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an anecdote related by literary critic Alice Deck |
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In the 1930s, an African-American woman travels to South Africa. In the Capetown airport, she looks around for a toilet. She finds four, labeled: "White Women," "Colored Women," "White Men," and "Coloured Men." (Colored in this context means Asian.) She is uncertain what to do; there are no toilets for ''Black Women'' or "Black Men," since black Africans under the apartheid regime are not expected to travel, and she is among the first African Americans to visit South Africa. She is forced to make a decision that will cause her embarrassment or even police harassment.
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care is separated from care that only indirectly benefits the patient. Indirect care includes, for instance, coordinating treatment schedules, discharge planning, and patient supervision. One step further removed from the bedside is administrative care, activities for creating a work environment supporting either direct or indirect care. This includes tasks such as coordinating administrative units and supervising nurses. Initially, the NIC group concentrated on direct-care interventions. The researchers deliberately supported an image in the classification of nursing as a clinical discipline. This was a political decision, as several NIC team members noted in interviews, one said: "Nurses think that laying hands on patients is nursing. We would not have had the attention of the nursing community if we had not begun there." |
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Questions arose in the course of the project, however, about the distinction between direct and indirect care. For instance, if nurses must check resuscitation carts with every shift, and this is not included in NIC, then these activities will not be reimbursed when NIC is implemented. Time spent on this task will be invisible and thus fiscally wasteful. Over the course of the project, there has been increasing recognition of the importance of indirect interventions, and these were included in the second edition of the NIC classification system. The researchers have even adapted their initial definition of a nursing intervention to include indirect interventions. Nurses themselves are somewhat ambivalent about how to account for indirect care time. Statistical analyses based upon different validation studies reveal that |
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