1. YOUNG-MASON, JEANINE EdD, RN, CS, FAAN, Column Editor

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To conclude the current series of Nursing and the Arts columns dedicated to healing environments, our attention must now turn to the third component of the healthcare environment-that of the social and professional interactions between patients, families, caregivers, and the community. Pertinent to this discussion is the following definition of environment. The environment consists of the physical and aesthetic elements of every space within and outside any building and every social and professional interaction that takes place within each of those spaces. A healing, restorative, life-enhancing environment can only be achieved when physical spaces are designed, arranged, and maintained to accommodate all human beings in comfort and safety in aesthetically pleasing spaces that afford access to natural elements, and when each individual in the healthcare setting maintains a "consistent standard of care and concern"1 for all who use these spaces. Aesthetically pleasing spaces are those which take into account the perception of the 5 senses and their impact on health and healing. These spaces embody beauty, color, light, life, nature, and privacy. Paramount to all of these components is a requisite mindful humaneness of each member of the healthcare institution. Mindful humaneness embodies an attentive presence, listening with discernment, and deep understanding of the words and language that enhance dialogue and communication, and the ability to communicate with clarity, confidence, and ease.


Assessing human interaction in a healthcare setting is a daunting task. One cannot simply send all medical and nonmedical personnel to workshops on communication and be done with it. And it is expressly ineffective to send out memos and dictums stating that "this is a hospital where all are compassionate and caring" and insist staff adhere to the Golden Rule. Of course, it does help greatly if people act like they care and act like they are compassionate. But as the months and years of service and care for those who are wounded and ill roll on, acting takes a toll on their human spirit. This is so because acting as though one care successfully wards off the personal acknowledgement of one's own limitations and potentials.


Awareness of our own limitations and potentials and those of patients and families are at the core of being and becoming compassionate. Acting as though one cares leaves the "actor" above the patient and unable to connect humanly. The perceptive faculties of the wounded and ill are especially acute and the lack of genuine human connection is instantly perceived by them. Both the caretaker and the patient remain isolated from one another. There is no felt attentive presence. The patient senses rightly that his/her story is of little interest. Honest dialogue, which allows both to question one another, is hampered. Neither the patient's nor the caregiver's voice is heard. The patient is left isolated in one of the most stressful environments possible.


Conversely, if there is a genuine human connection, an atmosphere of calm discussion emerges. It becomes possible to listen with discernment for the language of pain and loss. It is to appreciate that "discussion stimulates the imagination and intellect by awakening the creative and inquisitive powers."2 In calm discussion the afflicted can share their point of view, their values, their sense of what happened and what is happening and what it means to them. They are then able to exchange thought with their caregivers and both can question one another and both will be heard and understood.


Entering a truly healing, restorative, life-enhancing healthcare environment as a patient or a visitor is an enlightening almost inspirational experience. The entrance and lobby are inviting with lush plants and the sounds of nature and calm music. The distractions of uncomfortable furniture, garish colors, dead or dying plants, troublesome noises and odors, dirty chairs and carpets are eliminated. The air is fresh, colors are inviting and warm, elements of nature are present and access to nature is possible. Integrative therapies are close at hand. There is immediate access to information and knowledge. Individuals are welcomed and guided to their destinations with gracious goodwill. One senses staff's respect for patients and visitors and one another. Privacy is possible in restful restorative spaces. Comfort food and pure water are easily available. There is ample, carefully selected reading material. Selected works of art adorn the walls throughout. In such an atmosphere patient and staff alike feel cared for and their abilities to question one another in genuine dialogue are greatly enhanced.




1. The Healthcare Consumer's Environmental Bill of Rights. Center for Health Design; 2004. [Context Link]


2. Adler M. The Paideia Proposal. New York: Collier Books, MacMillan; 1982:29. [Context Link]