Promoting a Healthy Work Environment to Decrease Work-Related Stress

Purpose: The field of transplant nursing is a vastly changing specialty with many challenges. Transplant nurses often experience stress related to caring for patients through complex medical treatments. Cumulative exposure to work-related stress can lead to provider burnout and an unhealthy work environment. National organizations, such as the American Nurses Association are promoting healthy work environments. With the increased awareness of the negative effects of stress, it is important to implement strategies to promote a healthy workplace. The purpose of this initiative was to determine the impact of mechanical chair massage among registered nurses (RNs) and advanced practice providers (APPs) on perceived stress, blood pressure (BP), and heart rate (HR).

Description: This nurse-led pre-post design practice initiative was conducted in an ambulatory care transplant clinic. A storage closet was repurposed, cleaned, and painted in order to create a warm, calming environment. The massage chair was located in a secured room accessible by key, and the room contained a refrigerator with refreshments and snacks. A total of 24 nurses (RNs and APPs) in the transplant clinic were eligible to participate. Prior to the study initiation, an email was sent to the nurses with screenshots describing the purpose of the initiative, the usage of the chair, and the requirements for completion of the pre-post measures (perceived stress, BP, HR). The massage chair was available for 15-minute cycles and could be pre-scheduled using an Outlook calendar or spontaneously in response to a stressful event.

Evaluation/outcome: Participants self-recorded BP and HR using an Omron wrist-automated cuff device and perceived level of stress using the visual analog scale (0-10). Descriptive statistics were used to assess nurse characteristics and paired t-tests were used to compare differences in BP, HR, and perceived level of stress.

Data were collected from February 1 to October 31, 2019. Among the 110 massage chair encounters, nurses were aged 37.6 ± 7.0 and working in transplant 7.9 ± 8.3 years. There were significant decreases in systolic BP (117.3 ± 10.8 vs 111.7 ± 13.4 mmHg) and diastolic BP 70.8 ±9.8 vs 66.7 ± 10.3 mmHg), respectively p