Ageing populations and rising rates of chronic disease globally have shifted key elements of disease management to ideas of integrated care and self‐management. The associated policies and programmes often focus on intervention and support beyond the sites of the hospital and clinic. These shifts have significantly impacted the delivery and practice of nursing for both nurses and the clients with whom they work. This article argues that Foucault's comments on space, place and heterotopia (1986) are useful in exploring these changes (...) from a philosophical perspective, to draw out the complexity of these programmes and add texture to discussions on the ways these shifts to localisation and the dominant discourses of self‐management and responsibility have reconfigured nursing practices. The theoretical discussion is augmented with illustrations from an Australian integrated health care programme. (shrink)

During the last 3 years the interface between geography and nursing has provided fertile ground for research. Not only has a conceptual emphasis on space and place provided nurse researchers with a robust and subtly different way to deconstruct and articulate nursing environments, but also their studies have provided a much needed focus on certain areas of health‐care, and in particular clinical practice, not currently prioritized by health geographers. We argue that, as something that is forcing fundamental re‐considerations of the (...) nature of both nursing and geography, cyberspace is a particularly important phenomenon that lies comparatively under‐researched at this interface. To encourage some interest in researching nursing and cyberspace through a geographical lens, and at least to showcase a range of potentially useful and transportable concepts, we provide an overview of some of the key debates pertaining to cyberspace developed by human geographers, and make some initial and tentative connections to nursing. (shrink)

The provision of “closer-to-patient” services has increased in most industrialized countries. However, the migration of services in non-traditional health care settings implies redefining the role of technical and human entities and transforming the nature and use of technologies and places. Drawing on various scholarly efforts to conceptualize space, place, and technology, this paper compares and contrasts satellite and mobile dialysis units implemented in two regions in the province of Quebec, Canada. The satellite units were hosted in two small, local hospitals (...) where nursing staff had been recently trained. The mobile unit was a bus adapted to host five dialysis stations; nurses traveled back and forth between a university teaching hospital and two sites located within a radius of 7.6 miles. In both projects, nephrologists supervised from a distance via a videoconferencing system. Our aim is to illustrate the ways in which the displacement of technical and human entities gives shape to new forms of emplacement in non-traditional health care settings. The satellite and mobile units contributed to the culture of dialysis care and transformed the identity of nurses, doctors, patients, and technologies. By contrasting two projects involving different spatial and clinical logics, we analyze in what ways certain forms of recombination of human and technical entities can prove incomplete but nevertheless acceptable to providers and project managers. (shrink)

This paper focuses on the patient's perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the intensive care unit (ICU) patient room. It also addresses the question of whether the aspects that support at‐homeness are applicable to ICU patient rooms. The concept of “at‐homeness” in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at‐homeness can be created in an ICU, when one (...) or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of well‐being in situations involving severe illness or life‐threatening conditions. (shrink)

Although a large body of literature exists propounding the importance of space in aged care and care of the older person with dementia, there is, however, only limited exploration of the ‘acute care space’ as a particular type of space with archetypal constraints that maybe unfavourable to older people with cognitive impairment and nurses wanting to provide care that is person‐centred. In this article, we explore concepts of space and examine the implications of these for the delivery of care to (...) older people who are cognitively impaired. Our exploration is grounded in theorisations of space offered by key geographers and phenomenologists, but also draws on how space has been constructed within the nursing literature that refers specifically to acute care. We argue that space, once created, can be created and that nursing has a significant role to play in the process of its recreation in the pursuit of care that is person‐centred. We conclude by introducing an alternative logic of space aimed at promoting the creation of more salutogenic spaces that invokes a sense of sanctuary, safeness, and inclusion, all of which are essential if the care provided to the older person with cognitive impairment is apposite to their needs. The concept of ‘person‐centred space’ helps to crystallize the relationship between space and person‐centred care and implies more intentional manipulation of space that is more conducive to caring and healing. Significantly, it marks a return to Nightingale's wisdom, that is, to put the person in the best possible conditions for nature to act upon them. (shrink)

Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health‐care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi‐structured interviews with Canadian family caregivers, care recipients and nurses, the intersection (...) of language, place and health‐care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as ‘guests’; home environments facilitate the development of nurse–client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health‐care. We conclude by discussing the importance of considering the language–place–healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice. (shrink)

The concept of ‘place’, and general references to ‘geographies of …’ are making gradual incursions into nursing literature. Although the idea of place in nursing is not new, this recent spatial turn seems to be influenced by the increasing profile of the discipline of health geography, and the broadening of its scope to incorporate smaller and more intimate spatial scales. A wider emphasis within the social sciences on place from a social and cultural perspective, and a wider turn to ‘place’ (...) across disciplines are probably equally important factors. This trend is raising some interesting questions for nurses, but at the same time contributes some confusion with regard to imputed meanings of ‘place’. While it is clear that most nurse clinicians and researchers certainly understand that place of care matters to their practices and patients, many diverse uses of ‘place’ are found within nursing literature, and contemporary understandings of the term ‘place’ within nursing are not immediately clear. It is in this context that this article plans to advance the discussion of place. More specifically, the aims of this paper are threefold: to critique ‘place’ as it appears in nursing literature, to explore the use of ‘place’ within health geography, whence notions of place and ‘geographies of’ have originated and, finally, to compare and contrast the use of ‘place’ in both disciplines. This critique intends to address a deficit in the literature, in this era of growing spatialization in nursing research. The specific questions of interest here are: ‘what is “place” in nursing?’ and ‘how do concepts of place in nursing compare to concepts of place in health geography?’. (shrink)