Ethics and the geography of the nurse-patient relationship: spatial vulnerable and gendered space

In a study that sought to understand the ethical concerns of home care and psychiatric nurses, relationship proved to be of central import. Yet the sense of relationship was not limited to, not even primarily, the interpersonal bond that is most commonly understood by relationship. For the nurses in this study, serious ethical concerns originated in those structural aspects of relationship reflecting the social space that patients and nurses occupy. These concerns can be broadly grouped into two categories, spatial vulnerabilities and gendered space. The ethical concerns of spatial vulnerability include poverty, exploitation of patients for institutional gain, homogenization of identity, and the fragmentation of care. Gendered space includes invisibility, instrumentality, and relations to other nurses. Geography may be a useful way to think about the nurse-patient relationship because relationship is itself a spatial term and because geography allows for the dimensionality of scale from the local or intimate to the global or structural. How we organize and structure our social relations is ethically significant.