By exploring the dialogue of nursing as it is lived in the real world
the factor of space becomes apparent. Here again the dialogue is
influenced by space as it is measured and space as it is experienced by
nurse and patient. When thinking of health care facilities, "space" may
be synonymous with such things as beds, waiting rooms, interview rooms,
treatment areas, size of patient's room, visiting areas, a quiet place,
a private place. Naturally, the physical setting, whether in a hospital,
home, anywhere in the community, can serve to enhance or impede the
nursing dialogue. However, the person's experience of the space may be
even more important.
Space is lived in terms of large and small, far and near, long and
short, high and deep, above and below, before and behind, left and
right, across, all {35} around, empty, crowded. These perceptions and
experiences of space may be influenced by the effects of illness, for
example, changes in vision or locomotor ability. Thus, a patient's
spatial world may change, expand or diminish, become unmanageable or
manageable day by day. Furthermore, a patient's attitude toward and
experience of a particular place may be affected by his mental
association to it (for example, oncology ward, psychiatric unit), his
previous experience in it (for example, emergency room, operating room),
or a desire to be somewhere else (for example, "This is a nice hospital
but I'd rather be home").
Place is a kind of lived space. It is personalized space. One says, for
example, "Come to my place" meaning to my home. Or even more personally,
it relates to where I feel I belong or am, for instance, "he put me in
my place; I felt put down." The patient may feel "out of place" in the
health care setting, while it may be commonplace to the nurse. There may
be areas in the setting that the patient experiences as his territory,
for example, his bed, his room, his ward; while other areas are "theirs"
or "restricted to authorized personnel." So a nurse and a patient may be
in a place together, yet one feels at home and the other does not. For
the nurse to be really _with_ the patient involves her knowing him in
_his_ lived space, in his here and now.
Lived space is interrelated with lived time. Patients hospitalized for a
long time often express a proprietary attitude toward the hospital. The
same holds true for personnel. With time and familiarity a feeling of
reciprocal belongingness grows. The person belongs in the place and the
place belongs to the person. On the other hand, when a person finds
himself in a new place he may feel the discomfort of not belonging. This
is as true for the nurse in an unfamiliar setting as for the patient.
Again in this regard, the lived nursing dialogue is enhanced by the
nurse's awareness of not only her own experience of space but the
patient's as well.