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No nurse should have to cry in the bathroom.  Ever.

But when faced with emotional exhaustion during a hard shift or after a patient dies, many do because it's the closest place to go. They feel guilty for leaving their patients to go to a staff lounge or place of respite that's off their unit. And they don't want others to see them crying.

This was one of the topics that came up in the interactive session Gensler's Tama Duffy Day and I led at the Healthcare Design Expo and Conference in New Orleans several weeks ago. Our discussion explored how design can help prevent clinician burnout by tapping into intrinsic motivation.

Finding Meaning and Purpose

Intrinsic motivation is tied to finding meaning and purpose and a drive to take on challenges. Its opposite, extrinsic motivation, is based on rewards such as compensation, advancement, and recognition.

I think we can agree that most clinicians went into healthcare because they are intrinsically motived to learn new things and take on challenges. They thrive on being able to find purpose and meaning in their work.

And yet surveys show that clinician burnout happens because of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Nurses report their work is mentally and physically demanding and that their jobs make them fatigued.

Clearly, the healthcare workplace is not supporting intrinsic motivation.

Environmental Factors That Can Contribute to Clinician Burnout

When we asked our group of 40+ design and construction professionals, healthcare providers, product manufacturers, and students what environmental factors contribute to clinician burnout, some of the things they said were:

  • Noise
  • Lack of natural light or proper lighting to support circadian rhythms
  • No appropriate private place to go to vent or express emotion
  • Lack of color
  • Spaces that create or encourage separation of staff from each other

Edward O. Wilson's biophilia hypotheses has taught us that human beings have an innate desire to connect with nature and other forms of life. So I'd add lack of nature to the list.

And clutter. Messy environments are stressful environments.

Supporting Why People Work

How do we create healthcare environments that communicate mission, but also allow staff to experience mission and organizational meaning directly? This question to our group came from Gensler's "For the Love of Purpose" report on what motivates people to work for not-for-profit employers.

While we didn't get into design specifics in our 60-minute discussion, some of the things they identified as being important to supporting why people work:

  1. Collaboration and learning
  2. Socialization
  3. Flexibility
  4. Beauty

I'd also add access to nature, as well as convenient, private break and re-group spaces that are comforting and/or bring joy and fun into the workplace.

For example, the teenage wait staff at the upscale, but somewhat traditional senior living community where my mom and dad live in Central Illinois are notoriously slow and not very pro-active. Sometimes you have to ask two or three times just to get something as simple as a missing spoon.

If they had a workplace environment that they thought was fun, they’d be much happier, more engaged, and might just do a better job. Of course, teenagers might just be there for the paycheck.

But what if you could awaken their dormant intrinsic motivators? I think this could be very powerful for the senior living industry.

Where Do We Go From Here?

There's a lot more to explore on this subject.  I'm particularly interested in diving deeper into the design solutions that can support why people work in healthcare.

Gensler's report suggested a couple of good strategies to help create those design solutions:

  1. Identify design principles that help deliver on the opportunities for meaning and purpose
  2. Create a new vocabulary to talk about design that has mission and purpose at its core

We Want to Hear From You

What do you think? Are you designing environments that support why people work, not just how they work? What are the barriers to doing this?

Please share your ideas, stories, or thoughts in the comment box below. Or contact me.

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Anne Taylor

4 years ago

Hi Sara, excellent piece as a nurse I am grateful for you highlighting this subject as too many nurses are burning the candle in both ends - I was once one of them. Nurses give of themselves all day long and the culture in healthcare and nursing is always patients first, which is wonderful but we are completely forgetting nurses also live with mental and physical health just like any other human being. The rate of suicide among nurses and doctors is on the rise - its alarming. Thank you again for shining the light on this subject. Kindly, Anne

Marjorie Serrano

4 years ago

I agree with Anne. Excellent piece and a subject that needs much more discussion. I would like to see NIHD and other clinicians form a work group on this subject. Would Gensler or other supportive firms be willing to sponsor such an event?

Sara Marberry_013-Retouched-New copy

What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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