According to nursing statutes to which registered nurses (RNs) must conform (called “nurse practices acts” and “nursing practices acts”), nursing is both an art and a science. There is much confusion over just what this description means for RNs—whose vocation entails legal obligations, but who have little independence as healthcare professionals and whose knowledge base is not unique. This confusion has facilitated the construing of nursing art as metaphysics—specifically, paranormalist speculation or philosophizing—and to the contamination of nursing science therewith.

For example, the State Board of Nursing of Colorado (CBN) used to accord continuing education (CE) credits (“units”) to nurses on the basis of their completing attendance of uncritical conferences on nonbiomedical methods such as Therapeutic Touch (TT). After the Rocky Mountain Skeptics, headed by Bela Scheiber, M.B.S., contested this, the CBN appointed a subcommittee, which in 1992 recommended:

Because Nursing is both a science and an art, nurses require access to and familiarity with many belief systems and knowledge bases, including, but not limited to, the traditional sciences. . . . Nurses also use the insights and experiences gained from studying peoples of other cultures and learning other perspectives to alleviate suffering and promote health and healing, which may lack modern scientific investigation. . . . [T]he State Board of Nursing of Colorado, like other State Boards of Nursing all over the country, should continue to be an advocate for the public safety and for patients’ rights to access the full range of caring and healing interventions by continuing to acknowledge continuing education units earned for the study of Therapeutic Touch.

The CBN adopted this recommendation.

In 1993 the skeptics group turned to the Colorado State Senate’s committee on Health, Environment, Welfare, and Institutions (HEWI). In May of that year, the HEWI committee required that the CBN “thoroughly review alternative healing practices, such as Therapeutic Touch, neurolinguistic programming, and crystal healing, prior to approving the study of these healing methods for continuing education.” The committee also requested that the CBN “send copies of future board meeting agendas listing hearings of the above courses, and any other courses based on nontraditional healing practices to the Senate HEWI committee members.”

The following year, the CBN announced that it had abolished CE requirements for nursing license renewal.

Culture War

Paranormalist currents emerged in the field of nursing more than 25 years ago, not long after the struggle to establish a new identity for nurses—one emphasizing extra-institutional practice and nondomination by physicians—had begun. The prestigious nursing department at New York University (NYU) started inspiring students toward pseudoscience in 1975. Such graduates became key in metamorphosing the American nursing academe into what it is—a stronghold of junk science. Today, NYU’s Holistic Nursing Program favorably covers guided imagery, reflexology, and TT.

In a paper on “postmodern nursing,” former Washington Post journalist Sarah Glazer correctly describes as widespread among nursing academics the worldview that, because every health profession is a social construction, nursing has no objective imperative, and thus the nurse has the right to base her art on whatever she cares to base it—notwithstanding generally established nursing standards and other parts of the social construction her nursing school or healthcare facility wants to impose on her.

The field of nursing is the site of a culture war between the forces of science and reason and the upholders of mysticism, vitalism, and supernaturalism. It is a war in which, as Glazer states, “words like ‘reality,’ ‘objective,’ ‘evidence-based practice,’ ‘quantitative research,’ and even ‘measurement’ have become code words for all that is evil, patriarchal, and insensitive about modern science and modern medicine.” The mystics and vitalists and their feminist sympathizers in this war treat science (or at least what most scientists call “science”) as merely political—the status quo’s main line of defense. These feminists contend that science’s appearance of objectivity has long obscured its male bias.

In “Men Researching Women Working,” published in a 1996 issue of Nursing Outlook, Sam Porter, Ph.D., stated: “There is an increasing realization among female nursing commentators that there is, or at least should be, a close consonance between nursing knowledge and feminist epistemology.” That “women's knowledge is central to nursing knowledge,” he said, has been determined. And in a letter published in Nursing Research in 1995, P. Heidt, a prominent advocate of TT, asserted: “[B]ecause we are primarily a woman's profession, we can never be content with using a reasoning mind alone in our scientific search.” She further stated: “TT was not meant to be subjected to a scientific tool.” Evidently, physicians and their patients have long, often, and unreflectively used the verb “heal” as a synonym for “cure.” But, in an article published in the December 1989 issue of Nursing & Health Care, researcher Janet F. Quinn, Ph.D., R.N., questioned such usage on the basis of etymological similarity between “healing” and “wholeness.” According to those nurses who are metaphysicians, healing (what nurses do) entails treating the whole person, whereas curing (what physicians do) entails treating definite body parts and delimited ailments. Thus, the mission of nurses purportedly transcends that of physicians. Glazer states:

Nurses searching for professional distinctiveness have plugged into a philosophical tradition that declares there is no absolute truth. . . . Nurses who have adopted the relativist view in its most simplistic form have simply taken it to its natural conclusion: If science does not represent truth, then anything goes. Anything can include Therapeutic Touch, the Science of Unitary Human Beings, or communicating with the dead.

Strange Magic versus “Bad Science”

Although science is an obstacle to what postmodern nurses want for their profession, most of these nurses do not eschew using the word “science” affirmatively. Perhaps the most important reason for this is that a frontal assault is the riskiest form of attack, even in a culture war—and in this case, the potential target is widely appreciated by Americans. (Virtually all Americans, it seems, accept science at least pragmatically.)

So the vast majority of postmodern nurses have come to exploit—yet to profane—both the term “science” and its referent. Postmodern nurses and assorted other healthcare metaphysicians in the U.S. tend to misrepresent magic as scientific, because without the trappings of science, ritualistic magic that lacks mainstream religious approval generally does not play in American healthcare.

Some admirers of the late NYU Dean of Nursing Martha E. Rogers have effectively promoted an incorrect interpretation of her theoretical framework—the Science of Unitary Human Beings (SUHB)—in connection with TT. According to SUHB, the world is organized into irreducible fields, and each human and the environment constitute two such fields, which interact continuously and are mentally perceptible. Unlike TT theory, however, Rogers did not posit “life energy,” nor manipulatable “human energy fields.” No objective observation of these alleged fields, nor of the irreducible fields that Rogers posited, has ever been published in any notable scientific journal. Furthermore, they are inconsistent with what is known in science.

Caring Science is a brainchild of Jean Watson, Ph.D., R.N.—past president of the National League for Nursing (the source of American nursing schools’ accreditation), the former dean of the University of Colorado’s School of Nursing, and the founder and director of the Center for Human Caring at the University of Colorado Health Sciences Center. Caring Science rests solely on (a) a set of conjectures about the significance of compassion and empathy, and (b) some qualitative studies (i.e., studies distinguished by comparisons that are not accurately quantifiable).

Neither Caring Science nor SUHB qualifies even as a body of scientific knowledge.

Postmodern nurses tend to exploit and degrade not only the word “science” but also the term “theory.” Theories are the goals of science. In the scientific domain, a theory is a well substantiated, comprehensive, predictive explanation, generally approved in the scientific community, though not final, of a phenomenon or set of data. This hardly describes the state of affairs in the nursing academic community, many of whose major theorists are propounding not authentic, predictive explanations, but rather theories in the popular sense of the word—i.e., speculations. Nursing graduate students are likely to be exposed to such speculations as King’s Systems Framework and Theory of Goal Attainment, Kolcaba’s Theory of Comfort, Newman’s Theory of Health as Expanding Consciousness, Orem’s Self-Care Deficit Theory, Orlando’s Nursing Process Theory, Parse’s Theory of Human Becoming, and Watson’s Theory of Human Caring (the harbinger of Caring Science).

Because there is much dissonance among such putative explanations, each cannot be well substantiated. Indeed, all of those cited above are not much more than abstractions of little use to nurses working in healthcare facilities. Moreover, their use can conduce to spending time pointlessly. Evidently to ward off criticisms like mine, the nursing academia, in the form of John R. Phillips, R.N., Ph.D., has described “bad science” as “[consisting] of elements and activities that bring dissolution of wholeness or do not enhance the awareness of wholeness.”

The Bottom Line

Among the expressions that the postmodernists of the nursing academic community have not perverted is one that best fits what they centrally advocate: junk science. By making scientific principles subordinate to their ideals, such academics put nurses at risk legally and patients at risk medically. In addition, they are delaying the progress in the field that can come only with scientific rigor.

Glossary

Guided Imagery (Guided Visualization): A method akin to creative visualization and led meditation. Its purported design is to promote physical healing, or attitudinal or behavioral changes. Acting as a “prompter,” the practitioner orally outlines a scene. Otherwise, the practitioner gives the client instructions on using imagery for self-help.

Health Patterning: Allegedly, a process of facilitating “unitary well-being.” It includes imagery, mediation, and Therapeutic Touch.

Knowledge Base (Knowledge Domain): In healthcare, the information and rules in any field, especially the information and rules used by experts in a particular field to solve problems in that field.

Mysticism: In philosophy, the belief, tendency to believe, or doctrine that there are momentous realities apprehensible only subjectively and nonrationally.

Paranormal: 1. Outside normal human experience and scientifically inexplicable. 2. Supernatural. 3. Relating to alleged paranormal events, such as ESP or psychokinesis.

Paranormalist [adjective]: Showing acceptance of alleged paranormal events.

Postmodern (postmodernist): Of, relating to, or being any of several movements that emerged in the 20th century against establishmentarian nontraditionalism (which was characterized by rationalism, objectivism, realism, and faith in technology).

Reflexology: 1. Variation of acupressure whose postulate is that all bodily organs have corresponding external “reflex points” (on the scalp, ears, face, nose, tongue, neck, back, arms, wrists, hands, abdomen, legs, and feet), and that manipulating these points can enhance the flow of “energy.” 2. Foot Reflexology. 3. Zone therapy. 4. Macroreflexology and microreflexology. 5. A type of shiatsu that focuses on the hands and feet.

Science of Unitary Human Beings (SUHB): The conceptual system created by Martha E. Rogers, Ph.D. (see “Unitary Health Care”), the author of Reveille in Nursing (1964) and An Introduction to the Theoretical Basis of Nursing (1970). According to SUHB, all humans are only manifestations of a whole that is both knowable and unknowable.

Therapeutic Touch (TT, Krieger-Kunz Method of Therapeutic Touch): Derivative of the laying on of hands, initiated in 1972 by Dolores Krieger, Ph.D., R.N., and Dora van Gelder Kunz, a clairvoyant born in the Dutch East Indies (Indonesia). Nursing professor emerita Dolores Krieger is the author of Accepting Your Power to Heal: The Personal Practice of Therapeutic Touch (Bear and Company, 1993), Foundations for Holistic Health Nursing Practices: The Renaissance Nurse, Living the Therapeutic Touch: Healing As a Lifestyle, The Therapeutic Touch: How to Use Your Hands to Help or to Heal (Simon & Schuster, 1992), and the Therapeutic Touch Inner Workbook: Ventures in Transpersonal Healing (Bear and Company, 1996). TT theory posits chakras and manually transmittable “human energies.”

Unitary Health Care (Unitary Nursing): A mode of nursing based on the work of nursing professor Martha E. Rogers, Ph.D., during the 1950s in New York. It includes Health Patterning and Unitary Pattern Appreciation.

Unitary Pattern Appreciation (Pattern Appreciation): A “process” based on the theory of the Science of Unitary Human Beings and developed by W. Richard Cowling III, R.N., Ph.D., reportedly to promote understanding of one’s “underlying energy.”

Vitalism: The theory or doctrine that something nonmaterial and nonchemical is basically or partly responsible for life or for human life.

***

Former administrative clinical dietitian Jack Raso, M.S., R.D., is Director of Publications at the American Council on Science and Health; editor-in-chief of its quarterly, Priorities for Health; and a contributing editor to The Scientific Review of Alternative Medicine. He is also the author of A Dictionary of Alternative-Medicine Methods and two trade books on alt-med.

The publishing was authorized by the author of the original essay.

The original essay is available at http://www.WritersHood.com/00dec/tnfRaso.htm

Translations to spanish and grammar corrections on the translation to portuguese are welcome.