Competencies: 726.10.2: Manager of the Healing Environment

Chapter 14

Creating a Healing Environment

Olpin/Hessen, Stress Management for Life: A Research-Based, Experiential Approach , Fourth Edition. 2016 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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Key Questions

When I walk into my best friends apartment, I seem to relax Something about that place helps me unwind. Do things like color, plants, and light really make a difference in how we feel?

If all this new technology is supposed to help me have more time to relax, why do I feel busier and more stressed than ever?

Objectives (1 of 3)

Is it my imagination, or do I feel more stressed and frustrated in hot weather?

My friend said she read a book on feng shui to give her ideas on how to arrange the furniture in her new apartment. What is feng shui anyway?

Objectives (2 of 3)

Define what is meant by a healing environment

Describe the role of color, light, smells, air, noise, temperature, nature, and organization in creating a healing environment

Explain how a healing environment helps to prevent stress

Objectives (3 of 3)

Identify the physiological and psychological impact of increasing exposure to technology and how technology can be managed to prevent stress

Evaluate your environment to determine the impact your surroundings have on your stress

Stress and the Environment

External environment:

Objects, conditions, and situations that surround us

Environmental stressor

Some aspect of our environment that we perceive as annoying, distracting, uncomfortable, or stressful

Types of Environmental Stressors (1 of 2)

Some make headlines

Tsunami or a terrorist attack

Others are more subtle

Air pollution, noise, overcrowding, technology

Individual perception

Perception is the important component of whether an environmental factor is stressful

Types of Environmental Stressors (2 of 2)

Learned response and the environment

When we associate a specific environment with something painful in that environment, the two get linked

Dentists are well aware of this effect

Managing environmental stressors

Take a proactive approach

Reduce or eliminate the stressors

FYI: Violence and the Environment

Clear link between a stressful environment and violence

Extent to which stress contributes to violence is hard to measure

Generally agreed that homicide and suicide may result from increased levels of stress

Source: Community and Population Health (8th ed.), by L. Green and J. Ottoson (St. Louis: Mosby, 1999).

Culture Connection: Healing Color

Color has been an important part of healing for thousands of years

Ancient Egyptians ascribed healing powers to various colors

In India, colors and specific meaning are assigned to the 12 chakras, or energy centers of the body

Source: Integrative Health: A Holistic Approach for Health Professionals, by C. Young and C. Koopsen (Boston: Jones and Bartlett Publishers, 2009).

FYI: Healthy Home

Florence Nightingale believed that a healthy house had five essential characteristics

Pure air

Pure water

Efficient drainage

Cleanliness

Light

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1645993/ retrieved March 16, 2014.

A Healing Environment

Healing environment is one in which:

Individuals are supported and nurtured

Individuals feel calm

Health and well-being are promoted

Color

Can raise or lower your stress and energy level

Chromotherapy

Specific discipline that uses colors to treat individuals who have certain disorders

Light

Form of electromagnetic energy that can have both positive and negative effects on living organisms

Shorter periods of daylight, as occur naturally in the winter, have been shown to trigger seasonal affective disorder (SAD)

Related to melatonin produced by pineal gland

Culture Connection: Scents

Some elderly people in Europe associate lavender with death

Lavender bags were used to keep linen sweet-smelling and moth-free

As bed-ridden person became sicker, the linen was changed more frequently, and the smell of lavender became more prevalent

Source: Mosbys Complementary and Alternative Medicine: A Research-based Approach (3rd ed.), by L. Freeman (St. Louis: Mosby, 2009).

FYI: Smells Good

Natural scent of pine is calming

Source: 100 Ways to Reclaim Your Life, by S. Calechman, Mens Health (August 2004): pp. 183190.

Scents and Air (1 of 2)

Smell is analyzed in the limbic part of the brain, an area associated with emotions

Not surprising that an aroma can affect how we feel

Aromatherapy

Therapeutic use of essential oils

Can lower stress levels

Essential oils vs. synthetic products

Scents and Air (2 of 2)

Air quality

Benefits of good, clean, and fresh air

Study in fresh air

Reduce exposure to tobacco smoke

Remember pleasant scents

Noise (1 of 3)

Noise is among the most pervasive pollutants today

Negatively affects human health and well-being

Hearing loss, stress, sleep loss, distraction, and lost productivity, and a general reduction in the quality of life and opportunities for tranquility

Measured in decibels

See Figure 14.1

Loud and Louder

Figure 14.1 Loud and Louder

An Invitation to Health 20092010 Edition, by D. Hales (Belmont, CA; Wadsworth/Cengage Learning, 2009). Used by permission.

FYI: Indoor Pollution

The U.S. Environmental Protection Agency has estimated that indoor air pollution is one of the top five environmental risks to public health

Indoor air may contain more pollutants at higher concentrations, than outdoor air

Source: Healing Spaces: Elements of Environmental Design That Make an Impact on Health, by M. Schweitzer, L. Gilpin, and S. Frampton, Journal of Alternative and Complementary Medicine, 10(1) (2004): pp. S7183.

Research Highlight: The Nose Knows

Patients administered a pleasant scent during an MRI report lower levels of stress

Sources: Using aroma to reduce distress during magnetic resonance imaging, by W. Redd and S. Manne in A. Gilbert, Compendium of Olfactory Research: 19821994 (New York: Olfactory Research Fund, 1995).

Mosbys Complementary & Alternative Medicine: A Research-Based Approach (3rd ed.), by L. Freeman (St Louis: Mosby, 2009).

FYI: Hear Today, Gone Tomorrow

As many as one in four college students have mild hearing loss

Could be the result of use of personal music devices and extended use of earbuds that deliver sound close to the eardrum

Source: Exposure to Transit and Other Sources of Noise among New York City Residents, Environmental Science and Technology, 46 (1) (January 3, 2012): 500-508.

The issue or topic is Violence in the Emergency Department.

APA format with references

1-3 paragraph answering each section. Opinion acceptable.

A1 – The Issue

In simple terms, what is your issue? Briefly, how does it relate to a practice, policy, population or education need?

A1A – Explanation of the Issue

After having a clear sense for what the issue is, the reader of a proposal will need some context; consider writing a general description of your workplace and then offering a fuller, more detailed explanation as to why you need to address the problem or issue. What do you know about the problem? Why do you think it is an important issue and why it is a concern in your workplace?

A2 – Investigation

Your investigation is focused on how you investigated the issue and/or learned it was a problem, including details about whom you talked with, what information they provided you, as well as your own experiences and observations in the place where you work (this may feel a little redundant with the Stakeholder sections, this is OK). Did you review any documents from your workplace? Did you consult the nursing literature or other national source materials, information or data?

A2A – Evidence of Problem or Issue

In follow up to your investigation think about the information you found that substantiates that your topic is indeed a problem. Ideally provide thoughts/info here from at least one internal (organizational) and one external source (nursing literature, national source doc like the ANA, CDC or NIH) to justify that your issue is valid and needs to be addressed. APA will be required here. A conversation with a Stakeholder is considered evidence, you can cite this as Personal Communication (you may need to consult the Writing Center or the OWL at Purdue …)

A3 – Analysis

For the Analysis section, examine what you’ve learned from your investigation consider/discuss/analyze the implications of the internal/external data you’ve gathered. What is the current state of things in your workplace vis-à-vis the evidence? Provide an analysis as to generally what might be contributing or causing the issue you are addressing (discussed in more detail in A3A). Are there problems with the process? A policy that needs to be created or revised? Or is it perhaps just that people are not being compliant? Don’t worry if things seem a little redundant, just compose well-reasoned and well-written responses and stay “lock-step” with the Competent language in each Rubric category/prompt. A3A – Contributing Factors For this section think about, in greater detail, what you think is contributing to or is the root cause(s) of your problem. Why is the problem occurring? Who or what is causing it or what may be occurring that is not preventing it from happening? What barriers might there be?

A4 – Proposed Solution or Innovation

Consider again, in fairly simple terms, what your proposed solution is. What is your solution? How it should take care of the problem?

A4A – Justification of Proposed Solution or Innovation

Why is your proposed solution important? How does it relate to your investigation and analysis? Would your justification be more powerful if it included data to support it?

A5 – Cost-Benefit Analysis

Every proposal should have a budget. As the proposal change-agent you would want to list an “accounting” of all of the possible resources you will need to develop and implement your planned solution. You can write things out narratively, provide as a bulleted list, or you can create a table for the Cost-Benefit Analysis with three columns. The first column would be the list of resources, the second column would be the cost of each resource, and the third column would be the benefit. Include every resource, even if it will be provided for you and the cost is $0.00. Remember, these costs/benefits can be equated addressed both quantitatively and qualitatively – as dollars or timeliness, efficiency, safety, saved revenue, improved patient and/or staff satisfaction, health of population – the list goes on and on! You can describe it in any/all of those terms. You may have to do a little research that may involve averaging of salaries/hourly wages, etc.

A6 – Timeline

What is your general estimation for your proposed plan? A week (probably not), a month? 3 months? Plan to write about your overall timeframe, saving most of the discrete details for A8.

A7 – Stakeholders’ Importance

Who are your Stakeholders and why are they important to your proposal? What are their roles? How are they important and how might they be impacted? Also, think about how they might contribute to the success of your plan? Stakeholders might include nurses, physicians, patients, ancillary departments, board of directors, etc.

A7A – Stakeholder Engagement

Consider your meetings/conversations with the key Stakeholders think about how you engaged them. Also consider questions like these: What feedback did those individuals give to you about the problem? Did they agree with you? Why or why not?

A7B – Stakeholder Success

Now that you have considered who your key Stakeholders are and how you engaged with them, next think about how you would proceed to partner with them to implement your plan. What will their roles be and how you would you work with them to make sure your plan would be a success (if you were to implement it)?

A8 – Implementation

If you were to rollout your proposal, you’d need to have a detailed step-by-step outline – in days, weeks, months – whatever you foresee needing to happen. A table might work well in this section. Whatever you decide to do, march out each of the steps so the projected timeframes are clearly demonstrated for your plan throughout its implementation. So, how/when would you implement each step? How would you evaluate your plan once it is implemented, so that you would know whether it was successful?

B1 – Role of the Scientist

How did you fulfill the role of Scientist as you worked through your proposal?

B2 – Role of the Detective

How did you fulfill the role of Detective?

B3 – Role of Manager of the Healing Environment

How did you fulfill the role of Manager of the Healing Environment?

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