When Nursing Meets Architecture

Building a Unique Nurse Consultant Role in Healthcare Design

September 5, 2018

Partner, NBBJ

Editor’s Note: This post was originally published on Medscape. It was coauthored by Kristina A. Krail, RN, BSN, MPH, and Teri Oelrich, RN, BSN, MBA.

Nurses as Design Consultants in Architecture

As a nurse, have you ever watched in wonder the marvel of a new hospital rising out of the ground? Are you curious about the history of your campus or building — how it came to be or who created the design? Have you enjoyed serving on a committee when your organization was planning a new building, unit, or renovation? Was there ever a time in your nursing practice when you were frustrated with the design of your work setting and asked yourself, “What were they thinking?”

If you answered “yes” to any of these questions, you may be interested to know about the small but growing group of nurses who work directly with architects, engineers, and construction managers to build or renovate healthcare facilities. Employed as clinical consultants, project managers, planners, data analysts, or group facilitators, these nurses play a vital role at the cornerstone where the design and healthcare industries meet. By representing the various constituents through a keen understanding of the perspectives of each (and the language they use), and by leveraging those effective interpersonal skills honed as healthcare providers, nurses employed in this serve a vital role in all stages of the design process.

This area of specialty is relatively new. In 1989, the architecture firm NBBJ became one of the first to employ full-time nurses after I completed my MBA and responded to a NBBJ job posting for healthcare consulting. Today, I’m a partner in the multimillion dollar company.

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Co-author Kris Krail (at right)

At NBBJ I am joined by, among others, Kris Krail, who came to the firm serendipitously after a long career in nursing administration serving as a chief nursing officer at a variety of hospitals. She was excited to join an architecture firm because her father was a draftsman, she was active in preserving historical buildings, and the most enjoyable times during her administrative practice were when her hospitals were in a building mode.

Although the American Nurses Association does not yet recognize this type of work as its own specialty, it does direct interested professionals to the Nursing Institute for Healthcare Design — a 150-person organization of like-minded professionals with a common goal of integrating clinical expertise into the planning and design of healthcare environments.

The Role of Design Consultant

Nurses in the architecture, engineering, and construction industries must possess leadership qualities, demonstrate emotional intelligence, and be nurse experts in their field of functional or clinical specialty. We work both internally within a project team and externally with healthcare clients, so the ability to collaborate and communicate is paramount, and well-honed writing and public speaking skills are essential. They must also be comfortable and self-assured enough to interact with all client levels of personnel, from entry-level service staff to physicians and board members. An advanced degree may be required, but more important is the ability to demonstrate astute organizational skills and manage projects in a self-directed way.

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Co-author Teri Oelrich (at left)

The work itself and the benefits derived from the role are also varied, which makes the job enjoyable for us. No two days are ever alike; joy comes from interacting with a variety of people both within our firm as well as on the client side. Our nursing and healthcare expertise is relied upon extensively, but our “people skills” are also counted on, because architects are classic introverts. We achieve great satisfaction through building coalitions, managing conflict, and facilitating teams in resolving problems. There are always numerous opportunities to teach and mentor — another favorite nursing skill that gets tapped into often.

It’s hardly an easy job. We are called upon to balance priorities, often at odds, between building requirements and patient care or staff needs. Resource allocation — staffing, dollars, space, and time — continues to be a challenge for all involved. We have to go where our clients are, and so some travel is entailed, a requirement that either fits into one’s work/life balance equation or it doesn’t. And there are always deadlines, tight schedules, and sometimes late nights.

Still, the satisfaction realized by being involved in creating a new setting for patient care is unmatched. The opportunity to translate the needs of staff, patients, and families to those who design and build those settings creates a legacy that makes an impact for years to come — a legacy of spaces that are not just newer but also better, more efficient, safer, and more healing.

Banner image courtesy of NBBJ.

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Neuroscience Is Optimizing the Office

How a Molecular Biologist and an Architecture Firm Teamed up to Reimagine the Workplace

July 3, 2018

Partner, NBBJ

@ryanjmullenix

Editor’s Note: This post was originally published by the Wall Street Journal. It was co-authored by Ryan Mullenix, partner at the architecture firm NBBJ, and John Medina, developmental molecular biologist, author and affiliate professor of bioengineering at the University of Washington School of Medicine.

 

As competition for employees and ideas increases, employers are looking to office design to give them an edge. That’s why companies like Amazon, Google and Samsung have asked us to create spaces that directly affect how their employees think and feel. Our research over the past four years has shown how design affects human biology and experience, allowing us to maximize comfort and productivity. This means creating spaces with all five senses in mind and thinking about the impact of everything from diet to color theory. Here’s a look at how the office of the future could promote the health of the organization and the individual.

 

Keep It Down — Unless Brainstorming

Neuroscience tells us: The human voice evokes some of the most potent emotional responses in our auditory experience. Voices in excess of 55 decibels — roughly the sound of a loud phone call — cause measurable stress. Even more disruptive are overheard “halfversations,” in which the listener is privy to only one side of a dialogue; our brains automatically imagine the other.

How design can help: Sonically diverse environments — private phone booths, outdoor gardens and acoustically buffered spaces for activities like brainstorming and team-building exercises — keep noise away from traditional desk setups. Sounds found in nature, like moving water, can be particularly helpful for drowning out disruptions. At Amazon’s Spheres, an office for 800 employees that opened in Seattle this winter, a rushing brook and waterfall permeate the workspace with continuous, calming white noise.

 

Go Green

100876_02_Spheres_N17_mediumNeuroscience tells us: Exposure to plants makes us less emotionally volatile and error prone; even pictures of plants have a calming effect. As a bonus, certain plants give off antiviral, immune-boosting chemicals called phytoncides that promote office health.

How design can help: Amazon’s Spheres contains more than 40,000 plants and hundreds of species, but just one plant per square meter can benefit mental and physical health — while creating a more pleasant-smelling work environment.

 

Seek Visual Relief

Neuroscience tells us: Humans have an evolutionary need for private spaces that offer a sense of safety, but we also crave vistas for inspiration — a condition known as prospect refuge. Open spaces foster creative thinking, while close confines increase focus. Specific colors have been shown to enhance or hinder these abilities.

How design can help: Enclosed, comfortable booths promote focus, while open floor plans with low seating, high ceilings and outdoor views can aid in brainstorming and creative ideation. At Tencent’s headquarters in China, seating along the windows provides views of the surrounding hillsides, while benches in secluded outdoor garden spaces give employees private, peaceful retreats. Colors should be deployed wisely: blue for stimulation, green for focus, and orange for decision-making.

 

101014_00_Samsung_N9_mediumGet a Move On

Neuroscience tells us: Just 30 minutes of aerobic activity can boost executive function and reduce stress; outdoor exercise increases these effects. At just 1.8 miles an hour — a moderate walk — reaction time and quantitative skills improve.

How design can help: The layout of each floor should encourage physical activity, with elevators hidden in favor of stairs, indoor and outdoor workout spaces where possible, and designs to accommodate walking meetings. At Samsung’s North American headquarters, employees are no more than one floor away from an outdoor terrace, where they can attend yoga classes or walk through campus gardens for meetings.

 

Eat to Think

Neuroscience tells us: Mediterranean-type diets — rich in fruits, nuts and vegetables — have been shown to boost cognition, particularly executive function, which is responsible for problem-solving and impulse control.

How design can help: Our design for the Bill & Melinda Gates Foundation campus courtyard included blueberry plants, which employees can pick and enjoy.

 

Banner image courtesy of NBBJ.

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Letter to a Young Architect

What I Wish I Had Known When My Career Began

May 23, 2018

Managing Partner, NBBJ

@SteveNBBJ

A friend recently asked if I would write a letter to my younger self and embody advice and insights that I could offer the next generation of architects and design professionals – to capture what I wish I had known the day I graduated from design school. As we welcome summer interns to NBBJ, I thought sharing this letter could be valuable to them, and to everyone striving to impact our world through the limitless potential of design.

Enjoy this lesson from the future. Your comments are encouraged at the bottom of this post. I’d love to hear your thoughts on what you wish you had known or your own wisdom on fulfillment…

 

Dear friends,

My most sincere congratulations on your dedication to learning, exploring, growing. You have arrived at an extraordinary place in life, a trailhead in many ways, with many choices to confront. It is these choices — these turning points — that will have a profound influence on how your career unfolds. Some you will see coming from a distance; others will arise unexpectedly.

Start your career by cultivating your core values. It is these values that will become your compass for the great journey ahead. Commit yourself to these values underpinning every decision you make. Consciously navigate toward the destination of your dreams — and set that destination at unimaginable heights — knowing that fulfillment is not about arriving at the destination, it is how you live the journey itself.

Consciously think about what you stand for in professional practice and how you will impact the lives of others through design. Start this process now and return to these questions time and time again to hone your skills. Cultivate your confidence. Suspend your insecurities, not to be ignored, but to limit the ways in which they might impede your progress. Beware of acquiescence. Be proactive, taking one step at a time. Persevere — now and forever.

Seek and create speaking opportunities to discover your voice, and in so doing to become comfortable with that voice. Learn to be a skillful and passionate communicator. Learn to allow your mind to be open and free in service to your ideas. And never forget that listening is active, not passive. Clients will choose you because they trust you, and at the heart of that trust is their belief that they are understood. Learn how to build trust and be empathetic.

Step into your career every day. Be courageous, and know that being too comfortable or holding back is to play the game too safely. It is when we are uncomfortable that we stretch and grow the most. Learn to be comfortable with being uncomfortable. Take care of yourself in health and fitness, for this is the longest of journeys that you now embark upon — it is the journey of your life.

Looking back some 40 years after my career began by running blueprints for a local architect, I recognize I was blessed with untold opportunities to design dozens of momentous works — corporate headquarters, courthouses, stadiums, towers, global institutions and so much more. Yet beyond any talent or favor nothing was more important than my drive and belief in myself against the tide of the commonplace. And it is this belief more than any other thing that opened the doors to a magical career journey.

Believe in yourself.

Steve

 

Editor’s Note: This essay by Steve McConnell was recently published in Lessons from the Future, a book given to M.Arch. students upon their graduation. Sixty-five leading architects around the world participated in creating the book, answering the question, “if you were to start out in architecture all over again, what would you do differently?” In essence: advice to a younger self. It is edited by James P. Cramer and Scott Simpson.

Image © NBBJ.

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