Florists say bright and cheerful arrangements are popular for patients recovering in hospital. (Mary Hattler, Press-Register, Associated Press )

Patients would be better off if British hospitals let them have flowers, a paper published Thursday suggests.

The paper in the Christmas issue of the British Medical Journal disputes the arguments hospitals in the United Kingdom have made for banning or discouraging bedside bouquets.

Hospitals argue that the water for the flowers may harbour potentially dangerous bacteria, the blooms may compete with patients for oxygen, and the bouquets may be a health and safety risk around medical equipment.

Staff inconvenience may be a bigger reason for the bans, suggest Giskin Day, a course director at the Imperial College medical school, and Naiome Carter, a medical student.

They surveyed medical literature and talked to patients and staff at two London hospitals, the Royal Brompton Hospital and the Chelsea and Westminster Hospital, about their attitudes towards flowers.

No infections in years

The authors said a 1973 study found high levels of bacteria in flower water, but since then no researchers have found evidence of a hospital-acquired infection caused by flower water. Hospitals in the U.K. began banning flowers in 1996.

The suggestion that flowers compete for patients' oxygen at night was dismissed by the authors because of studies showing flowers made little difference to what's in the air in wards.

Finally, the authors argued that flowers pose no greater risk to medical equipment than food or drink containers around bedsides.

A previous study found 80 per cent of 39 nurses from a range of workplaces were not in favour of flowers, mainly because of the amount of work involved in changing the water and cleaning up spills, an opinion that Day and Carter also found in their interviews.

At the hospitals where flowers are allowed, the procedures vary, with some offering vases usually donated by patients, and others using health-care assistants or volunteers to maintain the blooms. In some cases, visitors resorted to using water jugs as vases.

Flowers and herbs have been used as remedies since the earliest hospitals and to cheer up hospital environments for at least 200 years, the authors noted.

Patients who were interviewed said they enjoyed the flowers because they made them feel better — an argument that Flowers Canada cites in its tips for ordering flowers for patients.

Hope of recovery

Hospital gifts such as flowers, fruit or chocolate, are ephemeral in nature, noted Simon Cohn, a medical anthropologist at Cambridge University, who wrote an editorial that accompanies the paper on flowers.

"[T]here is something reassuring about them lasting a finite period, echoing the hope that soon the patient will recover and head home," Cohn wrote.

"A patient looking at a bouquet doesn’t just see the flowers but the person who gave them. And a nurse or doctor is often part of this — remarking on the gifts in small talk, and consequently becoming entangled in a comforting form of interaction."

The decision to ban flowers "seems to reflect a much broader shift towards a model of care that has little time or place for more messy and nebulous elements," Cohn concluded.

According to Flowers Canada, a not-for-profit association that includes retailers, distributors, growers and educators, many urgent care and intensive care units in Canada do not allow flowers.