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Why every hospital should have a garden

8 Nov, 2013

Hospitals aim to treat patients and help them get better as soon as possible, but what if there were something other than medical supervision and expertise that could speed up the healing process? Clare Hickman, Wellcome Research Fellow in Medical History and Humanities at King’s College London, puts forward the argument that we can’t afford to overlook the benefits of hospital gardens.

Hospital gardens are ‘essential not dispensable’ argues Clare Cooper Marcus, Professor Emeritus in the Departments of Architecture and Landscape Architecture at the University of California. This is backed-up by work carried out by the environmental psychologist, Roger Ulrich. His research suggests that gardens can actually enhance patient recovery.

36 King Edward VII postcard 1954 Author's Own

In the past hospitals often included gardens because medical practitioners and hospital governors alike felt that they aided patient recovery. For example, the famous nurse, Florence Nightingale, wrote in 1860, that for patients with fevers, the most acute suffering for patients in huts, was not being able to see out of a window. “ I shall never forget the rapture of fever patients over a bunch of bright-coloured flowers” she noted, adding “people say the effect is only on the mind. It is no such thing. The effect is on the body too”.

Nightingale felt strongly about the importance of views, and suggested “it is the seal of ignorance and stupidity just as much on the governors and attendants of the sick if they do not provide the sick-bed with a ‘view’, or with variety of some kind, as if they did not provide the hospital with a kitchen”. Little could she imagine that new hospitals are sometimes built with microwaves but no real kitchens, let alone accessible gardens!

In 1865 Frederick Law Olmsted, an influential American Landscape Architect whose most famous work was Central Park in New York, wrote that the enjoyment of scenery “employs the mind without fatigue and yet exercises it; tranquillizes it and yet enlivens it; and thus, through the influence of the mind over the body, gives the effect of refreshing rest and reinvigoration to the whole system”.

43 Maggies Centre Authors OwnThis idea that looking at nature in parks and gardens can have an impact on how we feel is still with us today. Recent studies have shown that just looking at green spaces help to reduce levels of stress. In terms of hospital gardens, Ulrich’s work shows that they can provide an escape from the stressful clinical environment of the hospital.

A study published by Ulrich in Science in 1984, found that a view of trees out of a window had a positive effect on patients. He found that the patients whose windows looked out on to a natural scene stayed in hospital for a shorter length of time and took fewer painkillers than the patients in similar rooms whose windows faced a brick wall. This benefits of this are not only for the patient, but have economic implications. Fewer painkillers and shorter hospital stays can save money as well as help patients recover faster.

In the twenty-first century a garden is the element most likely to give a ‘natural’ view from a window. The British Medical Association discussed the importance of views, access to light and hospital gardens in January 2011. In The Psychological and Social Needs of Patients, the BMA argue that hospital design should take into account the important therapeutic role of gardens. The environment is hopefully once again being seen as relevant for the well being of patients.

Gardens can act as important spaces that connect the hospital with the wider world. They allow people to spend time in a recognisable setting and can provide privacy and space away from the often crowded and noisy wards. These elements are all important whether you are a patient,a visitor, or you work in a hospital. It may be hard to quantify statistically, although researchers are currently trying to calculate such effects, but there is certainly a qualitative response to accessible green space. In the past this was valued and proved influential in hospital design throughout the nineteenth and early-twentieth centuries.

I would argue that it is time such spaces were seen once again as important features in their own right rather than as inconsequential luxuries added onto the hospital building. Given their apparent economic and therapeutic benefits, can we really continue to consider hospital gardens to be anything other than essential?

2 Comments leave one →
  1. Nichola Jones permalink
    11 Nov, 2013 12:04 pm

    Excellent article, and I whole heartedly agree that consideration of the environment patients in hospital spend there time can have massive impact on both psychological and physiological health and recovery. Despite research findings you discussed above and many more, it seems hospitals and care environments don’t see this as a priority. What do you think can be done to change this?

  2. 11 Nov, 2013 2:05 pm

    Last year I visited a facility where a ground level wing had doors wide enough so the entire bed could be rolled out to the garden. It was wonderful to see patients enjoying their slice of nature even while confined to bed.

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