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Problems with Nursing PDF Print E-mail
Swift
Written by Bart Farkas   

 

Before I came to work for the James Randi Educational Foundation, and even before I became a writer/author, I was a registered nurse. I became an R.N. back at a time when men in the profession (and I struggle to call it a profession) were an insignificant minority. In the 20+ years since I was in school this ratio has changed, but one thing that hasn’t seemingly changed is the intense amount of ‘woo’ that seeps into nursing curriculum. In terms of specifics, I can only refer back to my personal experience at a major teaching hospital in a major city in Canada, but it would seem that my experiences are not unique.

Before I entered nursing school I was at university taking microbiology and biochemistry; and while I was not a motivated student I was learning enough to have an idea of what the scientific method is and how it is applied in science, life, and medicine. So imagine my surprise when the teaching staff spent time teaching us about the ‘healing properties of touch’ and the ‘power of the mind to heal’. I might have been more open to these concepts if my instructors hadn’t already destroyed all their credibility by describing Legionnaire’s Disease as a ‘virus’ (it’s caused by a bacterial infection).

My personal experience in nursing school was that the instructors were mostly reading out of textbooks, had little understanding of the science behind what they were teaching, and tended to stray into the land of ‘woo-woo’ all too often. More than once I got into arguments with instructors about homeopathy, with the instructors insisting that homeopathy was valid because ‘real drugs come from plants’. This is the sort of thing I was up against, and it is actually still accurate in my personal experience. Many nurses have such a weak education in the actual science of disease and pharmacology that they have very simple ideas about what alternative medicine is, and they are all too often open to ideas that just a pinch of critical thinking would crush.

 

Probably the most disturbing ‘woo-woo’ that permeates nursing and nursing education is the concept of Therapeutic Touch (TT).  TT was developed in the 1970s by Dolores Krieger and Dora Kunz, and is reportedly taught in nearly 100 nursing colleges and Universities across North America. Certainly in Canada TT has gained a foothold in the nursing community with organizations like the Therapeutic Touch Network of Ontario.

Barbara Schuster, in the “What is Therapeutic Touch?” portion of the TTNO website states:

One of the underlying working assumptions of Therapeutic Touch is that human beings are open energy fields. We may think of our own energy fields surrounding our bodies, or go even further along the lines of Quantum Physics and the Theory of Relativity, and consider ourselves consisting of pure energy, as matter is considered to be energy. This is just a question of degree or interpretation. In either case, any physical illness can be viewed as an imbalance in this energy field - as some form disorder.”

Whenever something defies explanation we get folks playing the old ‘quantum physics’ and ‘Einstein’ cards. My experience with my fellow nurses was that they struggled with simple ratio and proportion problems for figuring out medication doses, so it’s not surprising that floating the term ‘quantum physics’ as a catch-all explanation for an energy field therapy is common.

In what has become one of the most famous examples of solid basic science and critical thinking debunking an alternative medical claim, a 9-year-old girl, Emily Rosa presented a science fair project in 1997 that tested 21 TT practitioners in an attempt to see if the practitioners could sense the Human Energy Field without being able to see if the subject’s hand was there or not. Not surprisingly these practitioners performed no better than chance and Emily Rosa went on to be the youngest published author in the Journal of the American Medical Association.

The JREF itself put up nearly three quarters of a million dollars in 1996 and challenged over 60 nursing organizations and TT practitioners, including Dolores Krieger, to prove their ability to detect these energy fields. Not surprisingly the one TT practitioner that participated failed to achieve a success rate greater than chance.

Why is nursing so prone to blatantly non-scientific pseudoscience such as Therapeutic Touch, Homeopathy and Reiki? In my opinion the answer is two-pronged. First, nursing educators have long pushed nursing education to focus on the patient, their feelings and emotions, and have ignored the hard science necessary to look after sick patients and understand the disease process. The second reason is that this sort of thinking (non-critical ‘thinking’ thinking) is entrenched at the institutional level and it’s quite simply too difficult to wash away all those years of woo-woo. Let’s hope that over time the attitudes will change and nursing can move to be a more respected field of work.

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written by LovleAnjel, September 17, 2010
I work in the Biology Department at a 4-yr state university (US), and we have several service courses for the Nursing program (intro bio, A&P, micro, pathophys). These classes are mostly info crams, learning technique and terminology, and there honestly isn't enough time to do science process development. I would be surprised if that were not the case in many schools. Nurses are not taught how to be scientists or to think critically, so the wooiness is not all that surprising. (We have reformatted the lab for the intro bio course to emphasize scientific process, experimental design, evaluating evidence, ect. in compensation, but I don't know how much of that sticks.)
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The problems are decades old !
written by pailott, September 17, 2010
I was married to a nurse during her graduate education at McGill.
It did not take long before I realized that much of what the nursing school was teaching
(especially at the graduate level) was hogwash. I would hear them say things, and read in their textbooks
statements that were so idiotic I could not believe this was being taught in a world class university.
The problems, I believe, started when the nursing community tried to establish itself as a profession
with a high level of medical standards. The problem was that the doctors had most areas closed up.
So some in the community resorted to pseudoscience. The biggest culprit was the so-called "Rogerian" model of nursing,
propagated by Martha Rogers. Her nonsensical writing influenced several generations of nurses, to the point where her
semi-new age BS permeates the nursing community, and even its school of higher learning. And they are very defensive
about it of course, as are most adherants to woo-woo science.
The entire medical community needs to purge the nursing schools of this idiotic nonsense.
We can all start by drawing attention to it, and demand a nursing profession based on science, not the rambling of
of a lunatic. If you don't know what I mean read her stuff. I quote a reviewer of her works; "Martha Rogers' theory has three principles of homeodynarnic. First, Integrality a human energy and environmental energy are integrated, one affects the other. Second, Helicy is all energy patterns are continuous and unpredictable providing increasing diversity. Lastly, Resonance is a continuous change in energy fields..."
Need I say more ? This is what nursing students are taught. The same nurses who are charged with injecting drugs into your veins.
Not worried,,,,, I am !
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The problems might be centuries old!
written by Willy K, September 17, 2010
Many, if not all centers of "higher" education in the Western Hemisphere were run by/with religious centers as well. The first true scientist, Issac Newton, was a theologian, though I've read that he did not want to be ordained as a minister.
Today, many colleges and universities are secular. However, they are all run as business's, but they don't need to meet any of your typical consumer expectations. You can get a degree without really getting an education. Most "teachers" I've dealt with didn't know how to teach and many didn't know much of anything about the subject either. As Pailott said, they simply read from a textbook.
So the problem of woo being taught to nurses is actually a wider problem! smilies/cry.gif
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Agreed...
written by JarlNjord, September 17, 2010
I, too, am a male RN but I left the field after about 10 years to pursue a more technical/scientific health care profession as a laboratory technologist. My health care career began as an Army medic during Vietnam after which I became an RN in the 1970s and worked exclusively in ERs and Intensive Care/Cardiac units. Graduate education in the field of nursing is a joke! They earn their "MSN" (Master of Science/Nursing) with NO science at all. I've read the research papers - no resemblance in comparison with research in any other scientific field. I've completed graduate work in health care administration, public health. epidemiology and organizational analysis. My entire adult career has been in hospitals and clinics while moving up into increasingly more diverse administrative positions. So - I've had continual contact with RNs and I've witnessed the insidious creep of "Woo" into the profession for 40+ years.

I have some personal theories about this trend. First of all, almost universally, nursing programs have extremely watered down science prerequisites. I recall special "Only for Nursing" science courses at one of the colleges I attended. As a group, most RNs do not develop the intellectual tools of critical scientific thinking. This was at a university affiliated with a major west coast medical center. In my laboratory technology program, we attended medical microbiology, anatomy & physiology and biochemistry courses along with the medical students but the nursing students had it easy. Also, I feel that RNs desperately seek something to make them different from all the other "Sciency" health care professions and this woo pathway does it for them.
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Pailott's on to something
written by garyg, September 17, 2010
Pailott said:

>... The problems, I believe, started when the nursing community tried to establish itself as a profession
with a high level of medical standards. The problem was that the doctors had most areas closed up...

Give that doctors are mostly male and nurses are (still) mostly female and given that
doctors outrank nurses, I think that TT and the like arose as "something that nurses can
do that doctors can't/don't". That is, I think that to some degree this is a theater in a battle of the sexes
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nurses and woo-woo
written by StarTrekLivz, September 17, 2010
I've had the unhappy experience of being hospitalized for serious ailments a couple times, and fortunately the nurses I've experienced in those situations were serious, dedicated, overworked and compassionate providers of science-based care.

But I have run into nurses (in doctor's offices or clinics, not hospitals) who have quietly recommended herbal remedies, homeopathic brews (i.e. well shaken water), mega-doses of expensive vitamins (Gary Nulls would be proud), which left me wondering about both the quality of care from my primary physician and the quality of education in Michigan nursing schools. (I live in Detroit)
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written by laursaurus, September 17, 2010
graduated in May of '86 and subsequently sat for and passed state boards, shortly after the NCLEX became standardized. It was obviously a long time ago, but I don't recall any exam questions designed to evaluate competency in "woo."
But this blog post is a bit misleading to imply that emotional status has no impact on the duration and intensity of an illness and/or rate of recovery. Before I go off just to discover I've only beat up a poor straw man, I'll hold back until I'm sure exactly what you meant.
As an RN, it's difficult not to feel a little insulted that you "struggle to call it(Nursing)a profession."
I can't imagine even as a lowly first year student not speaking up to an instructor who described Legionnaire’s Disease as a ‘virus’. Nursing full fills an important and independent role. Your speculation that doctors edged them out of every available field really puzzles me. What area of nursing have you worked in and how long? Are you confusing RN's with midwives?
I practiced full time until just 2 years ago, and the opportunity to stay home raising my children was financially possible. I NEVER heard of TT until Skeptoid ran an episode on the topic. Here in the JREF is only the second time I've encountered this subject. Every comment so far has been anti-RN. And there were no "nurses only" science courses at the University from which I graduated. I passed the same inorganic & organic chemistry, microbiology, anatomy & physiology, and calculus college courses along with the pre-Med students.
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@Farkas
written by Caller X, September 17, 2010
You seem to be complaining about the CANADIAN nursing education system. Did you know that at one time Canada had a plan to invade the United States, called "Scheme 1"?

"Before I entered nursing school I was at university taking microbiology and biochemistry; and while I was not a motivated student..."

What conclusions should we draw from that?
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Pharmacy Techs as well
written by Sadhatter, September 18, 2010
I agree whole heartedly with the article. I have recently enrolled in a pharmacy tech program ( with my goal being to take the schooling necessary for becoming a pharmacist afterward.) and within my first two weeks i have found myself biting my tongue at some of the things i have heard.

And what kind of kills me is in one breath a professor will say something like " and of course we know palmistry and graphology are wrong, but has anyone heard of reflexology?". And if the prof would follow this up with a sourced study or two i wouldn't bat an eyelash. But that is not the case they are spreading this woo in the same manner as any other woo spreading individual.

In my short time i have heard about anti vax, reflexology , how hormones in plastics are making girls hit puberty earlier, and homeopathy. And not wanting to disrupt a class with what is essentially a personal issue, i say nothing.

One of the things i have noticed though is we have a large portion of students from india in the program. A good deal of which are qualified pharmacists in india ( as a side note you wouldn't believe the CT's that abound in my city about why there are so many indian students in the pharmacist course.). And so far each and every one has been a stone cold rationalist. I was tickled pink when a new friend looked back at me when homeopathy was mentioned with a eye roll.

So what are we to do? When the people instructed to teach us are spreading woo? And not even mistaken in their conclusions, but spreading it in a non intellectual " i heard this one time..." kind of way. As much as my stomach turned when i saw an anti vax promoting assistant probably gain a follower, i feel awkward trying to correct or debate people who are hired to teach. I mean if they were promoting something offensive like holocaust denial, i would step in in a second. But when the subject comes under the " what's the harm?" category it makes it a bit more difficult from a social perspective.

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Quantum Relativity
written by Blizno, September 18, 2010
As soon as I read "...along the lines of Quantum Physics and the Theory of Relativity..." my brain clenched in spasms of pain. I though homeopathists were blindingly ignorant but they are...slightly less ignorant...than those who mumble magic words like "relativity" and "quantum" without having the least awareness of their meanings.

As Phil Plait likes to quote, "The stupid! It burns!"
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Not Personal
written by Blizno, September 18, 2010
"And not wanting to disrupt a class with what is essentially a personal issue, i say nothing."

Sadhatter, this isn't a personal issue. This is terribly important for the health of us all. If those in charge of training the next medical professionals are this poorly educated, the entire medical profession suffers.
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...
written by JarlNjord, September 19, 2010
Some of the RNs I've encountered who promote "Woo" such as Healing Touch maintain that they're not "Care Givers" (that's what nursing aids do, they say!), they are "Healers". This is a classic title used by all manner of alternative providers.
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My Nursing Background
written by Bartmon, September 19, 2010
Laursauras,

Your comments are at least partially valid in my opinion. In my days (and nights) as an RN I came across many, many smart critically thinking nurses. My comments are generalities about my time in nursing in Western Canada. (by the way, I wrote the state boards and was licensed in Idaho and Hawaii. Also, the American State Board exams were MUCH better than the Canadian exams, actually asking about diseases etc. rather than just asking about what to say in order to get a patient to 'feel their emotions').

I graduated in the late 80s and worked for 10 years as an RN in Trauma ICU, Oncology, General Surgery, Adolescent Psychiatry, and Opthamology (the vast majority of my work was in Trauma ICU).

The fact is though, that the number of nearly 100 nursing education centers teaching woo is accurate according to several sources including Quackwatch. It's a problem (again, in my opinion)

Why don't I think nursing is a profession? That's a complicated question. For some nurses it is. But of my graduating class of 112, by 20 years after grad only 31 of those nurses were still nursing. Many left like I did, but the majority found husbands, had kids, and put all their time into their kids (a noble and good cause and something that I MYSELF did). However, the problem with a profession where most employees are women of child-bearing years is that many will opt to be moms (which is critical) and not nurses. And if they continue to work as nurses, they'll work a point 2 or point 3 (20% or 30% of full time) and won't contribute like a 'lifer'.

Now, my ex wife wasn't like that, she had three kids and still works full time. Obviously, nursing is full of all kinds of people, good, bad, smart, dim, etc. (just like medicine I might add), but when such a large portion of the workforce is only into it half-heartedly, and it's unionized (which it is in Canada), then mediocrity can be the result.

Laursauras, I certainly don't want to insult you. There are a lot of great, sharp, critical thinking nurses out there and they save a lot of lives every year. I put nearly 17 years of my life into nursing in one form or another, and I say these things about nursing with some sadness.

My experience was that nurses were always desperately trying to get recognition as a 'real profession' but they always went about it the wrong way. Again, only my opinion.

Most nurses are not woo-centric nuts. Most nurses are awesome and we should all be grateful for that because it saves OUR lives when we're in hospital. Unfortunately, even the good nurses often didn't get a sound footing in critical thinking. That, however, is true of almost any profession.



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...
written by Jacobus van Beverningk, September 19, 2010
I read that TTNO webpage, and this utterly ignorant Barbara Schuster's 'explanation' of what TT is (and isn't).
If it weren't so sad, I would call it hilarious!

"our bodies and energy fields, just like the universe in which we live, have an innate tendency towards order"
The universe has a tendency towards order? Someone, please, explain the 2nd law of thermodynamics to her!
And then she even compounds the nonsense by saying "This may sound like a commonplace statement" ..
NO, it doesn't, it's utter gibberish and the exact opposite of reality.

"as matter is considered to be energy"
Oh Jeebus... where to even BEGIN to explain that.

.. and then .. wait for it, wait for it .. YEAH, there it is:
"or go even further along the lines of Quantum Physics and the Theory of Relativity"

Please, tell me more! Especially about the theory (which one of the two, by the way?) of relativity.

"Energy flows where intention goes, [..] you are certainly all familiar with the power of intention!"
*blink* No. Enlighten me!

"we are bilaterally symmetrical, not just physically, but in our energy field as well"
So, errr.. *puzzled* the energy field isn't physical? And bilaterally symmetrical? As opposed to unilaterally symmetrical I suppose?

"an eight-week study with Therapeutic Touch was done [...] Soon the staff noticed that not only the clients were calmer, more relaxed [..]"
Compare to WHAT/WHO? Where's the control group?

Then there is this:
"The practitioner usually moves her hands at a distance of a few inches from the body, although touching can be involved"
And then, without blinking, a few paragraphs down:
"Therapeutic Touch can also be administered at a distance. The sessions to my friend giving birth were "delivered" across the ocean!"

It's all becoming a bit clearer now to me:
"Therapeutic Touch was developed in the 1970's by Dolores Krieger, at the time a professor of nursing at New York State University, and her mentor Dora Kunz, an intuitive with clairvoyant abilities"
Developed by a professor, who has a mentor (!), an intuitive with clairvoyant abilities.

I'm beginning to develop some intuitive clairvoyance myself right now!

See: http://www.therapeutictouchont...eutictouch

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written by LovleAnjel, September 19, 2010
And bilaterally symmetrical? As opposed to unilaterally symmetrical I suppose?


As opposed to radially symmetrical, like a sea urchin.
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More about TT...
written by JarlNjord, September 19, 2010
I must continue with some my experiences and confrontations over the years with TT practitioners, I've got a bunch. A while back, I noted that a comprehensive cancer treatment center in my area was sponsoring a Therapeutic Touch seminar and the term "Healing" was liberally used in the description of benefits to patients. It was to be taught by a fully certified TT teacher who had, apparently, has been involved with the practice for decades. The instructor's credentials were impressive - 30+ years in nursing plus a master's degree. I've read that Therapeutic Touch instructors are not allowed to study and rise to the level of teaching the craft unless they are an MSN. They're seeking academic creditably, I suppose! I wrote a detailed letter to the instructor via e-mail asking for evidence that TT was anything other than the placebo effect. I presented a detailed challenge to the plausibility and efficacy of TT. I said it had no place in modern scientific medicine, compared it to religious rituals and said it was unethical to assert that hands over the body could heal anything. I received no response from TT instructor. My E-mail was eventually forwarded to the desk of the director of the center and I was contacted by the upper management with a curt communication recommending that I should not contact instructors and that I should keep my "opinions" to myself. However, I did make a positive impact because the next time they sponsored the seminar, there was no mention of "Healing", only that it relaxes patients.

Another experience, quite personal, that happened about 10 years ago. My wife and I cared for my ailing mother-in-law in our home for the last two years of her life. This was with the assistance of RNs from a hospice organization and they were, overall, caring, kind and compassionate in her time to need. Only one unsettling occurrence marred the continuum of care - an RN who practiced TT with my mother-in-law. On the day this happened, my mother-in-law was unusually unsettled after the RN left. My wife asked her what the problem was and she said the nurse waved her hands over her and mumbled some sort of incantation. She then proclaimed that she didn't want to see that RN again and if she'd wanted a priest to visit her, she would have asked for one!

OH - BTW - The TT organization had their 13th annual Therapeutic Touch retreat at SEDONA earlier this month. Darn, I missed it!
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nursing is/is not a profession...
written by sowellfan, September 19, 2010
@Bartmon: Your supporting reasons for the notion that nursing isn't a profession don't pass muster, in my opinion. You point out that only 31 people from your graduating class of 112 are still practicing, and you declare that therefore, they weren't committed to nursing (20 years later, even....), and therefore it doesn't count as a profession.

So, by your definition, what *is* a "profession"? What's the magic percentage of graduates that still need to be working in the field 20 years later, such that it counts as a true profession? I'm personally seeing scads of people with law degrees (who may have gone to law school without thinking carefully about the oversupply of lawyers) looking for jobs in some field, any field. Plenty of engineers end up in vastly different jobs 10 or 15 years down the road. A significant portion of IT workers never got degrees in IT. Teaching has a big problem with retaining teachers for a long time, for the same reason that nursing might have that problem. But an issue of retaining nurses in the work-force is separate from "they're not professional". Or perhaps you've got some better-reasoned arguments that you didn't mention in that vein.
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@Bartmon/Bart Farkas (Polish for "wolf")
written by Caller X, September 19, 2010
Totally agree with sowellfan that your idea of what constitutes a profession is, how to say it? Ridiculous.

"Laursauras,

Your comments are at least partially valid in my opinion. In my days (and nights) as an RN I came across many, many smart critically thinking nurses. My comments are generalities about my time in nursing in Western Canada. (by the way, I wrote the state boards and was licensed in Idaho and Hawaii. Also, the American State Board exams were MUCH better than the Canadian exams, actually asking about diseases etc. rather than just asking about what to say in order to get a patient to 'feel their emotions')."

Again, you seem to be complaining mainly about the training of CANADIAN nurses. No wonder your government officials come down to the land of the (once upon a time) free for their healthcare. Perhaps this thread should be renamed.

No one's mentioned the role of Ohshina in the creation of Therapeutic Touch. It's totally an offshoot of Theosophy. Do with that information what you will.
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Do Not discredit nursing....
written by otl500, September 23, 2010
Where did you people go to school? In my nursing school (in the U.S.A.) we were taught the basics, physics, chemistry, biology, anatomy, physiology, pharmacology, etc... There was no mention of therapeutic touch, homeopathy, auras, crystals or any other kind of New Age mumbo jumbo. As a nursing student we had no time for anything other than learning the basics and attending clinicals which began the 2nd or 3rd week of school. I have been an RN for 31 plus years now and the reason that most nurses leave nursing is because of the crushing work load and terrible hours. I have often left work frustrated and unhappy because there were so few nurses and too many patients. How can 2 nurses take care of 40 patients, half of whom are new surgeries? How can one RN work the night shift in a nursing home with 220 patients and give them the sterling care she/he was trained to give? There was never enough time to sit and comfort the dying, hold a frightened hand, or even empty my own bladder half of the time. I am expected to continue my education and required to have a number of CEU's in order to maintain my license. I don't know what they teach in Canada but do not discredit my profession or my professionalism. I'm truly sorry you have been exposed to what you call "woo" but I can assure you that that is not typical in the United States. So once again please, DO NOT discredit nursing as a profession. As an RN I must be well versed in anatomy, physiology, physics, psychology, pharmacology, physical therapy, chemistry, and mathematics as well as conflict negotiation, political and economic principles. My decisions and actions/inactions can result in the death of a human being. I can't think of too many other "professions" that require as much from their employees.

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Exposing the fraud of medicine, Lowly rated comment [Show]
@otl500 & @refract
written by Caller X, September 24, 2010
@otl500

As I mentioned above, this article should be retitled to reflect it's subject matter, CANADIAN nursing education.

@refract

Where to begin? You seem not to know quite a bit.
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Sorry
written by Caller X, September 24, 2010
Should have said "its" not "it's". D'oh!
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written by sowellfan, September 24, 2010
@Caller-X: Bart may only have been able to speak to his experience in Canadian nursing, but the infiltration of pseudoscience into nursing is not just a Canadian problem. There have been a number of articles at the Science Based Medicine blog that talk about pseudo-science and quackery being taught in medical schools here in the US (usually as 'supplemental' lectures, I think/hope), as well as nursing schools. Additionally, there are plenty of reports of hospitals here in the U.S. that have nurses offering Reiki therapy.
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