Patients and nurses need to reconnect with nature

By Michael C. LaFerney | 09/01/2016

You thought you had five senses? Make that 54.

Image of dandelion in field

Joseph, a nursing home resident with mild dementia and depression, has not been outside his unit in more than three years. Mary, one of his nurses, works a double shift on the unit several times a week. When she isn’t working, she spends time in her apartment using her cellphone and computer. Both are unhappy with their existence but cannot really identify the cause. What do they have in common? Both are disconnected from nature.
 
Michael LaFerneyEcopsychology is a branch of psychology based on the premise that mankind has lost connection to nature, which leads to the anxiety, depression, and empty feelings found in so many lives. We spend much of our time indoors. Having lost touch with nature, we forfeit our natural attraction to its wonders and fail to utilize all the senses that full engagement with nature provides.
 
Human beings are deeply rooted in nature. To compensate for its loss and fill the void, we often substitute material gain or chemical dependency. A brisk, 30-minute walk outdoors can reduce stress for about four hours, or we can get about four hours of anxiety relief by taking a Xanax tablet. Which option are we offering our patients?
 
Nice doggie!
Sometimes, we reveal awareness of our patients’ disconnection to nature by the therapies we offer. A visitor brings a dog to the nursing home when visiting a relative. Many patients light up when they see the animal, a sight not common in that setting. They want to engage with it and often pet the dog or interact with it in other ways. We expand upon this concept by providing pet therapy—also known as animal-assisted therapy—in which several animals are brought in for patients to engage with in a structured activity.
 
Nursing homes make other attempts to connect patients with nature by providing plants for patient rooms or taking patients to courtyards populated with flowers. Birdhouses and feeders placed outside patients’ windows allow them to observe daily interactions of creatures other than fellow patients.
 
How can we reconnect to nature, and what can we as nurses do to aid patients—and ourselves?
 
What is more peaceful than watching seagulls?
Mary, the nurse mentioned above, recalls how as a girl she loved to go to the beach, watch the seagulls, look for horseshoe crabs, smell beach roses, and build sandcastles. Thinking back to positive experiences in nature helps us reconnect with nature and regain those positive feelings. Mary had planned her next vacation for Las Vegas, but now is thinking that a week near the ocean might be more what she needs. She tells herself, instead of staring into a slot machine, which is not unlike what I’m doing now with my cellphone and computer—at home and at work—maybe watching a brilliant sunset over ocean waves would release a greater amount of dopamine.
 
Joseph, the patient, used to love gardening and bird watching. What can Mary do to help him reconnect with nature?
 
First, get him outside. The nursing home has a beautiful courtyard, but it’s empty and poorly utilized. It has space for a small garden. Ask the activity director if a small group of patients could be organized to grow some flowers or other plants. Let Joe get his hands dirty and share some of his knowledge with others. As a lifelong gardener, his gardening knowledge is safely stored in his long-term memory bank. Because the courtyard is enclosed, it is safe for self-directed wandering so everyone can share in the sunshine and activity. Nurses notice that Joseph is less depressed and seems eager to get out of bed in the morning to check on the plants outside in the courtyard. Others are joining him.
 
When was the last time you went on a field trip?
Another interesting activity to engage people is taking nature “field trips.” It can be as small as exploring a nearby group of trees or as elaborate as driving to a scenic spot that provides a mountaintop view. When you get there, take a deep breath and ask nature for permission to be there. Then, drawing upon as many senses as you can, observe, feel, and experience what is going on. Look for colors, discern wind movement, feel the temperature, notice textures, and observe objects, plants, and other living beings. Realize that, in fact, you have a right to be there and that you are part of nature and nature’s beauty.
 
See and experience all you can. You thought you had five senses? Ecopsychologist Michael J. Cohen has identified 54. Share your experience with others. Reviewing and processing the event in a group after going outside are great ways to engage patients in sharing their experiences.
 
A few cautions: We should respect nature. Remember that many patients take medications that increase photosensitivity and that sunscreen is needed. Protect yourself and patients from disease-bearing insects such as mosquitos and ticks. Be aware of objects that can harm an elderly patient who has vision or hearing issues. On walking trails, watch for rocks that can trip or other hazards. But these are all common-sense issues, and the benefit of being in nature usually outweighs the risk it may entail.
 
Mary did vacation at the beach and returned refreshed and positive. She is not a high roller in Vegas anyway, but she feels “lucky” to have chosen this destination. She realizes, of course, that you don’t have to go on vacation to get the benefits of nature. They can be found in your own backyard (or nursing home courtyard) if you allow yourself to experience them! 
 
Michael C. LaFerney, PhD, RN, PMHCNS-BC, is a psychiatric clinical nurse specialist at Arbour SeniorCare in Haverhill, Massachusetts, USA.

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