The restorative power of hospital gardens

Florence Nightingale asserted in her landmark “Notes on Nursing” that the most challenging ordeal for a feverish patient is:

“not being able to see out of window, and the knots in the wood being the only view.  I shall never forget the rapture of fever patients over a bunch of bright-coloured flowers”.

In 1859, she was emphasizing the value of plants and space in the healing of patients:

“People say the effect is only on the mind. It is no such thing. The effect is on the body too”.

Nightingale was not alone in her appraisal of gardens and green spaces as therapeutic tools which were indispensable in the recovery process. Throughout Victorian and Edwardian periods, green spaces in hospitals were championed as havens for healing.  In the succeeding decades, this notion appears to have been forgotten as priorities in hospital construction were directed elsewhere, with little attention given to green spaces, and the replacement of park areas by car park areas.

Perhaps a renaissance was provoked following a 1984 study by American psychologist Roger Ulrich, who demonstrated that patients with views of trees and animals from their wards recovered faster after gallbladder surgery, and spent less time in hospital than those who had no such views.  In the UK, we are in the midst of re-appraising the role of gardens and green spaces, not just for patients but for staff and visitors as well.  The British Medical Association stressed in 2011 that hospital design should always make allowances for the important therapeutic role of gardens.

The Ninewells Community Garden isn’t just a space for rest and relaxation, but also provides a source of community spirit amongst volunteers, be they patients, staff or visitors. Credit: Ninewells Hospital Dundee

Remembering the history of these beautiful spaces, including the unique roles of specific colours and scents in therapy, helps guide the design of future hospital green spaces. In her book “Therapeutic Landscapes”, medical historian Dr Clare Hickman summarises how importantly hospital gardens were regarded, and the plans for new well-designed green spaces in the future, for example the upcoming Horatio’s Garden at Stoke Mandeville Hospital in Aylesbury.  

Painting classes at Horatio’s Garden with artist-in-residence Miranda Creswell. Credit: Horatio’s Garden, Salisbury

Whether they deliver a natural and calming scene from a patient’s bed, an accessible treat for the senses of a waiting visitor, or some relaxation, freedom and privacy for a staff nurse away from the wards, these spaces are once again being seen as crucial for health and wellbeing.   It is no surprise that a reclaimed boiler-house roof, now showpiece garden at Great Ormond Street Hospital designed by Chris Beardshaw, won a Gold Medal at last year’s RHS Chelsea Flower Show.

Hospital gardens need not be highly conceptualized spaces occupied by incongruous abstract sculptures and with little space to walk.  They can be triumphs if they are peaceful, interesting, accessible, well-maintained and engage the senses (though not too strongly).  Here are some beautiful, functional and peaceful hospital gardens across the UK.

                      Ten Hospital Gardens around the United Kingdom

The Morgan Stanley Garden for Great Ormond Street Hospital

The Morgan Stanley Garden for Great Ormond Street Hospital. Credit: JOHN CAMPBELL

Constructed by renowned garden designer Chris Beardshaw, this woodland-themed garden was transplanted from the RHS Chelsea Flower Show (where it won a Gold medal) to a disused roof space, surrounded by tall hospital buildings that look onto it.  The garden provides a quiet and peaceful space for childern and families, with a roof designed such that summer mornings will light up the sculpture of a child which is the centrepiece of the garden.

Horatio’s Garden at Salisbury District Hospital

A path for the senses at Horatio’s Garden, Salisbury. Credit: HORATIO’S GARDEN

Horatio’s Garden is a charity which makes gardens of sanctuary in centres for spinal injury. The gardens are named after Horatio Chapple, who came up with the idea alongside his father whilst volunteering in Salisbury. Horatio was tragically killed aged only 17, but his legacy endures in these beautiful gardens which combine a sensory and aesthetic feast with events and activities. For example, painting the scenic garden with artist-in-residence Miranda Creswell at Salisbury Hospital adds the extra element of creative and expressive arts therapy for patients suffering from spinal injuries.

Ninewells Community Garden, Dundee

A community spirit in action. Credit: NINEWELLS HOSPITAL

This huge community garden is overlooked by the Ninewells Hospital, and emphasizes a spirit of volunteer gardening for patients, staff and the local community.  The garden’s vegetable and sensory gardens, orchard, wildlife habitat and play areas offer a multitude of options for people to de-stress, recuperate and exercise. 

John Radcliffe Hospital Women’s Centre Garden, Oxford

Credit: John Radcliffe Hospital Women’s Centre Garden, Oxford

This discarded area adjacent to the Women’s Centre was transformed into an open space with a compact walking area and two subtle sculptures in the centre. Instead of the previous drab view in front of the building, the colourful array of flowers and scents of thyme and lavender provide a welcome area for female patients and staff to relax during the course of the day.

Horatio’s Garden at the Scottish National Spinal Injuries Unit, Glasgow

Credit: Horatio’s Garden, Glasgow

The second Horatio’s Garden on this list was inaugurated in August 2016, with views of the stunning woodland garden (above) from the hospital wards.  The garden has six distinct spaces, all of which serve to stimulate different senses, and a greenhouse which is surrounded by areas used for horticultural therapy activities.

Chase Farm Hospital Rehabilitation Gardens, Enfield

Credit: Chase Farm Hospital

Chase Farm Hospital has just renovated two of its areas into specialist therapeutic gardens aimed for the specific needs of patients, but open to staff and visitors. One of the gardens supports dementia patients, whilst the other (above) support stroke and rehabilitation patients. Based on a Japanese design, it provides a very compact but tranquil sanctuary within the hospital.

Guy’s Hospital Courtyard Garden, London

Credit: Guy’s Hospital, London

The contemporary feel of the courtyard garden at Guy’s Hospital in London is accentuated by the number of sitting areas amidst the shrubs and hedges, with the vindicated expectation that the garden was designed that the garden would become a preferred spot for having lunch or sitting with family outside the wards.

Bournemouth Hospital Orchard Garden, Bournemouth

A desolate tarmac courtyard in the hospital has only recently been revamped into a three-segmented garden: a therapeutic courtyard garden outside the chemotherapy suite (above), a sensory garden linking the courtyard to a lakeside garden, giving patients and visitors not only options for their retreat of choice, but also a large area to walk around and exercise in.

Chapel Garden, Norfolk and Norwich University Hospital, Norwich

A bland lightwell was transformed into this chapel garden, featuring a central “wish tree” and a number of water features such as a vertical water fountain and a water rill giving the impression of water moving continually throughout the garden.  The calming flow of water and illusion of space allow for, once again, a small and previously unused area becoming a peaceful reservation amidst the hospital.

Dick Vet Hospital Gardens, University of Edinburgh

Credit: University of Edinburgh

Animals, animal-owners and animal-lovers should not be excluded from the healing power of gardens.  This luscious retreat at the University of Edinburgh’s Easter Bush Campus provides ample space and quiet, together with several benches. It is capped off by the Path of Memories, a path lined by granite stones which can be engraved with an animal’s name.

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Saudi Arabia’s takeover of British politics will be complete with the Tory-DUP Coalition

Saudi Arabia’s takeover of British politics is complete following the Tory-DUP coalition (as they have a more direct financial link with the DUP)

DUP Referendum campaign funded via Prince Nawwaf:
https://www.opendemocracy.net/…/secretive-dup-brexit-donor-…

http://www.independent.co.uk/…/election-dup-brexit-donation…

£3,300,000,000 = The amount we got last year for arms exports to Saudi Arabia.

Wikileaks: Saudi Arabia’s rulers threatened to make it easier for terrorists to attack London unless corruption investigations into their arms deals were halted… told they faced “another 7/7” and the loss of “British lives on British Streets” if they pressed on with their enquiries.

Wahhabism (as part of the Salafi movement) = The ideological concept of destruction and terrorism (suicide bombings, indiscriminate attacks) which is the root of current home-grown terrorism. From Saudi Arabia. We have now sponsored it for years and years to come.

And to protect us…

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Theresa May – Money or Lives?

46,700 = Total number of police cut by Theresa May since she became home secretary

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£3,300,000,000 = The amount we got last year for arms exports to Saudi Arabia

Saudi Arabia 2016 (Wikileaks) Saudi Arabia’s rulers threatened to make it easier for terrorists to attack London unless corruption investigations into their arms deals were halted… told they faced “another 7/7” and the loss of “British lives on British Streets” if they pressed on with their enquiries 

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Wahhabism (as part of the Salafi movement) = The ideological concept of destruction and terrorism (suicide bombings, indiscriminate attacks) which is the root of current home-grown terrorism. From Saudi Arabia. We have now sponsored it for another decade.

What is more important, money or lives?

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Doctors With Mental Illness – Time For A Change

Mental Illness, particularly in the workplace, remains a stigma. It is time for attitudes toward mental illness to change, and we cannot ignore the doctors who suffer.

A push for mental health

 

https://www.gov.uk/government/news/prime-minister-pledges-a-revolution-in-mental-health-treatment

Earlier this year, former prime minister David Cameron pledged a mental health revolution of almost a billion pounds. Whilst this proposed outlay is welcome, it must be matched by a proactive change to the stigma attached to mental health in media, the workplace, and at home.

Mental health and doctors

 

Professor Debbie Cohen of Cardiff surveyed almost 2000 doctors this year and found that 60% had experienced mental illness in the UK (82% in England alone). In the general population, the rate is 28%. Doctors experience the same range of problems as everyone else, but the cocktail of work, exams, academia, family and relationships lowers the threshold for illness. Many have perfectionist traits which lead to doubt and self-criticism when things go wrong, leading to a self-perpetuating cycle.

Worryingly, more young doctors are being diagnosed with mental health problems. There may not be a pre-existing illness: After 25-year old junior doctor Rose Polge tragically committed suicide in February 2016, her family described a young lady with an infectious enthusiasm for life and no previous mental health problems, but long hours and work-related anxiety contributed to her decision to end her life.

Extreme stress early on

 

Doctors are as susceptible to mental problems as the general population. However, particularly early on in their careers, they face a unique combination of challenges. These include the need to develop countless skills within a short period (for which university education can never fully prepare) and service burdens in a chronically under-resourced environment, only more challenging for those with family or caring roles. Early junior doctors shifts are usually incompatible with outside interests, and losing day-to-day balance can unearth mental health struggles.

Doctors face a societal and professional weight compelling them to ignore difficulties. A cultural idiosyncracy of willing martyrdom exists, in which doctors feel it their role to attend work regardless of fitness. This is less prevalent in other countries, for example Australia and New Zealand, where attitudes towards sickness are more rational.

The stigma

 

Fewer professions stigmatise mental health disorders more prominently than medicine. In the Cardiff study, 41% of doctors with mental illness said that they would not disclose it. Doctors are not supposed to get ill, and seeking help is weakness which imperils trust in the practitioner’s ability to do his/her job. This featured in the heartbreaking suicide of GP Wendy Potts in November 2015 after a patient read her blog on living with Bipolar Disorder and complained to the surgery.

Some doctors find changing roles from helper to patient unnatural, others find treatment from a colleague embarrassing. Often the prevailing fear is of a career-threatening “black mark” on a permanent record: Doctors must labour through appraisals and assessments, and competition for jobs and training posts can be ferocious.

A culture of fear

 

A 2008 Department of Health report said:

“Doctors may fear that acknowledging the need for help will damage their career prospects or lead to scrutiny of their fitness to practise”

This happened in the case of Dr Dakhsha Emson, who killed herself and her baby during a relapse of bipolar disorder in 2000. A stirring tribute from her husband reflected a talented doctor and a successful medical career. However, worry of colleagues and patients finding out when she was applying for consultant posts led to a lack of treatment. The report highlighted a:

“Widespread stigma against mental illness in the NHS”

This stigma can arise as early as medical school, fostered by a triad of competitiveness, fear and uncertainty. Students sometimes receive conflicting information about mental health, and may fear disclosing illness. Pastoral care can be arbitrary, often with little demarcation between disciplinary roles and support roles. Some universities have introduced “fitness to practice” hearings to monitor student behaviour, fostering a culture of castigation.

For some doctors, this culture is epitomised by the General Medical Council (GMC), whose role is to protect the health and safety of the public. All doctors with mental health issues are required to notify regarding their problems, which are investigated under the same procedures as misconduct and poor performance. Subsequent fitness to practise processes are required to be declared on application forms for jobs. These can sometimes be beneficial, for example recommending support. However, often they are described as harrowing experiences, and the duress of investigation affects doctors personally and professionally.

The toll can sometimes be too much, between 2005 and 2013 there were 28 reported cases of suicides following investigation. One of those was GP Belinda Brewe, describing the process:

“threatening and isolating”, eroding “self-confidence and self-belief”.

What’s needed

 
  • The NHS needs continued active campaigns to encourage openness, tackle stigma and promote healthy working practice.
  • Medical schools should be proactive in support and awareness: counselling services, pastoral care positions and peer support.
  • The insight that doctors with mental health problems have when treating their patients should be valued.

A doctor who has a mental health disorder might put his patient at risk, but a doctor hiding or in denial because of a culture of fear will put his patient at risk.

Support

  • http://www.php.nhs.uk NHS Practitioner Health Programme, free and confidential health service allowing doctors to self-refer.

Source: http://www.huffingtonpost.co.uk/nima-ghadiri/doctors-with-mental-healt_b_12760924.html

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Nigel Farage and UKIP’s Voting History at the EU Parliament

Former stockbroker Nigel Farage has been the figurehead for Britain’s impending exit from the European Union.  To analyse his moral compass, it helps to look at his voting history:

2016

EU Vote 2667 on 25/2/16
‘Draft Bill on automatic exchange of financial account information’.
Ukip Vote: “Against”, protecting Tax Dodgers again.

EU Vote 2748 on 25/2/16
‘Humanitarian situation in Yemen’.
Ukip Vote: “Abstained/No Show”, Ukip seem to support bombing of civilians.

EU Vote 2664 on 4/2/16
‘Systematic Mass Murder of Religeous Minorities by ISIS’.
Ukip Vote: “Against”, trying to block discussion of the matter.

EU Vote 2650 on 3/2/16
‘Stategy on Gender equality and women’s rights’.
Ukip Vote: “Against”, displaying their 1950’s misogyny again.

EU Vote 2565 on 21/1/16
‘Mutual defence clause (Article 42(7) TEU)’.
Ukip Vote: “Against”, putting their Politics over our National Defense needs.

EU Vote 2545 on 20/1/16
‘Consumer Protection – Appliances burning gaseous fuels’.
Ukip Vote: “Against”, seems they really don’t like new Safety Legislation designed to protect us.

EU Vote 2544 on 20/1/16
‘Consumer Protection : Personal protective equipment’.
Ukip Vote: “Against”, seems they don’t like new Safety Legislation designed to protect us.

EU Vote 2543 on 20/1/16
‘Presumption of innocence and right to be present at trial in criminal proceedings’.
Ukip Vote: “Abstained”, seems they don’t want any of us getting a fair trial anywhere.

EU Vote 2531 on 19/1/16’Skills policies for fighting youth unemployment’.
Ukip Vote: “Against”, seems they don’t want Young People to have jobs.

EU Vote 2530 on 19/1/16
‘Hurdles to European female entrepreneurship’.
Ukip Vote: “Against”, seems they don’t like Women starting their own businesses.
2015

EU Vote 2308 on 2/12/15
‘Eu-Liechtenstein Agreement, Exchange of Financial Information’.
Ukip Vote: “Against”, protecting Tax Dodgers.

EU Vote 2265 on 26/11/15
‘Freedom Of Expression In Bangladesh’.
Ukip Vote: “Abstained”, failing to Defend Free Speech.

EU Vote 2013 on 29/10/15
‘Transparency Of Securities Financing Transactions’. Ukip: ‘Against’.
Ukip Vote: “Against”, protecting Tax Dodgers.

EU Vote 1756 on 27/10/15
‘Mandatory Automatic Exchange Of Information In Taxation’.
Ukip Vote: “Abstained”, protecting Tax Dodgers.

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