Insights

Honoring the Year of the Nurse and the Midwife

We reflect on our series profiling nurses in 2020, inspired by their selfless dedication to delivering care, professionalism—and compassion.

“As a nurse, you must be a team member, a unifier, and keep the patient at the center of care. Being present with the patient is the essence of true nursing.”  – Sheila Burns, RN, Labor and Delivery Nurse, Abbott Northwestern Hospital

What an honor I have to wrap-up HGA’s “Year of the Nurse and the Midwife” celebration. When we conceived of this series to profile nurses, we thought it an amazing idea—interview bedside nurses and midwives to celebrate what they do and how it relates to healthcare design. And then COVID-19 hit and everyone’s world turned upside down, especially the world of healthcare.

Nurses were on the frontline of the pandemic and the important role they play in caregiving was elevated. And so, this was the perfect opportunity to tap into their thoughts and celebrate their contributions.

What’s So Remarkable About This Profession?

“Nurses have certain qualities that enable them to work in a high-stress environment—selflessness and adaptability to different circumstances,” says Kara Freihoefer, PhD, Director of Research at HGA, who leads our evidence-based design research initiatives during the healthcare planning process. “Their jobs are multifaceted. They must be nurturing and caring while having the professional background to succeed as a team.”

Nurses must adapt to their environment, whether it supports or hinders their delivery of care. There is an art and science to nursing—intuitive knowledge coupled with skilled technical training in an evidence-based practice. They multitask constantly because, in nursing, there is so much happening at once.

Nurses work in an intimate environment with their patients. They understand how that environment impacts patients, family members, and their own wellbeing. Florence Nightingale taught us that access to nature, cleanliness, and light impacts a patient’s ability to heal—and we still operate under that premise today.

In Their Own Words

For nurses, creating more efficient workspaces and finding places to unwind is about taking care of themselves so they can better care for patients.

“I like to do some deep breathing, just to be present in the moment—even when I’m in the delivery room,” says Sheila Burns, RN, Labor and Delivery Nurse at Allina Health’s Abbott Northwestern Hospital in Minneapolis. “The energy in the room can be amazing, so deep breathing helps. You have to get your ego out of the way. As a nurse, I’m there to facilitate the process, so the calmer I am, the better I can help the mother.”

Yet most of all, nurses rely on each other for professional and emotional support.

“As for a space within the hospital, I look for a place that has views to the outside and little noise distraction,” says Sarah Cypher, DNP, RN, CMSRN, NE-BC, Director of Nursing for Surgical Units at Froedtert & the Medical College of Wisconsin Froedtert Hospital in Milwaukee. “But I also like going to where staff is, relaxing with the other nurses, telling stories about what we did over the weekend, and enjoying a good laugh.”

This sense of teamwork, personal connection, and shared purpose inspired many of our nurses to pursue their careers.

“As a premed student, I participated in shadowing rotations with physicians,” says Brittni McGill, MSN, RN, CCRN, Vice President and Chief Nursing Officer at Norman Regional Health System in Oklahoma. “I quickly noticed the interaction differences between physicians and nurses as it relates to patients and their families. That is when I decided to pursue nursing. There was such a personal connection and ability to help people.”

Kate Hellmich, RN, Surgical ICU Nurse at Mayo Clinic in Rochester, Minnesota, also notes that her career inspiration was “to help others—it’s the reason most people go into nursing.”

Adds Allie Janous, RN, Medical ICU Nurse at Dell Seton Medical Center at the University of Texas in Austin, “It is very satisfying to know I might help relieve families and patients’ stress in some way.”

The Triple Aim

Hearing these words directly from nurses provides valuable insight into the planning and design process. Nurses work in high-stress situations. Whether in an intensive care unit, labor & delivery unit, surgical unit, or emergency room, their focus is providing the best bedside care possible for patients while working closely with physicians and communicating with family members.

Our contribution as designers is to make sure we plan and design environments that enable them to fully engage in the act of nursing. Creating environments that focus on human experience, operational efficiency, and clinical outcomes is the Triple Aim. Use of these filters allows us to explore and understand what is important to clinicians and how we can achieve the creation of a fully healing environment for all without sacrifice or harm to any of the aims. Nurses are essential to this process.

Why It Matters to Design

Nursing is the nation’s largest healthcare profession, with more than 3.8 million registered nurses (RNs) nationwide and, as such, they comprise the largest percentage of the healthcare workforce; nurses are at the core of healthcare delivery. They are the major users of all healthcare spaces and we need to have their voice at the design table—they represent those who work at the bedside, as well as the patients and family members in their care. As healthcare design team members, we play an important role in enabling nurses and midwives to express their voice and support their work.

First, we need to include as many staff voices in the design process as possible. Getting their feedback engages relevant staff in the upcoming change process, helps us understand their current and desired work situation, and encourages new ways to solve problems.

Second, as an industry, we are called to use Lean and evidence-based design tools to support their work environment, reduce non-value-added tasks (such as hunting and gathering supplies), ultimately providing more time for each nurse to be at the bedside, take a break, or have a moment of respite.

Lastly, design can inspire through color, materials, design elements, and artwork—intentional design choices inspired by those who use the space. Design certainly can’t solve all healthcare challenges, but it can help redirect work-arounds and provide access to areas of respite and wellness.

Onward

I cannot end without a quote from a nurse who made us healthcare designers, researchers, and nurses so much better at what we do—Florence Nightingale.

“People say the effect is only on the mind. It is no such thing. The effect is on the body, too. Little as we know about the way in which we are affected by forms, by color, and light, we do know this, that they have an actual physical effect. Variety of form and brilliancy of color in the objects presented to patients are actual means of recovery.”

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