Jacqueline Fiske Healing Garden, Jupiter Medical Center, Jupiter, FL. Photo courtesy of Studio Sprout
“So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself.” – Florence Nightingale
Let’s hear it for nurses!
If anyone knew the value of fresh air and access to the outdoors, it was Florence Nightingale (1820-1910); her birthday is on May 12th, and National Nurses Week began on May 6th.
Therapeutic and restorative gardens in hospitals and other healthcare facilities are not just for patients and visitors. Staff can benefit just as much – and sometimes even more. The outdoors is a critical place of respite where people who deal with life-and-death situations can go, by themselves or with colleagues, to take a physical, mental, and/or emotional break. Whenever possible, healthcare facilities should provide separate garden spaces for staff. This separation of space for different users with different needs can be as important as the space itself. Even a view of the outdoors has been found to benefit staff, for example by reducing stress and improving alertness (which, of course, benefits the patients as well!). See for example, Debajyoti et. al.’s article – citation and abstract are below. Nurses are also invaluable members of the Interdisciplinary Design Team, the team that makes decisions about the design and construction of new and existing spaces. They have the “on the ground” view and usually know the needs of patients, visitors, and other staff, as well as the programmatic and physical needs of the space being considered. For more on the IDT, see this recent TLN Blog post, “EDAC – Why it Matters.”
Please share your thoughts! For nurses and other hospital staff reading this, leave a comment and tell us what outdoor spaces at work mean to you, and how you use them.
Debajyoti Pati, Tom Harvey Jr., Paul Barach (2008). “Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination.” Health Environments Research & Design Journal, Vol. 1, No. 2, pp. 27-38.
Exterior views of nature decreased stress and increased alertness in pediatric nurses.
Abstract:
Objective: Examine the relationships between acute stress and alertness of nurse, and duration and content of exterior views from nurse work areas. Background: Nursing is a stressful job, and the impacts of stress on performance are well documented. Nursing stress, however, has been typically addressed through operational interventions, although the ability of the physical environment to modulate stress in humans is well known. This study explores the outcomes of exposure to exterior views from nurse work areas.
Methods: A survey-based method was used to collect data on acute stress, chronic stress, and alertness of nurses before and after 12-hour shifts. Control measures included physical environment stressors (that is, lighting, noise, thermal, and ergonomic), organizational stressors, workload, and personal characteristics (that is, age, experience, and income). Data were collected from 32 nurses on 19 different units at two hospitals (part of Children’s Healthcare of Atlanta) in November 2006.
Results: Among the variables considered in the study view duration is the second most influential factor affecting alertness and acute stress. The association between view duration and alertness and stress is conditional on the exterior view content (that is, nature view, non-nature view). Of all the nurses whose alertness level remained the same or improved, almost 60% had exposure to exterior and nature view. In contrast, of all nurses whose alertness levels deteriorated, 67% were exposed to no view or to only non-nature view. Similarly, of all nurses whose acute stress condition remained the same or reduced, 64% had exposure to views (71% of that 64% were exposed to a nature view). Of nurses whose acute stress levels increased, 56% had no view or only a non-nature view.
Conclusions: Although long working hours, overtime, and sleep deprivation are problems in healthcare operations, the physical design of units is only now beginning to be considered seriously in evaluating patient outcomes.