Task orientated nursing in a tuberculosis control programme in South Africa: where does it come from and what keeps it going?

Task oriented nursing is associated with traditional hospital ward organisational practice. This paper describes task orientation in a tuberculosis control programme which forms part of the public health system in Cape Town, South Africa. Task oriented practice is illustrated with clinical data from a focused ethnography on the work of nurses in a tuberculosis control programme. The origins of task orientation are traced to the colonial history of nursing in South Africa. The authors explore both the explicit and more functional reasons for maintaining task orientation, as well as the implicit and mostly unconscious socially structured defences which contribute to the continuation of this form of practice. Unless attention is given to the complexities of this phenomenon, initiatives to change task oriented practice may continue to fail.