Impact of Nurses Taking Daily Work Breaks in a Hospital Garden on Burnout

Am J Crit Care. 2018 Nov;27(6):508-512. doi: 10.4037/ajcc2018131.


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.

Publication types

  • Clinical Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burnout, Professional / prevention & control*
  • Cross-Over Studies
  • Female
  • Gardens*
  • Humans
  • Job Satisfaction
  • Male
  • Middle Aged
  • Nursing Staff, Hospital / psychology*
  • Prospective Studies