Who designs the layouts of these hospitals anyway??!!

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It has occurred to me that hospitals are often not designed with the nurse in mind. I have worked on units where the medications were kept on another unit. I have worked where you had to prepare your medications on a keyboard (no joke) because there was no other place to do it. I have worked where you had to walk long distances to get to the nurses station and break rooms are on the other side of the building. I have worked where everything that you need from medications, to trash, to needle boxes, to light switches are located differently in each room. Absolutely no consistency at all. Why don't they create ways for nurses to conserve energy so that we are more able to function at peak levels? So what gives?

Manufacturing seems to have accomplished the task of helping workers become as efficient as possible by creating atmospheres where less energy is required to accomplish more. Why hasn't this taken place in nursing and the design of hospitals? Is it because many hospitals are designed piecemeal with each addition? What about new hospitals? A relative complained that the new hospital where they were employed was "horrible" and "you just walk your legs off". What do you think about it?

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Specializes in Travel, Home Health, Med-Surg.

I couldn't agree more. No hospital I have ever worked in was nurse friendly, even newer ones. I don't know why they don't get nurse/staff input with the architects prior to building, probably because that would make too much sense.

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Hospital architecture is an interesting subject. Must of what you see is due to legacy facilities that had different workflows in mind. You can see this in especially in older hospitals, they were literally designed for a different type of staffing and patient flow.

I can assure you that any new construction most definitely has workflow in mind but unlike most manufacturing hospitals must balance efficiency, an incredible amount of regulatory requirements, technology, budget, and aesthetics. Nurses are almost always key decision makers in this process but it usually is a smaller core team that has input. Where on the scale these items fall largely depends on the architectural firm and leadership at the time.

Six Sigma is what you were likely thinking of with manufacturing efficiencies. The nice thing about designing manufacturing plants is that efficiency can be prioritized with little to no regulatory or aesthetic requirements.

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My current unit is two years old and is a nightmare in most aspects. I guess that is why I was venting. I just don't understand it. It is like the nurses are not valued.

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2 minutes ago, Forest2 said:

My current unit is two years old and is a nightmare in most aspects. I guess that is why I was venting. I just don't understand it. It is like the nurses are not valued.

What is odd about your particular unit?

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Lack of work stations for one. No medication prep areas either. Wheelchairs are far far far away in another galaxy.?

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, Asystole RN said:

What is odd about your particular unit?

It's a nightmare and nurses aren't valued. So there's nothing odd about it.

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Specializes in Psych (25 years), Medical (15 years).

It's not just with hospitals, however. It's common for those who actually have to use equipment to wonder in vain why the equipment was designed the way it is.

Two cases in point: A relative was a engineer for Trane who designed, for example, furnaces. I happened to mention this fact to a serviceman working on my Trane furnace. He said, "If I could talk to those engineers who design these things, I could teach them a thing or two!" and went on to complain about this bolt being in this place, etc.

Being a novice auto mechanic, I have seen drastic changes in automobiles over the years. I have many many examples, but here's one: On my '85 Toyota pickup, if I needed to change spark plugs, I got out my ratchet socket wrench, visualized the plugs, and then changed them. On my '07 Toyota pickup, I had to remove no less than three components and then use an extension on my socket wrench going all by feel to find the plugs down a deep well and not visualizing them until pulled.

It's an ongoing rivalry between those who design and those who have to make use of.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I've had the fortune (whether it is good fortune or ill) to have worked in three brand spanking new hospital buildings and a newly re-designed ICU. I'm fairly certain it isn't old ideas of work flow that are making the hospital designs so unfriendly to nurses.

About two months before we moved into our brand new hospital tower, a group of suits wandered onto the unit asking to talk to "a real ICU nurse." My charge nurse picked me. (She had a particular habit of choosing me when the Joint Commission came a-calling, too.) "Oh, I'm so excited," one of the suits told me. "We are the ones that designed your new building, and we have never seen an ICU before." Yes, they designed our new ICUs -- three of them. It turns out there was no input from nurses, but plenty of input from administration and even a few artists to help them decide what artwork to purchase and where to put it. Shocking, isn't it?

The current 12-year old ICU that we were moving out of had been designed by an NP who hadn't spent a day at the bedside, and who bragged about her input. We had pillars in places that made it impossible to get to the suction outlets without moving the beds, call light cancellation buttons behind the beds that you couldn't get to without moving the beds into the pillars, and not enough room for a balloon pump AND a dialysis machine. The dialysis nurses were using really LONG tubing and sitting out in the hallway. We also had a handy dandy code button that you had to be at least 5'8" to reach.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
2 hours ago, Forest2 said:

Lack of work stations for one. No medication prep areas either. Wheelchairs are far far far away in another galaxy.?

Sounds like business as usual. The suits who designed it had no actual idea what is done on a nursing unit.

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Specializes in Travel, Home Health, Med-Surg.

RubyVee's post reminds me of a similar situation. I was working at older hospital that was remodeling and the NM asked me for input. I was so excited and started telling him my many ideas for placement, reconfiguring etc., when he politely interrupted and said he just wanted my opinion on the new color of the walls (from 2 already chosen). Took the wind right out of my sails!! I should have known better.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, Ruby Vee said:

The current 12-year old ICU that we were moving out of had been designed by an NP who hadn't spent a day at the bedside, and who bragged about her input. We had pillars in places that made it impossible to get to the suction outlets without moving the beds, call light cancellation buttons behind the beds that you couldn't get to without moving the beds into the pillars, and not enough room for a balloon pump AND a dialysis machine. The dialysis nurses were using really LONG tubing and sitting out in the hallway. We also had a handy dandy code button that you had to be at least 5'8" to reach.

So she sucked at being a nurse and an interior designer. So nice to be multi-talented.

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