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provided a structure for educational programs. In the field, however, expert nurses soon "forgot" these words and developed their own rubric to get at the deep structure of the nursing situation (there is indeed a reference to transformational grammar here). Using NIC categories as a research tool, one could uncover the three key dimensions of nursing work (the intensity, focus, and complexity of care) that experts already knew about without there having been a nursing science. Having passed through the purifying cycle of forgetting, one could finally "bring intuitive clinical decision making to a conscious level." |
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There is a double complexity to this cycle. The first is the fact that the first author, Toni Tripp-Reimer, is a cultural anthropologist turned nursing informatician well versed in Kuhn, Lakoff, and other philosophers of science and language. The organization that produces NIC has to be broadly enough construed, on occasion, to include the community of sociologists of science and linguists, even though this inclusion may never be represented overtly in the records of the classification scheme. In passing, these alliances can form a kind of organizational memory that becomes instead forgetting. It means storing information in locations once within the network of an organization but now outside of it; a variety of outsourcing gone sour. The alliances may be fragile, or historical circumstances may change. Thus, for example, the problem of using a centralized external memory source like the library at Alexandria. . . . |
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The second complexity is that de novo classifications reflect a bootstrapping between what practicing nurses already know and what the science of nursing will tell them. Thus, to get the category of culture brokerage in NIC (see figure 7.5), Tripp-Reimer had to get it into the research literature as something that was already being done by nurses (and indexed in databases!). The NIC team in general claims both that nursing is already a science and that it is a science that has not yet been formulated. They need both points for their project. That is, they need to maintain the former to justify the profession against current attacks and the latter to justify their classification system, which when in place will protect it from future attacks. |
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One is reminded of Piaget's (1969) assertion that our earliest intuitions are of the relativistic nature of time, and that we need to unlearn our school lessons both to access the latest science and to get back in touch with our childhood insights. The point here is to suggest that unlearning, like forgetting, may be a more pervasive feature of organizational and cognitive life than accounts of learning and of memory |
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