'Recharge room' aims to relieve workday stress

[00:00:00] Host Amber Smith: Upstate Medical University in Syracuse, New York invites you to be "The Informed Patient" with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith. Jobs in healthcare can be stressful. Now, workers have a new way to recharge before or after work or during a break. I'm talking about the new recharge room with Upstate's chief wellness officer, Dr. Leslie Kohman. Welcome back to "The Informed Patient," Dr. Kohman.

[00:00:31] Leslie Kohman, MD: Thanks, Amber. I'm happy to be here to talk about this.

[00:00:34] Host Amber Smith: Well, can you start by describing what this room is like?

[00:00:38] Leslie Kohman, MD: Yes. A recharge room is something installed by a wonderful vendor in New York City called Studio Elsewhere, a creative design and neuroscience small company. A recharge room is an immersive, private space that includes music, scent, lighting, and sound, designed with research support from the Abilities Research Center at the Mount Sinai School of Medicine in New York, to support the wellbeing and recovery of care providers. These rooms use a biophilic design concept that aims to connect people to nature through the use of natural elements, space, and place conditions.

Biophilic design is actually a concept used in the building industry to increase the connectivity of building occupants to the natural environment. It can use direct nature, indirect nature, such as video or imaging and space and place. This can be on this building based level or the city scale, and it has health, environmental, and even economic benefits for the building occupants. This concept has been used in architecture as far back as the hanging gardens of Babylon.

[00:02:02] Host Amber Smith: Interesting. So it sounds like a place where you can take a short escape from the hospital setting.

[00:02:09] Leslie Kohman, MD: That's right. It's a voice activated, multi-sensory experience. It's dimly lit and quiet, unless an experience is in progress. There's a pleasant scent that's dispensed automatically. There are candles and plants. One wall is a very large video screen occupying the whole wall, and there are two or three comfortable chairs set up in front of this video wall. There's room for additional people to sit on the floor if they like to do that.

On the wall is a video menu of 10 different nature experiences that people can choose from. Many of them include water. There's a sunrise shores that's the sun rising over a sandy beach. There's rainforest falls that's a beautiful waterfall in a rainforest. There's a misty lake, which is mist rising off a lake at dawn. And several others, up to about 10 of these. Each of these experiences lasts 10 or 15 minutes and is accompanied by specific music, designed by a Studio Elsewhere's creative team to compliment the video experience.

And the system is voice activated, so once you sit down, you can look at those pictures and decide which one you want to experience. And the video and audio begin and lasts for somewhere between 10 and 15 minutes. These experiences are changed out by the creative team every six or eight months.

[00:04:05] Host Amber Smith:

Let's talk about how you decided that a recharge room would be a good addition for the staff and students at Upstate. What sort of research or surveys were done, and what were the results?

[00:04:16] Leslie Kohman, MD: During the beginning of the pandemic, as you can remember, there was extreme distress in New York City earlier than everywhere else because they had a large, large number of very critically ill patients pouring into their hospitals.

And the Mount Sinai Hospital said, we have to do something for these overstretched staff. And they put up blow up tents outside their emergency room where their staff could go to take a break, and they installed a prototype of this recharge room there. And this was actually in The New York Times and other publications, both Medical and non-Medical.

And we read about it. And of course we have many, many data points that show the increased distress of all of our healthcare workers during the main part of the pandemic. So we thought this would be a great thing to do. We discovered that this approach was actually supported by scientific research that's been published in the psychological literature, that even a 15-minute experience like this for frontline healthcare workers led to an average 60% reduction in self-reported stress.

So I was, I proposed this to hospital administration because. They were the ones who had to allocate the space and build out the space, which means they had to find a room, and we actually carved this space out of the cafeteria. It had to be built completely to specifications with no windows and outlets and wiring all in exactly the place that they were recommended by the company. And then in July of this year, workers from Studio Elsewhere actually came here and spent almost a week installing the equipment in the room. And, for the installation we used philanthropic funds from the Upstate Foundation. And we will be installing a second room at our community hospital as soon as that room build out is completed.

[00:06:46] Host Amber Smith: Now, what are some other things that staff and students have at Upstate to reduce stress?

[00:06:52] Leslie Kohman, MD: Well, I just made a comprehensive list of everything under the Upstate "Well" umbrella, and I will tell you that I have had the position of chief wellness officer for four years now, this month, four years. I am the second person that had any kind of official wellness role here, the first being Suzanne Brisk, who started our Pathway to Wellness program 12 years ago. This was under the direction of employee-student health and through HR (human resources,) and it was basically focused on personal resilience and didn't have any institutional improvement components to that program, but it was very valuable for many years. Besides me, we also have Dr. Kaushal Nanvati who is the assistant dean for wellness over in the colleges who has the wellness of the students and residents at the core of his focus area.

But for all hospital employees, staff, and we include all learners and workers at Upstate, we have a smorgasbord of more than 40 different programs that include community building groups for having dinner together and meeting new people. We have a trained cadre, more than 30 individuals who've been fully trained in critical incident stress management to help their colleagues when there's a stressful event such as a patient poor outcome, or an interpersonal conflict or whatever it is. We have a team of people on call 24/7 who can go to that unit. And they are trained to provide the support to help the staff through those.

We have a 24-hour nurse triage hotline for our staff. People can call there and get directed to the resource for whatever kind of challenge to their wellbeing they are experiencing at the time. And we have many personal resilience programs. We have a meditation Tranquility Tuesdays, we have a Monday Mile walking program. We have many New York state wellness activities that our people have access to as well.

We have coaching and leadership training. We have educational seminars and programs. We have department level activities, and we have, currently, about 25 representatives from all different departments who are taking a role in this, in the wellness activities for their own departments. So we have a very large number of things and a very small staff, so as people have ideas, they've been volunteering and working hard to get those ideas to come to pass.

One other one I will mention that people really love is our Pet a Pooch program where volunteers with their dogs come and spend time in with the staff, and 50 or 60 or even more staff members will stop in during an hour and a half when a dog is there, and you can just watch them calm down as this happens.

[00:10:26] Host Amber Smith: This is Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith. I'm talking with Upstate's chief wellness officer, Dr. Leslie Kohman, about recharging to help reduce stress. Is work in healthcare inherently going to be stressful?

[00:10:42] Leslie Kohman, MD: Well, I think yes. People can absolutely imagine we're dealing with life and death things, and we face people every day for whom the happenings of this day are the most life-changing thing that's ever happened to them. And we experience that through our patients multiple times a day. So there's a huge amount of emotional content to this type of work, as well as risks of bad patient outcomes or severe trauma that comes in through the emergency room. That really does create a lot of stress for the staff. So it's very important to help them.

All of us deal with that because nobody can bear that burden alone. And healthcare workers, by design, the people who go into healthcare work are self-effacing, and always want to put the patient first. But that's not always the right thing to do. The airline industry tells us to put our own oxygen mask on first before helping others, and we need to remember that.

Self-compassion is extremely important and also frequently absent in our very dedicated healthcare workers. And Dr. Robert Corona, our CEO, has a video message every week, and he always ends it with, "be kind to yourself, be kind to others," and you can tell from that statement that you have to start with yourself. If you don't care about yourself, No. 1 who else is going to care about you as much as you? And No. 2 how are you going to care for others if you don't care for yourself? So it's extremely important and not practiced nearly as much by healthcare workers.

[00:12:46] Host Amber Smith: Why do you think that stress-reducing programs like the Recharge Room for workers and students, why do you think those things matter to patients in the long run?

[00:12:56] Leslie Kohman, MD: Well, it's absolutely proven in the (scientific) literature that a stressed medical staff and stressed healthcare workers in general, nurses, doctors, whoever they may be, provide less optimal patient care. Well physicians, well nurses, well staff provides the optimum in patient quality of care. So we should all want our people who take care of us to be feeling very good and practicing self-compassion and wellness techniques because they will give us better care that way. And we definitely want to make sure that all our patients at Upstate are getting the absolutely best quality of care.

[00:13:47] Host Amber Smith: In your research, did you find other stress reducing ideas that might work in a healthcare workplace?

[00:13:54] Leslie Kohman, MD: Well, there's a huge literature or growing, shall I say, literature in things that help. Some of the things that we know about are peer support. So if you are having a bad day or a bad outcome, if you can talk, just even for a few minutes, to another person whose sole job for those few minutes is to listen to you and understand, you'll definitely feel better.

So we have had a strong peer support program in the past, and we are now working on getting 100 people trained in psychological first aid, which is just a 1-hour training. But if everybody did that, you could be more compassionate to those around you.

One thing we all need to remember is that you don't have any idea what is going on with your colleague. They may be having a crisis at home. They may have just had a bad patient outcome. They may have any kind of mental, physical, or emotional challenge that they're having this day, and when you relate to them, most of us don't really recognize what's behind somebody else's behavior, and if we learn to do that, everything will be so much smoother, and people will feel so much more fulfilled in their work.

[00:15:25] Host Amber Smith: Any ideas for relaxing things that staff and students can do outside of work?

[00:15:31] Leslie Kohman, MD: I think the most important thing is everybody has things they like to do, and it's different for everyone. The important thing is to do them. If you like to play tennis, if you like to swim, if you just like to play with your kids, if you like to go camping, whatever it is, read a book, it doesn't matter. It's what you enjoy. But to do it.

And don't say, "well, I really love X, but I haven't done it for the last months or years." To do it, to be with the people who fulfill you, your loved ones, your friends, and to give work a break when you're not there. Turn off your device when you don't have any clinical responsibilities, and just focus on something else. You will come back refreshed and able to give patients a much better self after any experience like that.

[00:16:29] Host Amber Smith: Well, I appreciate you making time for this interview, Dr. Kohman.

[00:16:33] Leslie Kohman, MD: Thank you. I hope that people will get the message of self-compassion. It's important for all of us.

[00:16:40] Host Amber Smith: My guest has been Dr. Leslie Kohman. She's Upstate's chief wellness officer. "The Informed Patient" is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe. Find our archive of previous episodes at upstate.edu/informed. If you enjoyed this episode, please tell a friend to listen too. And you can rate and review "The Informed Patient" podcast on Spotify, Apple podcasts, YouTube, or wherever you tune in. This is your host, Amber Smith, thanking you for listening.