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Virtual Reality Transports Frontline Nurses From the COVID Floor to Paradise

Analysis  |  By Carol Davis  
   January 10, 2022

'Soothing, immersive' technology has helped decrease Hoag Memorial Hospital Presbyterian nurse stress levels by an average of 34%, nurse leader says.

A California hospital with a national reputation in virtual reality (VR) for pain, patient stress management, patient education, and maternal care has deployed that same cutting-edge technology to help its frontline nurses combat stress, anxiety, and burnout.

Nurses at Hoag Memorial Hospital Presbyterian in Newport Beach, California, who experience high levels of stress, particularly from treating COVID-19 patients, began finding relief last March through CenteredVR, a virtual reality–based mindfulness and stress management program developed especially for them by BehaVR.

Prior to the COVID-19 pandemic, nearly four out of 10 nurses reported they felt burned out because of long work hours, greater workloads, poor environments, and caring for significantly ill patients, according to the Well-Being Index. By January 2021, that figure had grown to 70%, according to a study by the International Council of Nurses.

During the second half of 2021, hospitals and health systems battled a tsunami of patients whose respiratory systems were attacked by the highly contagious and deadly delta variant. There's no telling where the burnout rate currently stands.

"We have seen the power of virtual reality–enabled programming to support the mental health and well-being of our patients, so it was a natural fit for us to offer [this] tool to our nurses," says Dr. Robert Louis, chief of neurosurgery, under whose leadership Hoag has become a leader in healthcare VR.

"Mindfulness practices are shown to reduce chronic stress, and CenteredVR combines those principles with the neurological and psychological power of virtual reality, offering our nurses new resources to reduce stress and improve their overall health," Louis says.

'Soothing, immersive' environment

CenteredVR was developed in collaboration with Johns Hopkins Medicine, says Kim Mullen, MSN, RN, Hoag's director nursing professional development, research and Magnet program director.

"It guides users into a soothing, immersive VR environment that helps alleviate stress through educational elements and mindfulness practices," she says.

Over the course of six 20-minute sessions, which can be done in the privacy and comfort of their homes, nurses learn to become less reactive and more resilient to stressors.

"You learn those mindfulness concepts by practicing and training your brain. You learn how to cope better and be more resilient versus go down that negative pathway in helping you cope with stress," Mullen says.

The VR kits are sent to each nurse's home. Including a headset, headphones, and remote control, each kit arrives in an appealing, scented box to conjure a relaxing, spa-like environment, Mullen says.

"It's all about the personal experience," Mullen says.

When Hoag introduced the CenteredVR program, nearly two-thirds of the nursing staff in the COVID-19 unit signed up to participate.

Crystal Watson, RN, initially was unsure about the VR technology.

"We've always had other ways of dealing with stress, but none that had a visual element, so I wasn't sure what to expect," she says.

But once she put on the goggles and plugged in her headphones, she was "floating high above the ocean like a bird," she says.

As Watson began to use CenteredVR regularly, her stress-induced headaches gradually subsided, she says.

Watson and other nurses can choose which session they want to experience based on the level of stress they are feeling, from options designed to target specific feelings of anxiousness, sadness, or hopelessness.

"I fell in love with the 'Body Scan' series," she says. "One minute I was on my couch stressing, the next minute I was watching a beautiful waterfall or meandering through a lush green forest."

Once she focused on the breathing exercises, tension in her neck and shoulders began to relax, she says.

Though many of Hoag's nurses use the technology to decompress, Watson often uses it before work to prepare her for the day ahead, so she can better handle the stressful challenges of a 12-hour shift, she says.

Dropping stress levels

Early results on CenteredVR's impact on users' stress levels have been positive. Among the 70 nurses who have used the program to date, stress levels decreased, on average, by a reported 34%.

The hospital is also currently conducting a nursing research study to determine outcomes, Mullen says.

Further data has been gathered and submitted to the Institutional Review Board, Mullen says.

Nurse feedback has indicated that CenteredVR not only has decreased stress levels, but has helped dispel feelings of isolation and pain caused by stress and anxiety, Mullen says.

"They've said it's almost a getaway or escape, and you don't have to go anywhere," Mullen says.

Some, like Watson, say that VR has helped relieve chronic headaches, muscle tension, and anxiety.

"I always say, who wouldn't relax when you can lay and look at a beautiful waterfall and hear the sound, or walk through a beautiful, lush forest, or be at the beach?" Mullen says. "It's being able to travel when you can't."

“One minute I was on my couch stressing, the next minute I was watching a beautiful waterfall or meandering through a lush green forest.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


Nurses at California's Hoag Memorial Hospital Presbyterian are finding stress management through virtual reality (VR).

VR helps nurses train their brain to become less reactive and more resilient to stressors.

Among the 70 nurses who have used the program to date, stress levels decreased, on average, by a reported 34%.

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