Impact of nurses taking daily work breaks in a hospital garden on Burnout
Journal article, 2018

Background Nurses 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. Objective To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks. Methods A 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. Results For 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). Conclusions Taking daily work breaks in an outdoor garden may be beneficial in mitigating burnout for nurses working in hospital environments.


Makayla Cordoza

University of Pennsylvania

Roger Ulrich

Centre for Healthcare Architecture (CVA)

Chalmers, Architecture and Civil Engineering, Building Design

Bette J. Manulik

Legacy Clinical Research and Technology Center

Stuart K. Gardiner

Legacy Health

Paul S. Fitzpatrick

Legacy Clinical Research and Technology Center

Teresia M. Hazen

Legacy Health

Alar Mirka

Legacy Clinical Research and Technology Center

R. Serene Perkins

Legacy Clinical Research and Technology Center

American Journal of Critical Care

1062-3264 (ISSN)

Vol. 27 6 508-512

Subject Categories


Environmental Health and Occupational Health

Gerontology, specialising in Medical and Health Sciences





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