People who go to hospitals are not only sick; they are often in trouble, sometimes in serious trouble. Everyone who gives direct care to patients knows this to be true. Unless hospital staffs frequently resensitize themselves to the nature and meaning of trouble, however, this fact can be easily forgotten in the day-to-day routine of looking after large numbers of patients and in the “busyness” of “keeping up with the system.” In order to consider whether patients need a physical and social environment that is different from that now provided by the average general hospital, a brief summary is necessary...

The list of troubles presented in the preceding chapter could have been greatly extended and elaborated upon. It is more than adequate, however, to suggest that patients would like to find in the hospital help for their troubles, as well as treatment for their disease or injury. Many realize, of course, that there can be no solution of some of their problems, but for staff to recognize them as individual persons, to show interest in and sympathetic understanding of their difficulties, and to make their hospital stay as little frustrating and tedious as possible—these are forms of help they...

Clearly, care designed to meet psychosocial needs which rests primarily upon dynamic interpersonal relationships between staff and patients is exceedingly hard to achieve. This is particularly true at present when training in such relationships is only beginning, and when hospitals are increasing in size and complexity and are still procedurally rather than psychologically oriented. Hence, it becomes exceedingly important to seek other instrumentalities that may exist that could supplement what is achieved through relationships. One of the most obvious of these instrumentalities appears to be the planned use of the physical and social environment of the hospital. Environmental changes are...

We turn now to three chapters devoted to a discussion of social situations and social activities that have the potential for playing a significant part in any broadly conceived plan of patient care. The first of these, the admission of the patient, is particularly important because it is at the admission desk that a person, often acutely sensitive to every cue about the place to which sickness or injury has brought him, gains an initial impression of what that place will be like. This one brief experience may set the tone for acceptance or rejection of what is to come....

Through the large glass doors of the lobby a mother and son could be seen hurrying toward the fine new hospital. They were almost gay as they entered hand in hand somewhat breathlessly. Obviously, they had visited the hospital before because the mother stepped without a moment’s hesitation toward the elevators, while the boy went immediately to sit on a lounge in the lobby. Since this is a hospital for veterans, it may be assumed that the woman was going to see her husband, who was probably also the father of the charming lad of twelve or thirteen. For strangers...

This chapter seeks to examine still another aspect of the social environment, namely, that created by patients in their contacts primarily with other patients. The purpose of this examination is to initiate more consideration, if possible, of the potential psychological value of having patients assume a role of giving help to, or of receiving help from, other patients. This subject has already been touched on in the references to the “buddy-system” that often operates spontaneously in hospitals for military service men and veterans. Reference was also made to it in the statement about the encouragement that the post-polio patients gave...

The preceding chapters have attempted to resensitize both reader and writer to the well-known but greatly neglected fact that patients are people in trouble, and if such people are to be helped along the road toward cure and health, their psychosocial as well as their physical needs must be discovered and met. We have proceeded on the basic theoretical assumption that one way of meeting some of these needs is to make the hospital more nearly like the familiar social setting from which patients come and to which most of them will return. The isnterpolation of a sharp and unnecessarily...