The traditional nursing unit was based on the ward concept established by Florence Nightingale, which centred on the head nurse. It was a self contained unit for 35 to 40 or more patients, with its own kitchen and arrangements for all stores and supplies, where the nursing sister was the matriarch who combined the role of housewife with that of nurse.
The Nightingale ward was a pavilion type of ward and consisted of patient beds in two rows at right angles to the longitudinal walls, with toilets and bathrooms at one end, and the nurse’s table, doctor’s room and other technical facilities at the other end.
Nurses had to walk long distances to attend to patients. Subsequently, the nurse’s table saw a shift towards the centre of the ward, and the toilets and bathrooms were also shifted in the centre, in the form of an annexed.
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A later change was replacement of the nurse’s table by a nursing station to house various service facilities. In spite of these changes, the Nightingale ward suffered from disadvantages such as lack of privacy to patients, a not-so-quiet ward atmosphere and danger of cross-infection, all of which were a direct result of the pavilion.
It was gradually realised that a large ward of 40 patients and more resulted in reduction in human contact between the nurse and patient. This subsequently led to the reduction in the number of patients in each nursing unit to enable the nursing staff to establish a closer relationship with their patients.
Due to increasing complexities of nursing procedures, technical advancement in medicine, understanding the concept of hospital infection and changing expectations of patients, the nursing organisation has undergone considerable change during the recent past; the design of the nursing unit has changed accordingly.
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Even though a nursing unit now is better organised and administered, results in better material handling, has better nursing organisation, and designed for economy in space which are all important in planning of nursing units, the patient and his or her human needs require equal emphasis in planning. They should not be subordinated to design considerations alone.
