WARDS: ROUTES IN

by the Hospital Senses Collective

The ward is the quintessential hospital space. The idea of the ward derives from its original meaning of ‘to guard over, to keep in safety, to take care of, or to defend or protect’. It is where patients are supposed to be treated, watched over, and recover. It is also the space most likely to be associated, in the popular imagination at least, with the training of medical students via the ward round. Like much of the rest of the hospital, the development of ward design can also tell us much about the values, ideas, and practices of medical care.

From the mid nineteenth century into the twentieth, wards, known as ‘Nightingale wards’ (named after the famous nursing and hospital design campaigner), were ubiquitous in any new hospital design. They were long narrow rooms, shared by a number of patients with no subdivisions other than curtains between the beds. The original architectural plans were also designed to allow the circulation of fresh air and sunlight, believed to be both preventative and therapeutic, as well as the efficient movement of nursing staff who could retain a watchful eye on all the patients.

Whereas the Nightingale ward contained many beds, the contemporary ward is often divided into smaller groups of four or six beds, or even single occupancy rooms. The Nightingale ward, though, is still an integral part of those NHS sites that inherited hospitals from Victorian predecessors, and even features in some recently built institutions.

Today, care is provided and interventions delivered by a range of health professionals in a variety of hospital spaces. However, the ward round remains a key moment of interaction between doctor and patient. Consultants and their junior doctor colleagues proceed from bed to bed, patient to patient, enquiring after their health and making decisions about their treatment or discharge. The ward is, therefore, the location of some of the archetypal sensory interactions and experiences of modern hospital care. It is where patients are touched, their temperatures taken, and their rhythms monitored. It is where healthcare practitioners smooth pillows, take pulses, and insert cannulas. It can also be a sensorily complex space as noise from patients, televisions and radios, staff, visitors and medical technology mix and create a rich soundscape which can be stressful, or perhaps even soothing, dependent on the time of day or the individual patient.

Life on the ward is at once clinical and mundane. You will be subjected to medical interventions; the day is also punctuated by breakfast, lunch and dinner. Post-operative recovery is rewarded with the commonplace British meal of tea and toast. One of the key features of life on the ward is that it is highly regulated and most patients have little say over what they do and when. You are woken by someone else at strange times of the day and must eat at predetermined intervals. Patients on the ward also spend a whole lot of time doing nothing at all: waiting for treatment, waiting for food, or waiting for recovery.

Overall, the ward is a contradictory space for patients, staff and visitors alike. It is a space of recovery and decline; high emotions and boredom; sensory overload and understimulation; the exceptional and the routine; the public and the private; the technological and the personal; community and isolation. Each of these complex experiences is intensely sensory, from overhearing private conversations behind a neighbouring bed’s drawn curtain, to smelling the wafting aroma of breakfast bright and early every day, to daydreaming of the return home.

In this booklet we encourage you to remember or imagine your last visit to a ward, and to recall its sights, smells, sounds, tastes and surfaces.

Sensing Spaces of Healthcare

Rethinking the NHS Hospital

WARDS: ROUTES IN

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