"Serenity Lounges" reduce stress, anxiety and burnout among nurses, study shows

A new Cedars-Sinai study shows that "Serenity Lounges"–break rooms equipped with massage chairs and other relaxation tools–reduced feelings of stress, anxiety and burnout among nurses.

The study, co-authored by Cedars-Sinai nurse investigators Florida Pagador, MSN; Melanie Barone, MSN; Mana Manoukian, MSN, RN; Wenrui Xu, MPH; and Linda Kim, PhD, MSN, RN, PHN, found that use of a massage chair in a quiet room for as little as 10 minutes provided nurses mental and emotional relief, allowing them to return to patient care better equipped to handle the stress. The study appears this month in the American Journal of Nursing.

"We know that our nurses can't pour from an empty cup," said David Marshall, JD, DNP, RN, senior vice president, chief nursing executive and the James R. Klinenberg, MD, and Lynn Klinenberg Linkin Chair in Nursing in honor of Linda Burnes Bolton. "This study highlights the critical importance of caring for our nurses so they can provide the best care at the bedside, and demonstrates the widespread impact our nurse researchers can have on the worldwide medical community."

For the study, nurses were asked to fill out quick surveys before utilizing the quiet, calm break spaces, and then again after exiting. Surveys asked respondents to report levels of six feelings, including "worn out," "frustrated," "stressed," and "anxious." The investigators collected 67 paired responses.

Compared with participants who used the massage chair for less than 10 minutes, those who used the chair for 10 to 20 minutes had significantly lower levels of emotional exhaustion, weariness and anxiety. Anxiety was reduced even further among participants who used the massage chair for longer than 20 minutes.

Historically, studies have shown that nurses' wellbeing affects job satisfaction and performance, along with the quality of care we can provide to patients."

Melanie Barone, Cedars-Sinai nurse investigator

Co-author Pagador had the initial idea for the lounges pre-pandemic, when she was looking for a place to sit and relax during breaks. She figured that other nurses would appreciate such a space as well.

"Being at the bedside can be mentally, emotionally and physically exhausting," she said. "I needed a place to relax and recharge."

She brought the idea to Barone, at the time her manager, who helped Pagador find an underutilized locker room that could be transformed into a space they dubbed a Serenity Lounge.

Nurses in the unit came together to furnish the room with donated items from their homes, like aromatherapy oils and their own artwork. They agreed on ground rules for the space–no cell phone conversations, no loud music, no crowding.

"It's meant to be a serene and relaxing room where you can go and really recharge your batteries," Barone said.

Only a few months after the first Serenity Lounge was established, the COVID-19 pandemic began, stretching hospital resources worldwide to their limit. The topic of nurse burnout came into sharp focus.

"When the COVID-19 pandemic hit, I know that, personally, I hadn't seen that many people pass away in a long time," Barone said. "For many of us, it was just very challenging and emotionally exhausting seeing so many families struggle. Just knowing the Serenity Lounge was there if I needed it was important."

A total of 10 units have carved out spaces to transform into Serenity Lounges, which can accommodate two to three people at a time. Pagador said most nurses use the space during the second half of their lunch break, after they've eaten.

"We didn't expect that it was going to be such a huge sensation," Pagador said.

"I always look for silver linings," Barone said. "The silver lining of COVID-19 is that we've been able to bring this initiative to more units, because there's been even more of a focus on reducing burnout and exhaustion."

Barone said that top-down support is what helped make one nurse's dream a reality.

"It was very much supported at the leadership level from the very beginning," Barone said. "We didn't have to beg to make this happen. Instead, our leaders came to us and asked, 'What can we do?' They've established a culture where it is OK to take a moment for yourself."