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"With every project, I can envision myself in
the spaces I'm designing and really draw on my nursing
experience to assure that the needs of nurses are met,"
said Cardon, who worked in med/surg at a Bozeman, Mont.,
hospital before becoming a health care architect.
"I understand what nurses need," said Cardon
of Seattle-based Callison Architects. "I've walked
in the white shoes."
At St. Charles, which is undergoing an $82 million,
seven-year renovation, Cardon worked closely with staff
nurses, involving them in the design process. This resulted
in many innovations, such as making sure busy nurses
had a space of their own to retreat and rejuvenate-an
idea that is being incorporated at other hospitals around
the country.
One solution to reducing walking distances and increasing
efficiency was to incorporate mobile charting carts
that can be moved about and docked at "charting
islands" to give caregivers flexibility and easy
access to supplies.
Open inner court areas at St. Charles allow nurses
to look across and see other units and not feel isolated,
Cardon said. The hospital also provides private spaces
in rooms so that family members can stay 24/7 and actively
participate in a patient's care, which Cardon said has
significantly reduced the incidence of patient falls.
"When you provide spaces in rooms for family members,
this eases the workload of nurses and helps reduce some
of the stress," Cardon said. "It also gives
family members the confidence and competence to help
take care of the patient when discharged."
In a time of nursing shortages, designing thoughtful
spaces for nurses should be a priority for hospitals
administrators who want to recruit and retain the best
caregivers, said Cardon, who is helping to create new
and innovative units for nurses in several other facilities
in the Northwest.
Nancy Moore, Ph.D., RN, senior vice president of clinical
and healing services at St. Charles, said the emphasis
on a healing health care environment is beneficial for
patients, their families and caregivers. She said cutting
travel time for nurses, adding natural light, providing
a room for a retreat and a giving a sense of openness
in the work spaces does wonders for nurses' attitudes
and performance.
"I feel really blessed to be part of this dedicated
vision of creating an environment conducive to healing
on all levels," Moore said.
At Bronson Methodist Hospital, a $181 million redevelopment
of the downtown campus provided an opportunity to use
new design elements to their fullest potential. This
has resulted in dramatic improvements in patient and
staff satisfaction and a nurse turnover rate that is
consistently below the national average.
Jackie Wahl, RN, director of operation improvement
for Bronson, said nurses took part in the design process,
helping to conceptualize the optimum environment. "They
were involved in the whole journey of getting the new
hospital built."
A major mobility issue was addressed by designing units
for one-stop service. The surgery services, for example,
are on the same level, including general surgery exam
rooms, physician offices and surgical recovery spaces.
"Staff nurses and physicians who have to see patients
before and after surgery can easily do so without having
to go to another floor or hospital area," Wahl
said. "The whole area connects along a service
line and the same is true for the trauma, ER, and rehab
units."
Wahl said the hospital's open, airy environment gives
nurses space to work without bumping into things. The
patient rooms are private and made large enough to accommodate
family members with foldout furniture for overnight
stays. There is also no distracting overhead paging
system and nurses are connected via pagers or wireless
phones, creating a quieter healing atmosphere for patients
and nurses.
Susan Ulshafer, senior vice president of human resources,
said the use of natural light, soothing music, art and
gardens has resulted in a pleasant, healing environment,
but added the physical amenities come second to the
well-being of patients.
"A beautiful new building doesn't make a good
hospital-it's the people in the building," Ulshafer
said. "A main part of the healing environment is
making sure the patient is the center of all experiences."
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