How our hospital community spaces have changed.
Who remembers the ward day rooms with bookshelves and dining tables, TVs in the corner amidst sofas and armchairs? When I started my nursing career patients used these areas, dinner was served in shared spaces where patients would sit together, eat together, and talk together. Patients shared a comradery of illness, laughter could be heard as patients told their stories, reliving both their fortune and misfortune. What a support to have in each other. Even before the Covid pandemic we found ourselves using these communal spaces less and less. Patients eat at their bedsides; TV lounges have gone with the introduction of bedside TV/Radio screens and patients bringing in their own computers/iPads. These communal areas have been turned into offices, extra bed spaces or equipment rooms. I recall working the day of the royal wedding: King Charles and Camilla (2005), the care of the elderly rehab ward had two camps within the day room. Some patients had dressed up to celebrate, one lady wore a modern trouser suit in the brightest of canary, a union jack flag in her hand. Yet other patients remained in Pyjamas, refusing to eat the afternoon tea cupcakes provided by the hospital catering team. Some celebrated the royal wedding while others disputed it, angry on Princess Diana’s behalf, yet those two differing camps did it together. That afternoon the dayroom was a hive of activity. Similar scenes happened during football matches. On the male medical ward, patients wound be wheeled into the lounge, the reds on one side the blues on the other. From the nightingale ward we could hear the cheers and boos. Those patients confined to beds desperately asking nurses to check which team had scored.
Arguably being in hospital is lonelier than it was a few years ago? Curtains are often pulled round our patients, with the reduction of nightingale wards, patients find themselves in small bays of four or six. From an infection control, dignity and privacy point of view these small bays are fantastic, but how does this impact on our patient’s experience of isolation and loneliness?
By virtue of being in hospital, our patients experience a complete loss of self, a loss of control. The institution dictates when they eat, sleep, when the lights are turned on and off. When visitors are permitted and when they are not. Once in hospital the normality of daily life ceases.
Times have changed, in the home most families cannot decide on what tv programme to watch, so I’m not proposing that we bring back the hospital TV lounges or patients start eating at communal tables again. (I’m not sure how this would be possible with infection control measures being as stringent as they are now). But I do wonder how we can infuse normality into illness. Create a less lonely environment on our wards.
Hospitals are a community as a patient, one becomes part of that community (Willingly or not). In my hospital we have a cinema, a fully functioning cinema. With beautiful brightly coloured bucket chairs, spaces for two to three hospital beds. The cinema is staffed by volunteers and paid nurses. What an amazing space. A modern-day patient lounge. The cinema has trained nurses on each showing, and an emergency medical bag with additional emergency equipment. Patients can attend with drips or infusions as the trained nurses on shift can intervene if problems occur. What a wonderful space for patients to feel normal in, to watch the latest film on a Saturday afternoon.
Kelley, twenty-one, was admitted to the hospital with extreme sickle cell pain uncontrollable at home. Alongside her pink pyjamas and fluffy slippers, she wore a patient-controlled analgesia (PCA) allowing her to deliver a bolus of pain relief when she needed it. On watching the film, she administered less analgesia to herself, stating that being absorbed in the movie allowed her to focus on that rather than her pain. This of course didn’t take away her pain, but it did wonders for her wellbeing and mental health. She tells me that for those few hours she was able to absorb herself in something other than her illness.
I’ve seen other fantastic opportunities to break up the monotony of the ward routine, to normalise a day. So even though hospital day rooms and communal eating spaces are declining, cinemas, little libraries and other communal community spaces for our patients are indeed increasing. My hospital previously hosted a millinery conference in one of its main atriums. Patients the public and staff mixed exploring the wonderful hat creations. Dorothy having had her first course of chemotherapy purchased a red velvet hat, a green feather protruding out of the side.
‘I shall wear this if my hair starts to thin.’ She told me as the care assistant wheeled her back to the ward.
We’ve held author signings, bookfairs, musical concerts, and traditional Christmas fairs.
These shared spaces are vital to our hospital communities and ensure that even in illness patients can experience a slice of normality. Can experience enjoyment and stimulation.
One communal space I am glad that we have lost, is the smoking room. I don’t miss sitting in them with confused patients I was special-ing (1:1), or navigating patients and drip stands into the small cupboard like rooms. Patients would cough and splutter smoking extra cigarettes to combat the boredom. Fingers burnt orange, overflowing ashtrays. The doors shut tightly so not to let the fumes out. I remember my hair in its neat nurse’s bun smelling as if I’d been down the pub. No. I’m not sad we lost those communal spaces.
NURSEMUMNATURE 