• Makayla Cordoza, Roger S Ulrich, Bette J Manulik, Stuart K Gardiner, Paul S Fitzpatrick, Teresia M Hazen, Alar Mirka, and R Serene Perkins.
• Makayla Cordoza is a postdoctoral researcher at the Perelman School of Medicine, University of Pennsylvania, Philadelphia. Roger S. Ulrich is a professor of architecture at the Center for Healthcare Building Research, Chalmers University of Technology, Gothenburg, Sweden. Bette J. Manulik is the manager of Clinical Research, Legacy Research Institute, Portland, Oregon. Stuart K. Gardiner is an associate scientist at Devers Eye Institute Research Laboratories, Portland, Oregon. Paul S. Fitzpatrick is a research assistant, Legacy Research Institute. Teresia M. Hazen is a registered horticultural therapist and coordinator of therapeutic gardens, Legacy Health. Alar Mirka is the retired director of clinical research, Legacy Research Institute. R. Serene Perkins is the director of surgical and clinical research, Legacy Research Institute.
• Am. J. Crit. Care. 2018 Nov 1; 27 (6): 508-512.

BackgroundNurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood.ObjectiveTo compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks.MethodsA prospective crossover trial was conducted of nurses assigned to either 6 weeks of a work break in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for a subsequent 6 weeks. The Maslach Burnout Inventory was administered at the beginning and end of each 6-week period, and a Present Functioning Visual Analogue Scale was completed at the start and end of each break to capture immediate psychological symptoms. Change scores were analyzed by using generalized estimating equations.ResultsFor 29 nurses, for garden compared with indoor breaks, significant improvement was apparent in scores on the Maslach Burnout Inventory subscales for emotional exhaustion (4.5 vs -0.2; P < .001) and depersonalization (1.8 vs 0.0; P = .02) but not for personal accomplishment (-0.6 vs -0.0; P = .55). Compared with indoor breaks, total symptom scores on the Present Functioning Visual Analog Scale improved significantly when nurses took a break in the garden (garden vs indoor breaks, 4.0 vs 2.4; P = .04).ConclusionsTaking daily work breaks in an outdoor garden may be beneficial in mitigating burnout for nurses working in hospital environments.©2018 American Association of Critical-Care Nurses.

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