Light for nurses, and residents, shows results

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Elizabeth Newman
Elizabeth Newman

Much like one of my tabby cats, one of my favorite spots to lounge and read in my house is in front of a large horizontal window, in full sunlight. In my McKnight's office, I recently restructured furniture to try to maximize natural light, in case the cats stop by to visit.

If a new study is any indication, nurses need to follow this lead (with felines optional). More specifically, long-term care facilities should provide more natural light for nurses, and see the results with higher levels of quality.

The Cornell University research, which is slated to be published in the journal Health Environments Research and Design, says nurses who had access to natural light have lower blood pressure, communicated better with colleagues and did a better job serving patients, not to mention laughed more. Rana Zadeh, M.Arch, Ph.D., assistant professor of design and environmental analysis at the university, led the team. The research was supported by the Center for Health Design Research Coalition's New Investigator Award.

“The findings support evidence from laboratory and field settings of the benefits of windows and daylight,” according to the study's conclusion. “A possible micro-restorative effect of windows and daylight may result in lowered blood pressure and increased oxygen saturation and a positive effect on circadian rhythms (as suggested by body temperature) and morning sleepiness.”

It's not the first study, of course, to evaluate the effects of natural light. In an earlier study by Zadeh, she and her team looked at intensive care units with daylight and window views. One trend was that those patients with increased light levels had reduced pain perception. It's also possible natural light helped reduce healthcare errors. Staff attitude and absenteeism may be reduced as well, but more research is needed.

What's interesting about the work is the recognition of keeping nurses happy, both physically and emotionally. Many of our featured facilities in McKnight's Design Decisions have focused on architects recognizing the need for senior residents to have brightly lit spaces. That's important, of course, especially when families and residents are shopping. Who wants to send a parent into a facility that looks like a dimly lit 40-year-old college dorm? But facilities that brush off design and light may not realize how much staff errors or a good work product can change based on light.

Like many of you, I've had jobs in cubicles, and I once worked at a place where an office with a window was highly sought as a promotion. But that's trifling compared to a story that ran recently in the Washington Post that discussed how government whistleblowers are often shuttled to a basement cube. The article author clearly recognizes some people may say “meh, so?” and answers by telling a story about a man transferred to work in a windowless basement room. During a snowstorm, he discovered his workplace had been shut down — he went upstairs to find the doors locked and the lights off. No one had bothered to tell him, and tell me it doesn't break your heart a little to read his comment that “It was so lonely.”  It brings to mind Milton in Office Space, except with more deliberate cruelty on the part of management.

Obviously, basking in sunlight while filling out electronic MDS forms isn't reasonable for everyone (the glare, for one, would make it tough). But in an era where it's hard to find experienced nurses, administrators have to consider what makes people want to come into work. While no one might consciously respond “sunlight,” it could be worth including more windows, encouraging nurses to take breaks outside, and opening the blinds on a regular basis.

Elizabeth Newman is Senior Editor at McKnight's. Follow her @TigerELN.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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