As I ride the commuter train from the suburbs into the city each morning, I watch travelers stand for almost 40 minutes when there are empty, available seats. They take fleeting looks at these seats as if they are objects beyond their reach, or the act of sitting down is for some reason denied to them. In spite of this, they do not go and sit on the seat; it seems they choose to stand rather than sit down next to another person where physical contact cannot be avoided. In reality, this contact might simply be an arm or a shoulder touching. It seems that for some individuals, there is an unspoken rule: It is okay to sit alone in a two-seat row or in a three-seat row with the center seat vacant, but it is not acceptable to sit side-by-side with another person in a two-seat row.
When the train pulls into the city and I switch to the subway, another scene unfolds. Because of overcrowded trains during rush hour, human bodies are literally packed side-by-side in the car with little room for movement. Your face can be right in someone else's face or body area, depending on height differences. Everyone looks anywhere but into the eyes of others "trapped" around them. Facial expressions are blank and detached. People open a book or a newspaper to cover their faces; others engross themselves in iPods, cell phones, and other electronic devices. When the occasional animated conversation breaks through the silence, all eyes turn to this object of disruption. You sense discomfort, helplessness to change the situation, and, on some faces, recognize pain. All of this trouble, just to get to work everyday!
The evening return home, however, presents a reversed scene. Passengers literally lay in the seats, not caring in what position they fall, who is sitting next to them, or how much they are physically in contact with another person. Conversation is more open than in the morning, and expressions all around are more relaxed and comfortable. Why are the dynamics different on the ride back home? I do not know, but at that moment in time I am definitely curious.
Proxemics
I typed "personal space" into an Internet search engine and found an article in The New York Times that addresses what I observe daily.1 I discovered that scientists call this phenomenon proxemics, which is the study of the nature, degree, and effect of the spatial separation individuals naturally maintain (as in various social and interpersonal situations) and of how this separation relates to environmental and cultural factors.2
It was Edward Hall in The Hidden Dimension who defined personal space in measurable terms: intimate, personal, social, and public distances. An intimate distance, less than 6 inches, is most restrictive.
As nurses, we are well aware of the importance of acknowledging and respecting our patients' need for personal space, initially during interviewing and then in performing a physical examination. Follow the patient's nonverbal cues-if you are not sure where his or her comfort level lies, simply ask. If you need to invade their intimate space, explain why and ask their permission. You may lose the trust of a patient if you violate what they perceive to be normal behaviors in their culture. Personal space is private; think about your own perceptions, and be guided from there.
Jamesetta Newland, RN, APRN, BC, PhD, FAANP, FNAP
Editor-in-Chief, [email protected]
References