In patients with major depressive disorder, what is the effect of allowing nature therapy along with medications compared to medications alone over one year?

Nurses practice their profession by using their knowledge. For a long time, nurses obtain most of their knowledge from experiences, rituals, customs, or they rely on information provided by nurses before them. It was realized that this way of acquiring knowledge is not always the best practice. According to the video by Laureate education (2012), it was not until the 1990’s and beyond that evidence – based practice came into the picture. Evidence –based practice (EBP) is a way to approach creating a plan of care in which best evidence is used in conjunction with clinician’s expertise and the patient’s values and desires (Polit and Beck, 2017). A clinical experience I encounter that I believe is not evidence – based is the treatment of patients with major depressive disorder at my facility. The policy states that patients have stay out of their rooms and attend groups around the clock. They are not allowed to go to their rooms when they please, nor they are allowed to go outside for fresh air. This policy is counter to the needs of a depressed person. Not only do the patients are suffering from the side effects of antidepressant medications, but they also do not have any control over their environment. It is understood that being outside is good for everyone. In fact, according to Jordan (2015), Stanford researchers discovered that being in nature has positive effects in the human body and may reduce the risk of depression.

PICOT Question

In patients with major depressive disorder, what is the effect of allowing nature therapy along with medications compared to medications alone over one year?

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The treatment of the mentally ill population has gone a long way and much work has been done to de-stigmatize this disease. Unfortunately, many treatment centers still have employees who are old schooled and do not want to change their way. Their excuse is: “We have always done it that way.” According to Shaheen, Foo, &Luyt et. al (2011), one of the barriers to adopting evidence-based practice (EBP) is lack of time. Staffs at my facility constantly have to work shorthanded. The rate of employee turnover is so high that the facility cannot hire people fast enough to replace the ones who are leaving. As a result, training on new policies and evidence – based practice is difficult to implement. To be able for staff to have time allotted for training on EBP, facility managements need to find out the reason why workers are leaving. They need to increase the hiring rate as well.


Laureates education (producer). (2012) Timeline of nursing research. Baltmore, MD: Author.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer

Jordan, Rob (2015) Stanford researchers find mental health prescription: nature

Stanford News. Retrieved f

Shaheen, M., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236

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