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does not only require that the system classifies the same things across sites and times but also that it uncovers invisible work; this affects the recording of data. The combination of these two thus requires compromise. Finally, to keep a level of intimacy in the classification system, control is a trade-off against the requirement to make everything visible. These trade-offs become areas of negotiation and sometimes of conflict. |
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Because one cannot optimize all three parameters at once to produce simultaneously perfect degrees of intimacy, manageability, and standardization, a real-life classification scheme encompasses a thorough, pragmatic understanding of these trade-offs in their historical context. It places them in the work stream. Here we now situate this process in our observations of the building of a classification system in progress, the Nursing Interventions Classification (NIC). |
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The Nursing Interventions Classification |
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NIC itself is a fascinating system. Those who study it see it as an elegant ethnographic tool. Some categories, like "bleeding reductionnasal," are on the surface relatively obvious and codable into discrete units of work practice to be carried out on specific occasions. But what about the equally important categories of "hope installation" and "humor" (see figures 7.1 through 7.3)? |
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Here we look further into the category of humor in NIC. The very definition of the category suggests the operation of a paradigm shift from work as punctual activity to work as process: "Facilitating the patient to perceive, appreciate, and express what is funny, amusing, or ludicrous in order to establish relationships. . . ." It is unclear how this could ever be attached to a time line: it is something the nurse should always do while doing other things. Further, contained within the nursing classification are an anatomy of what it is to be humorous and a theory of what humor does. The recommended procedures break humor down into subelements. One should determine the types of humor appreciated by the patient; determine the patient's typical response to humor (laughter or smiles); select humorous materials that create moderate arousal for the individual (for example "picture a forbidding authority figure dressed only in underwear"); encourage silliness and playfulness, and so on. There are fifteen subactivities, any one of which might be scientifically relevant. A feature traditionally attached to the personality of the nurse (being a cheerful and |
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