title: Distal nursing.
abstract: This paper considers the spatial dynamics of nurse-patient relationships within hospitals, primarily in the USA, under conditions of organizational restructuring, and situates them within social theoretical perspectives on space. As a human practice to which relationship is considered essential, nursing depends upon sustaining an often taken-for-granted proximity to patients. But hospital nursing, I argue in this paper, is increasingly constrained by spatial-structural practices that disrupt relationship and reduce or eliminate such proximity. Three kinds of proximity are threatened: physical, narrative, and moral. Examining these proximities through a place-space lens suggests that nursing is increasingly "distal" to patient care. There are potentially dangerous implications in this loss of proximity.
authors.affiliation: Department of Social & Behavioral Sciences, University of California, Box 0936, San Francisco, CA 94143-0936, USA. rmalone@itsa.ucsf.edu
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Malone
mesh_terms: D004991:Ethics, Institutional; D005843:Geography; D006272:Health Facility Environment; D006754:Hospital Restructuring / Q000941:ethics*; D006801:Humans; D009014:Morals; D033262:Narration; D009723:Nurse-Patient Relations / Q000941:ethics*; D009732:Nursing Care / Q000523:psychology; D009737:Nursing Records; D009738:Nursing Service, Hospital / Q000941:ethics*; D012962:Sociology, Medical; D014481:United States