Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review
Abstract
:1. Introduction
1.1. Rationale
1.2. Objectives
1.3. Population, Concept, and Context
2. Materials and Methods
2.1. Overview
2.2. Inclusion Criteria
2.3. Exclusion Criteria
3. Results
3.1. Overview
3.2. Facilitators
3.3. Barriers
4. Discussion
4.1. Implementation and Process Improvement
4.2. Improving Nurses’ Well-Being
4.3. Retention and Resiliency
4.4. Management Buy-In
5. Study Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Public Involvement Statement
Guidelines and Standards Statement
Conflicts of Interest
References
- Arnetz, J.E.; Goetz, C.M.; Arnetz, B.B.; Arble, E. Nurse Reports of Stressful Situations during the COVID-19 Pandemic: Qualitative Analysis of Survey Responses. Int. J. Environ. Res. Public Health 2020, 17, 8126. [Google Scholar] [CrossRef]
- Neto, M.L.R.; Almeida, H.G.; Esmeraldo, J.D.; Nobre, C.B.; Pinheiro, W.R.; de Oliveira, C.R.T.; da Costa Sousa, I.; Lima, O.M.M.L.; Lima, N.N.R.; Moreira, M.M.; et al. When Health Professionals Look Death in the Eye: The Mental Health of Professionals Who Deal Daily with the 2019 Coronavirus Outbreak. Psychiatry Res. 2020, 288, 112972. [Google Scholar] [CrossRef]
- do Prado, C.B.; Emerick, G.S.; Cevolani Pires, L.B.; Salaroli, L.B. Impact of Long-Term COVID on Workers: A Systematic Review Protocol. PLoS ONE 2022, 17, e0265705. [Google Scholar] [CrossRef]
- Durand-Moreau, Q. The Hidden Occupational Health Burden of COVID: Work-Related Cardiovascular Diseases Related to Long Working Hours. Can. J. Public Health Rev. Can. Sante Publique 2022, 113, 405–406. [Google Scholar] [CrossRef] [PubMed]
- Iqbal, A.; Iqbal, K.; Ali, S.A.; Azim, D.; Farid, E.; Baig, M.D.; Arif, T.B.; Raza, M.; Iqbal, A.; Iqbal, K.; et al. The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-Recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors. Cureus 2021, 13, e13080. [Google Scholar] [CrossRef] [PubMed]
- NSI Nursing Solutions, Inc. 2022 NSI National Healthcare Retention & RN Staffing Report 2022; NSI Nursing Solutions, Inc.: East Petersburg, PA, USA, 2022. [Google Scholar]
- Cramer, E.; Smith, J.; Rogowski, J.; Lake, E. Measuring Moral Distress in Nurses during a Pandemic: Development and Validation of the COVID-MDS. Res. Nurs. Health 2022, 45, 549–558. [Google Scholar] [CrossRef] [PubMed]
- Trautmann, J.; Epstein, E.; Rovnyak, V.; Snyder, A. Relationships among Moral Distress, Level of Practice Independence, and Intent to Leave of Nurse Practitioners in Emergency Departments: Results from a National Survey. Adv. Emerg. Nurs. J. 2015, 37, 134–145. [Google Scholar] [CrossRef] [PubMed]
- Epstein, E.G.; Whitehead, P.B.; Prompahakul, C.; Thacker, L.R.; Hamric, A.B. Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals: AJOB Empirical Bioethics. AJOB Empir. Bioeth. 2019, 10, 113–124. [Google Scholar] [CrossRef] [PubMed]
- Buchan, J.; Catton, H. Recover to Rebuild: Investing in the Nursing Workforce for Health System Effectiveness; University of Technology Sydney: Sydney, Australia, 2023. [Google Scholar]
- Berdida, D.J.E.; Grande, R.A.N. Moral Distress, Moral Resilience, Moral Courage, and Moral Injury among Nurses in the Philippines during the COVID-19 Pandemic: A Mediation Analysis. J. Relig. Health 2023, 62, 3957–3978. [Google Scholar] [CrossRef] [PubMed]
- Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Moher, D. Updating Guidance for Reporting Systematic Reviews: Development of the PRISMA 2020 Statement. J. Clin. Epidemiol. 2021, 134, 103–112. [Google Scholar] [CrossRef]
- Kruse, C.S. Writing a Systematic Review for Publication in a Health-Related Degree Program. JMIR Res. Protoc. 2019, 8, e15490. [Google Scholar] [CrossRef]
- Arksey, H.; O’Malley, L. Scoping Studies: Towards a Methodological Framework. Int. J. Soc. Res. Methodol. 2005, 8, 19–32. [Google Scholar] [CrossRef]
- Hu, A. Quiet Room for Nurses: Can It Decrease Nurse Burnout? Crit. Care Nurse 2019, 39, E28–E29. [Google Scholar]
- Salmela, L.; Woehrle, T.; Marleau, E.; Kitch, L. Implementation of a “Serenity Room”: Promoting Resiliency in the ED. Nursing 2020, 50, 58–63. [Google Scholar] [CrossRef]
- Pagador, F.; Barone, M.; Manoukian, M.; Xu, W.; Kim, L. Effective Holistic Approaches to Reducing Nurse Stress and Burnout during COVID-19. Am. J. Nurs. 2022, 122, 40–47. [Google Scholar] [CrossRef] [PubMed]
- Gregory, D. Code Lavender: Designing Healthcare Spaces to Enhance Caregiver Wellness. HERD Health Environ. Res. Des. J. 2021, 14, 13–15. [Google Scholar] [CrossRef] [PubMed]
- Stallter, C.; Gustin, T.S. Evaluating Advanced Practice Nurses’ Burnout and Potential Helping Modalities. J. Nurse Pract. 2021, 17, 1297–1299. [Google Scholar] [CrossRef] [PubMed]
- Vranas, K.C.; Golden, S.E.; Nugent, S.; Valley, T.S.; Schutz, A.; Duggal, A.; Seitz, K.P.; Chang, S.Y.; Slatore, C.G.; Sullivan, D.R.; et al. The Influence of the COVID-19 Pandemic on Intensivists’ Well-Being: A Qualitative Study. Chest 2022, 162, 331–345. [Google Scholar] [CrossRef]
- Carter, K.F.; Bogue, R.J. Application of the Model of Leadership Influence for Health Professional Wellbeing during COVID-19. Nurs. Outlook 2022, 70, 458–464. [Google Scholar] [CrossRef]
- White, K.M.; Dulko, D.; DiPietro, B. The Effect of Burnout on Quality of Care Using Donabedian’s Framework. Nurs. Clin. N. Am. 2022, 57, 115–130. [Google Scholar] [CrossRef]
- Coicou, R.A. Our Responsibility to Be STRONGER: (Standing Together: Resilience Outreach Navigating Gracefully & Effectively to Recharge). Nurse Lead. 2021, 19, 348–351. [Google Scholar] [CrossRef]
- Kelly, L.A.; Weston, M.J.; Gee, P.M. A Nurse Leader’s Guide to Reducing Burnout: Strategies to Improve Well-Being. Nurse Lead. 2021, 19, 467–473. [Google Scholar] [CrossRef]
- Orton, D.G. Team Lavender Supports Healthcare Workers: “Our Spiritual, Emotional and Mental Health Matters”. J. Pastor. Care Couns. 2022, 76, 162–170. [Google Scholar] [CrossRef] [PubMed]
- Smith, S.A.; Kokoczka, L.; Cottrell, C. Utility of a “Lavender Lounge” to Reduce Stress Among Critical Care Registered Nurses: A Cross-Sectional Study. Am. J. Crit. Care 2023, 32, 198–204. [Google Scholar] [CrossRef]
- Tartaglia, A.; White, K.B.; Corson, T.; Charlescraft, A.; Johnson, T.; Jackson-Jordan, E.; Fitchett, G. Supporting Staff: The Role of Health Care Chaplains. J. Health Care Chaplain. 2022, 30, 60–73. [Google Scholar] [CrossRef]
- Haugland, W.A.; Crenshaw, J.T.; Gilder, R.E. Implementing a Resilience Bundle for Emergency Nurses: An Evidence-Based Practice Project. J. Emerg. Nurs. 2023, 49, 40–49. [Google Scholar] [CrossRef]
Year | Author | Facilitator | Theme | Barrier | Theme |
---|---|---|---|---|---|
2019 | Hu [15] | Quiet room can be used by nurses as a place to relax. | Places of relaxation | Lack of quiet room use led to decreased compassion satisfaction and increased burnout and secondary stress in nurses. | Lacking leadership |
Colors on the walls of the room, massage chairs, and aromatherapy diffusers can decrease stress and facilitate relaxation. | Assistive adjuncts | ||||
Quiet rooms can increase compassion satisfaction and decrease burnout and secondary stress in nurses. | Benefits | ||||
2020 | Salmela et al. [16] | In total, 71.1% of staff surveyed felt renewed after using the serenity room. | Places of relaxation | Staff who did not use the serenity room cited limited staffing or not enough time in their shift to utilize the room. | Lacking leadership |
Almost all (94%) of the staff surveyed thought that other departments would benefit from having their own serenity room. | Other effects | Staff were concerned about limited resources, including staffing, time, and room size, impacting their ability to use the serenity room. | Lacking leadership | ||
Serenity rooms were felt to be renewing and relaxing, while providing a place of privacy. | Places of relaxation | Staff need to be supported to use the serenity room, and when there are no other staff to relieve them it became difficult to leave their workstations (especially for doctors and advanced practice nurses). | Lacking leadership | ||
Interventions to improve hospital working environments positively impact nursing staff, which may lead to improved resiliency and retention. | Benefits | Staff need to feel comfortable enough to use serenity rooms, and this requires the support of coworkers and managers. | Lacking leadership | ||
2022 | Pagador et al. [17] | The use of massage chairs decreased feelings of emotional exhaustion, burnout, frustration, being worn out, stress, and anxiety. | Assistive adjuncts | Lighting, other décor, and essential oils may have contributed to negative outcomes and further examination of the comprehensive holistic environment is necessary. | Holistic concerns |
Longer use of massage chairs equated to lower levels of emotional exhaustion and anxiety. | Assistive adjuncts | ||||
Feelings of anxiety were significantly lower in those who used the massage chair for longer than 20 min compared to those who used it for 10 min. | Benefits | ||||
Massage chairs in serenity room are effective as part of a holistic strategy to care for frontline nurses’ well-being. | Assistive adjuncts | ||||
Lighting, other décor, and essential oils may have contributed to positive outcomes. | Assistive adjuncts | ||||
2022 | Gregory et al. [18] | Restorative spaces improve clinician well-being and resilience. | Benefits | Lack of respite areas affects nurses’ resilience and well-being. | Concerns regarding lack of space |
Ample daylight and separation from work areas are necessary parts of a successful respite space for staff. | Places of relaxation | Lack of space is often blamed for the lack of respite areas for staff members. | Lacking leadership | ||
Multiple tools can be built into restorative spaces successfully, which include: diffusers, light dimmers, blankets, massage chairs, pillows, sound machines, integrative therapies, mindfulness exercises, virtual reality, music therapy, yoga, adult coloring books, Watson Caritas cards, soundproof walls, no-talk zones, no-electronics zones, therapy animals, chaplains, social workers, behavioral health support, and others. | Assistive adjuncts | ||||
Support for these models must come from team leaders and have a caring culture to back it. | Leadership required | ||||
To be successful, these restorative spaces and tools need to be available 24/7. | Availability | ||||
Calling a “Code Lavender” allows nurses to step away for 15 min while another nurse steps in for them with no questions asked. | Places of relaxation | ||||
2021 | Stallter and Gustin [19] | A quiet room for APRNs was an assistive tool for preventing burnout: 54.5% agreed with this, and 16.2% strongly agreed, in those surveyed. | Benefits | ||
Unused patient rooms with adequate ventilation can be used as quiet rooms by adding fresh paint and comfortable furniture. | Assistive adjuncts | ||||
2022 | Vranas et al. [20] | Serenity spaces were created during the pandemic which allowed staff to be away from patients’ bedsides with positive results. | Places of relaxation | ||
A special quiet break room was provided with music and pictures which allowed staff to take a break and relax away from their patients. The spaces also allowed for meditation. | Benefits | ||||
2022 | Carter and Bogue [21] | Management support for evidence-based approaches, such as Code Lavender, can soothe the human spirit and enhance staff well-being. | Benefits | ||
2022 | White et al. [22] | Code Lavender and lavender lounges have emerged as a strategy to provide a stress-defusing environment for staff. | Benefits | ||
Lavender rooms or lounges provide a space for staff to retreat for relaxation and meditation. They allow a quiet place to reflect and relax uninterrupted. | Benefits | ||||
2021 | Coicou [23] | The ability of the staff to be able to “tap out” and have a serenity break can make the difference in the success of a nurse’s mental well-being and practice ability. | Benefits | ||
Serenity rooms acted as an accessible retreat for staff who were having difficulty in coping with the atrocities of the pandemic. | Benefits | ||||
Serenity rooms allow for self-care stations for staff to emotionally recharge away from their work area in order to prevent burnout. | Benefits | ||||
2021 | Kelly et al. [24] | Having Code Lavender processes in place allows for the resources, time, and activities of staff to be covered when critical situations occur. | Benefits | ||
2022 | Orton [25] | The availability of a team Code Lavender approach (“Team Lavender”) debunks the “keep your chin up and carry on” ideology that has persisted for years and can be detrimental to the health, safety, and wellness of healthcare workers. | Leadership required | ||
2023 | Smith et al. [26] | Facilitators of the use of lavender lounges include coverage by colleagues, visiting during lunch breaks, and having low unit acuity. | Leadership required | Barriers to use of the lavender lounge include high unit acuity, high unit census, and high patient care demands. | Lacking leadership |
A total of 74% of those using the lavender lounge reported it was somewhat, moderately, or very helpful in reducing their stress. | Benefits | Nurses may choose to not use the lounge due to their perceptions of what others might think of them. | Negative perceptions | ||
Some nurses were unable to use the lavender lounge because it took too much time away from their clinical responsibilities in the ICU. This shows an impracticality of the lavender lounge for this population and a concern for nurses’ health and well-being. | Lacking leadership | ||||
Simply having a room has no benefits at all: the nurses must be allowed to take advantage of the available resources. | Lacking leadership | ||||
2022 | Tartaglia et al. [27] | Chaplains can be used as an adjunct to Code Lavender and other support protocols to provide support to staff in distress following traumatic or stressful events. | Assistive adjuncts | ||
2023 | Haugland et al. [28] | Staff members appreciate the availability of tranquility rooms as a break from the hustle and bustle of the workplace. | Places of relaxation | Staff believe that tranquility rooms are useless if there is no time allotted to use them. | Lacking leadership |
Workplaces need to focus on allowing staff to be able to use serenity rooms instead of focusing only on the rush of the workplace. | Leadership required | Staff do not necessarily have time to use serenity rooms. | Lacking leadership | ||
Staff would like more time in the serenity room to get away from the workplace. | Leadership required | Simply providing a serenity room and similar tools is not enough for them to be successful. Managers must focus on the mental health and well-being of their staff members. | Lacking leadership |
Year | Author | Strength | Quality |
---|---|---|---|
2019 | Hu [15] | IV | B |
2020 | Salmela et al. [16] | II | B |
2022 | Pagador et al. [17] | II | B |
2022 | Gregory et al. [18] | III | B |
2021 | Stallter & Gustin [19] | II | A |
2022 | Vranas et al. [20] | II | A |
2022 | Carter & Bogue [21] | III | B |
2022 | White et al. [22] | III | B |
2021 | Coicou [23] | III | B |
2021 | Kelly et al. [24] | III | B |
2022 | Orton [25] | III | B |
2023 | Smith et al. [26] | II | A |
2022 | Tartaglia et al. [27] | II | B |
2023 | Haugland et al. [28] | II | A |
Facilitators | Occurrences | Sum | % |
---|---|---|---|
Benefits | 15–26 | 15 | 40.54 |
Assistive adjuncts | 15, 17–19, 27 | 8 | 21.62 |
Places of relaxation | 15, 16, 18, 25, 28 | 7 | 18.92 |
Leadership required | 18, 25, 26, 28 | 5 | 13.51 |
Availability | 18 | 1 | 2.70 |
Other effects | 16 | 1 | 2.70 |
TOTAL | 37 |
Barriers | Occurrences | Sum | % |
---|---|---|---|
Lacking leadership | 16, 18, 26, 28 | 12 | 80 |
Concerns regarding lack of space | 18 | 1 | 6.67 |
Holistic concerns | 17 | 1 | 6.67 |
Negative perceptions | 26 | 1 | 6.67 |
TOTAL | 15 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Mileski, M.; McClay, R.; Kruse, C.S.; Topinka, J.B.; Heinemann, K.; Vargas, B. Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review. Nurs. Rep. 2024, 14, 376-389. https://doi.org/10.3390/nursrep14010029
Mileski M, McClay R, Kruse CS, Topinka JB, Heinemann K, Vargas B. Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review. Nursing Reports. 2024; 14(1):376-389. https://doi.org/10.3390/nursrep14010029
Chicago/Turabian StyleMileski, Michael, Rebecca McClay, Clemens Scott Kruse, Joseph Baar Topinka, Katharine Heinemann, and Brea Vargas. 2024. "Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review" Nursing Reports 14, no. 1: 376-389. https://doi.org/10.3390/nursrep14010029
APA StyleMileski, M., McClay, R., Kruse, C. S., Topinka, J. B., Heinemann, K., & Vargas, B. (2024). Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review. Nursing Reports, 14(1), 376-389. https://doi.org/10.3390/nursrep14010029