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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