Gardens as Antidote to Nurse Burnout


Healthcare practitioners take a break outside. / Photo: Legacy Health

Hey, it’s Kat again. In today’s guest post, I’ll be talking about the timely topic of nurse burnout and research into hospital-based gardens.

Burnout among nurses was on the rise even before COVID-19. In a 2017 survey, 63% of registered nurses employed in hospitals self-reported workplace burnout.

Characterized by symptoms of emotional exhaustion, depersonalization, and loss of personal efficacy, burnout has far-reaching negative consequences for individual wellbeing, quality of patient care and costs to the healthcare system. One study estimated that nurse burnout adds up to $14 billion annual

In 2019, the World Health Organization included burnout in the 11th Revision of the International Classification of Diseases as “an occupational phenomenon” rather than a medical condition, saying burnout “is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

Research indicates that hospital gardens are one way we can lessen the fatigue and stress that lead to burnout.

For a study in 2018, a team of researchers that included legendary healthcare designer Roger Ulrich, looked at indoor and outdoor break environments and their effect on nurse burnout.

Time outdoors can help reduce symptoms of burnout. Photo: Legacy Health

Nurses at Legacy Emanuel Medical Center in Portland, Oregon were randomly assigned to 6 weeks of a daily work break in the garden and 6 weeks of indoor-only breaks. Researchers had the nurse-participants complete the Maslach Burnout Inventory-Human Services Survey (MBI), a tool used to measure burnout in healthcare workers, at the start and end of each 6-week period.

The nurses also recorded the immediate psychological impact of a break in both environments using another tool that asked them to rate feelings of anxiety, sadness, anger, worry, fatigue and pain on a defined scale.

What they found was that for the nurses who took their 20-minute break outside, the garden provided greater reduction in burnout.

They concluded that taking daily work breaks in a garden may be beneficial in mitigating burnout among nurses working in high-stress hospital environments.

The research setting was featured the Portland news recently, highlighting the positive response to the garden in light of COVID-19. One nurse said of the Legacy Health garden,

“It takes you to such a different place that it’s so refreshing to your spirit and your soul and your psyche.”

Gardens provide respite for practitioners, patients and their families. Photo: Legacy Health

Another nurse said of the garden,

“It is transformational for me. It really is. Just to even get five minutes in the garden, you shift your paradigm. You’re no longer thinking about the hospital. You’re looking at the plants, you’re smelling the herbs that are growing here, you’re seeing the sunshine.”

Providing spaces for respite is more important than ever—in hospital environments and public spaces alike. What’s good for the mental health and wellbeing of nurses is good for us all.

In the next blog post, I’ll be exploring best practices for designing restorative spaces, according to prominent thinkers in environmental psychology.

Guest post by Kat Shiffler, collaborator with The Farm at St. Joe’s and graduate student in Landscape Architecture at the University of Michigan.

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