Florence Nightingale wouldn't like our hospitals

“It is the unqualified result of all my experience with the sick,
that second only to their need of fresh air is their need of light.”
~ Florence Nightingale

Most of us don't think about hospital design, until we're inside one and can't find anything. That's if we can find the front door.

Proper hospital design and procedures are critical: Every year one in 25 hospital patients in the United States will acquire an infection during their stay, and 78,000 to 90,000 people die annually in the United States from hospital acquired illnesses.

Perhaps we can learn from the way hospitals were designed 150 years ago. Specifically, what I propose is that hospitals be surrounded by a walking path suitable for those who are ambulatory, those using walkers, and those in wheelchairs. It should be sheltered on both sides by trees, and especially pine trees.

Hospital wards in Florence Nightingale's day were long with tall windows on both sides to let in fresh air and sunshine. Her ideas were widely respected: She was often consulted on hospital design.

By the time of the 1918–1919 flu pandemic, it was common practice to put the sick outside in tents or in specially designed open wards. The treatment at Camp Brooks Hospital near Boston took place outdoors, with “a maximum of sunshine and of fresh air day and night.” In one general hospital with 76 cases, 20 patients died within three days and 17 nurses fell ill. By contrast, according to one estimate, the regimen adopted at the camp reduced the fatality of hospital cases from 40% to about 13%. This from Richard A. Hobday, PhD, of the University of the West of England.:
The patients at Camp Brooks recovered in direct sunlight when available. This may have kept infection rates down, because laboratory experiments have shown that ultraviolet radiation inactivates influenza virus and other viral pathogens and that sunlight kills bacteria. In addition, exposure to the sun's rays may have aided patients’ recovery, because sunlight is known to promote healing in other conditions such as septic war wounds. There is evidence that heart attack victims stand a better chance of recovery if they are in sunlit wards. Depressed psychiatric patients fare better if they get some sun while hospitalized, as do premature babies with jaundice. In one study, patients in hospital wards exposed to an increased intensity of sunlight experienced less perceived stress and less pain and took 22% less analgesic medication per hour.

This advice on fresh air and sun if valid today. But antibiotics and air conditioning came along, and plate glass windows that don't open for ventialation, and don't allow the healing power of the sun to enter, replaced the sash windows Nightingale would have known. During the energy crisis of the 70s buildings were sealed up, and sick building syndrome became a thing. It happens when noxious things build up in the air because of poor ventilation. Hospital aquired infrections are now also a thing. 

Essentially, our hospitals have become petri dishes. So:
Several prevention methods  have been created for hospitals. These include increased air ventilation, the usage of reverse pressure ventilation, filtration of air, increased air circulation, Ultraviolet Germicidal Irradiation (UVGI), HEPA filters and the proper sealing of work areas when there is construction in the hospital. 

Sounds like being outside.

I have no illusion that we can return to open windows in hospitals. But we could take the patients outside. This would, of course, require more people and changes in the nursing routine. We know that walking has healing power. So now we have fresh air, sunlight, and walking. Let's add trees:
Exposure to forests boosts our immune system. While we breathe in the fresh air, we breathe in phytoncides, airborne chemicals that plants give off to protect themselves from insects. Phytoncides have antibacterial and antifungal qualities which help plants fight disease. When people breathe in these chemicals, our bodies respond by increasing the number and activity of a type of white blood cell called natural killer cells or NK. These cells kill tumor- and virus-infected cells in our bodies. In one study, increased NK activity from a 3-day, 2-night forest bathing trip lasted for more than 30 days. Japanese researchers are currently exploring whether exposure to forests can help prevent certain kinds of cancer.

Now I'll specify pine trees in the mix.
Specific phytoncides produced by the pine tree include  α-pinene and α-phellandrene, both have which have shown to have anti-inflammatory properties and anti-cancer properties when inhaled and d-limonene and p-cymene phytoncides, which have shown to specifically act against allergic lung inflammation too. All of that benefit by just inhaling the pine tree aroma!

These wild and crazy ideas have been put into practice at Hospital San Juan de Dios (Córdoba, Spain). Dr. .C. Igeño-Cano writes:
Having reached this point, profound reflection causes us to regard the reconversion of hospital zones into gardens that are safe and accessible to patients, their families and professionals as a measure that should be contemplated by Hospital Management – considering the benefits demonstrated in the literature, the current trends in healthcare, and the relatively low costs involved.

Smart guy, that doctor.

"We live in an age in which it is no longer possible to be funny. There is nothing you can imagine, no matter how ludicrous, that will not promptly be enacted before your very eyes, probably by someone well known."
~ Malcolm Muggeridge

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