (those who were willing to learn) at Loma Linda. If you've a mind to confirm that, her name is Judy Ray and you can get her contact info off of the Healing Touch Colorado or International websites.

This "altered energy field" dx has been around for several years now, not new by any means AND I've no doubt it's here to stay. There are many things we cannot prove in the universe but that doesn't mean they don't exist.

[carolinapooh, BSN, RN]

I'm fairly fresh out of school, and this energy field disturbance thing is included in the Mosby book that I used in my care plans. I did not use it in any care plans in school.

I don't approve of the entire idea of nursing diagnosis. If you want to call them "categories of symptoms" then that would be closer to a description of what they did for me in school. I wasn't a CNA, or a LPN first, and lacked self confidence and possibly a good deal of common sense to boot.

So I would read the entire list of nursing interventions for some of the common nursing diagnoses that I kept using over and over. It's really good info in there, about what you CAN possibly do for your patient. It takes the esoteric knowledge of what happens during a disease and turns it into "look, here is what you do when you see this" type knowledge. Or it did for me; there were some things that happened to my patients in school, that the nurses did a bunch of things for and then left me to wonder how they knew to do all those things so quickly. So for the slack-jawed, bookworm, wide-eyed student that I was, the Mosby book was a lifesaver. I could stock away some ideas for care, maybe write them down, and keep these things in mind for either the next day or the next time I saw something.

I knew that these are things I would learn with experience, but lacking that, I took from that book what I needed to do well in clinical. But I don't agree with the idea that it's got to be a separate category of "what's wrong with this person." I don't have problems with just using medical diagnoses and learning what practical problems they present, and what actual things to do for the patient with that medical diagnosis.

So nursing diagnoses, for the most part, seem to me to be an ivory tower type invention to make us look like we know stuff that other people don't. Well we do know stuff that lay people might not know, and the physician might not be paying attention enough to know, but I guarantee you that the doctor knows enough pathophysiology to understand at least as much as the nurse does about the patient. It doesn't have to be a separate arena of knowledge altogether. And yes, I agree with ... I forgot her name now... the lady who wrote "Nursing Against The Odds" on the subject of nursing diagnosis.

Now we've got this care plan form at work, that we didn't have previously, with ... not nursing diagnoses, thank god, but just goals that we are supposed to put down for the patient. I really feel that I don't have time to write down my goals when I'm so busy busting my butt to achieve them.

One of our nurses was busy critiquing the goals in the stack of forms, and saying what she would write instead (yes, she wasn't working like the rest of us try to) and didn't realize she was spitting out some garbled twisted form of nursing diagnosis instead of goals. It was kind of ironic, quite amusing to see that the one person I can point to in my unit who works the least and talks the most, can spit out nursing diagnoses like they are second nature.

So I have no good things to say about any nursing diagnosis, really. I just appreciated the listing of interventions in a halfway understandable format.

That is exactly what I've read in a book I have at home; I have so many books about nursing that I can't tell you which one it is, but it builds on something you're pointing out.

The author said something along the lines of this: the reason the nursing profession continues to be looked at askance is partially due to nursing diagnoses. No one else has anything like that; they’re a holdover from when nurses’ opinions on the MEDICAL diagnosis of a patient wasn’t wanted, and when she wasn’t even expected (or for that matter, was wanted) to know WHY Dr. X was doing whatever it was he was doing – she was just expected to carry out the order or DO something for the patient within the context of the illness, but not BECAUSE the patient was sick with whatever illness he/she had. Why can't nursing just speak the language of the medical profession instead of having one of its own? Doesn't that just FURTHER separate nursing from everyone else? Why can't I say, well, I'm doing this because the patient has X disease, and doing this will alleviate/cause/lead to Y. Nursing diagnoses/interventions (aren't they treating a pt, not intervening? Intervening in what? With what? I don't get it) that I've read don't seem to do this. Feel free to tell me I have no idea what I'm talking about; it will neither bother nor offend me.

(Somebody refresh my memory - was this in NURSING AGAINST THE ODDS? OR was it in one of the other fifteen books I have on the subject?)

So I agree with you. And I'm RELIEVED to know I won't be the only one doing that or thinking that way in clinicals; I read fundamentals books now (keeps me motivated) and I think, well, aren't you doing THIS in reality...so why not just SAY it? I've gotten tips now on how to handle the frustration.

That said, while I think TT is not medicine in the classic sense of the word, I strongly believe in the placebo effect. If the patient says it makes him/her feel better – GREAT. They should use it. What I don’t doubt is that a quiet room at a warm temperature with a soothing voice standing over you (I can only go by what I’ve seen on the Discovery Channel – don’t judge me) talking calmly would make ANYONE feel better. If I were that ill – or whatever would prompt someone to use TT – I might try it in hopes it would work.

Personally, it's a bit too New Age for me, and it DOES disturb me that it’s listed – in all places – in Mosby’s. But if a patient says it works, they certainly should use it. I’m no scientist, I’m no expert; I do know we carry with us our own personal electrical field, and I’ve had days when it has CERTAINLY felt “altered” (what if that is what causes headaches? And aspirin - since they're not REALLY sure how it works - corrects some sort of electrolyte imbalance and cures the headache? I’m being serious). But….this is a bit OTT for me, I must admit….

[chadash]

The author said something along the lines of this: the reason the nursing profession continues to be looked at askance is partially due to nursing diagnoses. No one else has anything like that; they're a holdover from when nurses' opinions on the MEDICAL diagnosis of a patient wasn't wanted, and when she wasn't even expected (or for that matter, was wanted) to know WHY Dr. X was doing whatever it was he was doing - she was just expected to carry out the order or DO something for the patient within the context of the illness, but not BECAUSE the patient was sick with whatever illness he/she had. Why can't nursing just speak the language of the medical profession instead of having one of its own? Doesn't that just FURTHER separate nursing from everyone else? Why can't I say, well, I'm doing this because the patient has X disease, and doing this will alleviate/cause/lead to Y. Nursing diagnoses/interventions (aren't they treating a pt, not intervening? Intervening in what? With what? I don't get it) that I've read don't seem to do this. Feel free to tell me I have no idea what I'm talking about; it will neither bother nor offend me.

.

Oh my gosh! I had no idea that was why there were nursing diagnosis. I always assumed that if I went to nursing school, I would be learning about medical diagnosis and what nursing interventions were appropriate based on that. I just don't think I would fit into this field.

[SFCardiacRN]

I too was mystified by nursing diagnosis in school. I just didn't see the point. Now I realize it is an attempt to set us apart from medical diagnosis, to give us our own voice and gain respect from MD's. It really is to describe the care we give not to drive that care. I use it in my practice. I cut and paste pre-written care plans into my computer charting. I edit as necessary. But again, it does not drive the care but rather describes what I have already done. In order for us to gain respect we need to remain based in science. Nursing process is and should be objective. If people want to research and study alternative therapies that is a good thing. But to prematurely include unproven therapies into current nursing process helps no-one and hurts the nursing profession as a whole.

[Works2xs]

Now I realize it is an attempt to set us apart from medical diagnosis, to give us our own voice and gain respect from MD's.

It sounds good on paper, in a warm 'n fuzzy sort of way. In a more practical way, I suspect that a big driver for having such diagnoses is that once you have a label, you also have a means to track the activity in a computer database. Linked with "Nursing Intervention Classification" (NIC) which in turn lets you project based on the "Nursing Outcome Classification" (NOC), you now have a means to track/document "Nursing care". ID it.. track it... project it... BILL FOR IT.

Nothing brings legitimacy like $$$.

Of course, since there's no objective way to prove to some auditor that the patient DIDN'T have a disturbed energy field, I can see it becoming the most identified malady in any fee for service sort of system. We could find disturbed energy fields becoming the next pandemic!

Quick.. someone give me a Cynicism Vaccination....

[Works2xs]

2. Here's one I did with groups of thirty people at a time. Get a partner, preferably someone you know nothing about. It's more interesting if everyone wears long pants and shirts. Both are standing and each partner takes turns moving their hands from the head to the feet of their partner with their hands a couple inches off the body. Be aware of any sensation you feel, such as heat of cold, sensations such as drawing or repelling your hand, or anything that flashes through your mind. Change and let the other person do the same to you. Then discuss what you felt. 99% of every group has accurately pick up bruises, scars, old injuries, all kinds of current medical and even emotional problems. Since you're not touching the other person and they are covered up...how'd you do that, LOL!

I spread my hands out over my partner... I sense a cold spot over their left knee... the rest of the person feels somewhat warmer. Afterward, I ask my partner, "I sensed something 'off' in your left knee." They said "wow, I tore a MCL playing tennis in that knee!" Amazing!

Not really. Knees, ankles, elbows, backs.. I'd be willing to bet that any person you felt has at one time mucked up at least one of these areas. About the only 99% of anything happening here is the likelihood of having a partner with a problem (e.g. "bruises, scars, old injuries") in one of these areas.

I don't mean to point a finger at the practice. Just this particular exercise. I'll extend the benefit of a doubt and suspect that the description you provided is just too abbreviated for the forum to really capture what's what. Otherwise, it sounds just like the sort of thing Madame Esmerelda, palmist extraordinaire, would use.

Which, in response to the OP's question, is what at least some folks see as a cause for a lack of legitimacy.

[zenman]

If you insist on calling static electricity some kind of mystical healing source, and can't sense the difference in temperature between your hands and something else without touching it, you may have a problem. If you get too close to someone or something that has a static charge, you may easily get zapped even though you don't touch it. This is nothing mystical, and the phenomenon can be measured and duplicated.

No, no...when you get zapped with static electricity it's over in a second. Try again.

[zenman]

I can objectively see a chair. I can chart it's characteristics. I can tell if it is safe to sit on or not. I can measure it's dimensions and recommend any repairs that might be needed. The diagnosis of energy field has none of these.

Ha, ha...now do the same for wind as you just did for the chair!

[zenman]

From a purely practical approach: outside of this forum, nursing school, textbooks, and websites, I never hear about this diagnosis. I've never had a physician write an order for TT,

The last place I worked, Queens Medical Center on Oahu, physicians wrote orders for TT based on their evidence-based practice.