November is National Caregiver’s Month so we want to celebrate one of the most renowned caregivers of all times, Florence Nightingale. Not only did she empower nurses by raising their status as professional caregivers, but she also was one of the greatest proponents of hospital reform. Her discovery of the relationship between light and healing started a transformation in hospital design in the late 1800s. Known as the “Lady with the Lamp”, Ms. Nightingale’s innate understanding of the relationship between wellness and the physical environment made her a pioneer of environmental psychology.
In her early years, Florence worked as a caretaker to her neighbors near her family’s estate. After going against her family’s wishes and turning down a suitable marriage proposal, she pursued her dream of becoming a nurse. She attended nursing school in Germany, worked at a hospital for two years, and then served in the hospital wards during the Crimean War.
After arriving in the war zone with a team of 34 nurses, she was horrified to find that the mortality rate was 60%, largely due to infections which should have been easily preventable. The dark and airless hospital wards were filled with soldiers lying in their own excrement and blood with lice migrating from bed to bed. Her team of nurses immediately gathered materials to sanitize the wards, washing the soldiers’ bodies, boiling the sheets, increasing the amount of space between beds and letting in sunlight and fresh air.
She made nightly rounds with never-ending compassion earning her the nickname “Lady with the Lamp” or “the Angel of the Crimea.” Her persistent care instilled faith and hope among the soldiers, reducing their fear and chronic stress. Acknowledging the impact of mental health on healing physical ailments she also instituted the creation of special kitchens, laundry rooms, classrooms, and a library for patients’ intellectual stimulation. After her improvements the fatality rate declined by two-thirds.
In England after the war, Ms. Nightingale started a movement that would eventually result in significant hospital reform. Her ideals influenced the design of new hospitals throughout Europe. She was a proponent of architect Henry Currey’s design of the Saint Thomas Hospital in England. Based on the Pavilion Principle, Currey designed the wards with large windows to maximize light and ventilation, improving the likelihood of patient recovery. Once built, patients not only benefited from fewer infections but also as an unplanned benefit, experienced an improvement in their emotional well-being. It was discovering that views from the expansive windows of the surrounding countryside helped patients to replace memories of horrific battles and devastating illness with positive feelings. In turn, this reduced their stress and turned their focus outward away from negative thoughts and emotions.
The 19th century shed light and fresh air on patients, improving both physical healing and emotional well-being while significantly reducing the mortality rate. However, in the 20th century, the focus in hospital design shifted from the patient experience to accommodating medical equipment. New hospital wards significantly increased patient stress, exposing them to constant noise, artificial light and a sterile, institutional environment that was far from the nurturing home-like experience most conducive to wellness.
Similarly, the new “tract” housing of the post-war era shifted the experience of home from a healthy live/work environment to a highly stressful suburb/auto-centric experience. This began the trend of deteriorating health, sedentary lifestyles and increased chronic diseases so pervasive in society today. Over the past decade a new body of knowledge relating to how the brain processes environments has made a significant impact on the design of healthcare facilities, office buildings, schools and communities.
The innate human need for connection with nature, prompting the advancement of biophilic design, has resulted in environments that blur the lines between nature and building. Additionally, campuses and communities are now designing homes around amenities that encourage physical activity – hiking trails, bike paths, fitness centers, social gathering spaces, working gardens and healing gardens – in order to soothe a population experiencing severe emotional and physical challenges. Architects have joined forces with neurologists and psychologists to conduct further studies relating to how the human brain responds to environmental stimuli in order to help designers choreograph environments that promote health and well-being.
Sources: Healing Spaces:The Science of Place and Well-Being, Esther Sternberg, M.D., Harvard University Press, Cambridge, Massachusetts, 2010 http://www.biography.com/people/florence-nightingale-9423539#pioneering-nurse http://pmj.bmj.com/content/78/920/352.full