Clinical geography: nursing practice and the (re)making of institutional space


Gavin J. Andrews
Department of Health, Aging and Society, KTH 225
McMaster University
1280 Main Street West
Hamilton, ON, L8S 4M4


Aim  To present a geographical study that highlights the wide ranging spatial features of nursing agency. In turn, illustrate the further potential for geographical research to describe, support, challenge and guide clinical practice – particularly with regard to those ‘everyday’ activities and actions undertaken on a frequent basis.

Background  To provide a focus, and to anchor the study in existing clinical knowledge and debates, the role of nursing in the (re)making of institutional experiences and life is specifically explored.

Methods  In-depth semi-structured interviews were conducted with 15 nurses working in Buckinghamshire and West London, UK. The following specialties were represented: acute care including emergency (n = 3), midwifery (n = 3), children’s nursing (n = 2), elderly care (n = 1), rehabilitation (n = 2), mental health (n = 3) and palliative care (n = 1).

Results  Nurses claimed to actively manipulate, normalize and recreate clinical spaces as part of their everyday therapeutic practice. Specifically, the range of agency employed by them falls under the following six categories: adjusting social composition; introducing ‘normal’ activities; providing private spaces; seeking private spaces; explaining clinical spaces; spaces for personal escape and wellbeing.

Implications for Nursing Management  It is recommended that nurse leaders – including researchers, managers and clinical educators – explore geography as a source of social scientific evidence that sheds light on the complex nature of everyday professional practice. In this regard, some important disciplinary and structural issues are noted.