Under pressure: An ethnography of pressure ulcer care

The National Health Service (NHS) has been under pressure for years, with peak pressures since the start of the Covid-19 pandemic. In the biggest nursing strikes in NHS history, many nurses are protesting against the pressures they experience and how these are endangering patient safety. In my study I focus on one particular aspect of patient safety: pressure ulcers. I trace how the pressure on patients’ skin is connected to the pressure on the NHS.

Drawing on contemporary debates about care within anthropology, sociology and Science and Technology Studies, I ethnographically trace pressures in pressure ulcer care in an NHS hospital and in the medical device industry.

I find that when pressure builds up materially on the skin or metaphorically on people (e.g. time pressure), there are attempts at moving it, shifting it to other places, people, things, and times. This moving of pressures is uneven and lumpy, causing peak pressures and inequalities. I show different ways in which there is mess in the moving of pressure and attempts at taming this mess. In doing so, I conceptualise pressure ulcer care in the NHS as a ‘choreography’ (Cussins 1996) of pressure and reflect on the concept of pressure in care.