Oncology Nurse Acceptance of Virtual Reality as a Work Break.

Oncology Nurse Acceptance of Virtual Reality as a Work Break - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Search Log in Primary site navigation Search Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Clin J Oncol Nurs . 2025 Jun 1;29(3):254–256. doi: 10.1188/25.CJON.254-256 Oncology Nurse Acceptance of Virtual Reality as a Work Break Amy E Rettig 1, ✉ , Diana McMahon 1 , Rachel Arpin 1 , Kellen Maicher 1 Author information Article notes Copyright and License information 1 Amy E. Rettig, DNP, MALM, APRN-BC , is a mental health clinical nurse specialist, Diana McMahon, DNP, RN, OCN ® , is the director for professional practice, and Rachel Arpin, EdD , and Kellen Maicher, MFA, MS , are learning and development consultants, all in the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center in Columbus ✉ Rettig can be reached at amy.rettig@osumc.edu , with copy to CJONEditor@ons.org . ASSOCIATE EDITOR JOAQUIN BUITRAGO, PhD, RN, OCN ® ✉ Corresponding author. Collection date 2025 Jun. Copyright 2025 by the Oncology Nursing Society Single-user license only. ONS reserves all rights. For permission to post online, reprint, adapt, or reuse, please email pubpermissions@ons.org . PMC Copyright notice PMCID: PMC12124883  PMID: 40401846 Abstract Virtual reality (VR) technology has been studied in oncology nursing with favorable results. A comprehensive cancer center provided a Take-a-Break VR program. Participants reported that they would repeat this VR program as a wellness activity, use VR as a break, and recommend VR to others. AT A GLANCE ■ VR technology offers new opportunities to support oncology nursing wellness. ■ Oncology nurses and patient care associates rated VR experiences highly for taking a break. ■ Intentional work break programming supports oncology nurse wellness and resilience. Keywords: oncology nurse, work break, resilience, wellness, nurse self-care, virtual reality The intensity of oncology nursing care affects nurses’ overall well-being ( Payson & Webb, 2022 ; Phillips et al., 2021 ). These effects include compassion fatigue ( Payson & Webb, 2022 ; Phillips et al., 2021 ), chronic stress ( Eche et al., 2022 ; Payson & Webb, 2022 ), burnout ( Michael et al., 2019 ; Phillips et al., 2021 ), loneliness, depression, and anxiety ( Phillips et al., 2021 ). Taking breaks has been identified as an effective solution to help mitigate burnout and workplace fatigue and enhance mood ( Rettig et al., 2021 ) while supporting safe, quality patient care ( Williams & Riches, 2023 ). Breaks may include journaling, relaxation, or mindfulness ( Payson & Webb, 2022 ; Rettig et al., 2021 ), and now, virtual reality (VR) ( Michael et al., 2019 ; Williams & Riches, 2023 ). At an academic comprehensive cancer center, work breaks are an intentional event called Take-a-Break (TAB). Nursing staff and nursing leadership support the program, which provides nurses with a 10-minute rest or distraction from caregiving demands ( Rettig et al., 2021 ). TAB occurs on the nursing unit in an effort to improve nurse adherence. Participants report their mood after TAB as an evaluation of the program. VR for Nurse Well-Being The well-being challenges that oncology nurses face in their work (e.g., compassion fatigue, burnout, stress) are similar to those reported by Michael et al. (2019) in a feasibility study implementing VR for stress reduction. VR uses a headset and two hand controllers, providing immersive technology. The study included 24 inpatient oncology nurses and 8 nurses from a substance misuse treatment unit who participated in using VR as a break activity for more than six weeks ( Michael et al., 2019 ). Participants chose from eight different unnamed VR experiences that were offered via a third-party software provider. The study team provided a dedicated space, and each participant tracked the length of time they used VR ( Michael et al., 2019 ). Immediately following the VR experience, participants compared how they felt before and after the session, with the majority having improved positive feelings ( Michael et al., 2019 ), similar to another report of VR for wellness ( Williams & Riches, 2023 ). The postsurvey results from Michael et al. (2019) found that nurses perceived VR as beneficial, but reported it being difficult and guilt-inducing to take time away from patient care for a break. An instructional design team introduced oncology nursing staff at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center in Columbus, a comprehensive cancer center, to a wellness TAB VR break. Nursing staff evaluated the program for integration into current TAB activities for wellness at work. Methods TAB VR Experience Select nursing units and departments collaborated with nursing leadership, creating time and space on the unit for TAB VR to engage with the technology. Nursing staff included RNs and patient care associates who received email announcements offering the opportunity to schedule time to experience TAB VR. Participation was voluntary, and program evaluation data were anonymous. A trained VR facilitator instructed all participants on how to wear and operate the VR headset and controllers. Participants received a review of VR risks, including a notification that headsets could be removed any time if the experience became uncomfortable (see Figure 1 ). TAB VR offered four different applications (see Figure 2 ): TRIPP (meditation), Beat Saber (exercise), Puzzling Places (puzzle), and Tilt Brush (now called Open Brush) (drawing). Facilitators guided application use and maintained the safety of the participants, including headset and controller sanitation after each use. Total time using the headset and engaging with an application was about 10–12 minutes. FIGURE 1. Open in a new tab RISKS OF VIRTUAL REALITY EQUIPMENT AND IMMERSION Note . Based on information from Ohio State University Office of Responsible Research Practices, 2020 . FIGURE 2. Open in a new tab VIRTUAL REALITY APPLICATIONS Program Evaluation Information collected before the TAB VR activity included basic demographic information (e.g., role, gender, age, education, years in current role, years at the current organization). Participants provided no personal identifiers. After the TAB VR activity, participants completed a program evaluation of the chosen VR experience and whether TAB VR could be incorporated into a work schedule (yes, maybe, or no). Participants rated the following factors on a five-point Likert-type scale ranging from 1 (low or no) to 5 (high or yes): the potential of VR as a wellness activity, whether the experience met expectations, and the likeliness of using VR again. Participants rated their likeliness to recommend TAB VR to colleagues on a 10-point Likert-type scale ranging from 1 (no or not likely) to 10 (yes or highly likely). In addition, participants listed barriers and challenges to VR use. Results There were 35 participants in this evidence-based intervention, of which 29 were RNs and 6 were patient care associates. Participant ages ranged from 26 to 59 years. There were 29 participants who identified as female, 5 as male, and 1 as cisgender. Among the participants, 19 reported that they had a bachelor’s degree, 8 had a master’s degree, 1 had an associate degree, 5 had some college education but no degree, and 1 had a high school diploma. Participants’ length of work tenure at this institution varied between 0–1 years (n = 11), 2–5 years (n = 8), 6–10 years (n = 3), 11–20 years (n = 8), and 21 years or more (n = 4), and one person did not respond. Of the different VR experiences available, the participants most frequently selected the active standing game (Beat Saber, n = 16) and sitting meditation (TRIPP, n = 15), followed by Open Brush (n = 3) and Puzzling Places (n = 1). Participants responded that relaxation or meditation, movement, games, art, or music would be helpful VR experiences for wellness and breaks. All participants rated TAB VR as meeting or exceeding expectations, with many reporting that VR has high (n = 6) or exceeding (n = 27) potential as a wellness solution. In terms of whether there should be future incorporation of TAB VR, 29 participants reported yes, 4 reported maybe, and 2 reported no. Participants were likely (n = 4) or highly likely (n = 28) to use VR technology again (3 did not respond). Twenty-one participants responded that they would recommend TAB VR to a coworker. Participants responded that time (n = 7), mindset (n = 4), availability of technology (n = 4), side effects (n = 4), cost (n = 3), technology (n = 2), learning curve (n = 2), safety (n = 2), sanitation (n = 2), eye issues (n = 1), losing track of time (n = 1), accessibility (n = 1), limitations (n = 1), and a variety of challenges (n = 1) would be barriers to TAB VR as a wellness intervention. Discussion In a feasibility study of VR for stress reduction ( Michael et al., 2019 ), VR was self-directed, available over a period of time, and located in a designated area. Engagement was higher at the beginning of the study and tapered toward the end of the study ( Michael et al., 2019 ). Participants reported time constraints and patient care as barriers to ongoing use, but the activity was well received, and there was interest in engaging with VR again ( Michael et al., 2019 ). Similarly, in the current study, oncology nurses and staff participated voluntarily in this TAB activity using VR technology and indicated that they would likely participate again and recommend participation to a colleague. Participants reported similar barriers that included time constraints and mindset, which may indicate a focus on patient care, although this was not conclusive. An established program incorporated TAB VR as an activity for a work break in the current study. Facilitators for TAB VR provided support for novice VR users. Although there was a difference in methods, the feasibility study ( Michael et al., 2019 ) and current study’s participants reported positive well-being results. VR technology could be included as an intervention to support oncology nurses’ well-being. Other studies ( Michael et al., 2019 ; Williams & Riches, 2023 ) reported technical considerations as well as space and logistics as barriers. Because of these barriers, TAB VR occurred on the nursing unit instead of creating a designated space. Planning a specific event with a trained facilitator is an important consideration for successful VR implementation. For example, the peak use time, 4–6 am, in the feasibility study ( Michael et al., 2019 ) indicates an opportunity for a planned event during a night shift. Mobility of VR technology addresses space and logistic barriers. This is a key to sustained use and feasibility on nursing units and in departments in acute care facilities. In addition, having a VR technology expert available helps with the technical considerations, like troubleshooting headset and controller issues. Although the majority of participants in the TAB VR program identified as women with a bachelor’s degree, distributions of ages and length of employment were more equal. There was consensus among participants across different generations to use the VR technology for TAB. Participants also expressed gratitude toward the VR wellness activity, stating: ■ “I think staff that could safely do this experience would get so much out of it. I think it is a great way to channel stress and negative energy.” ■ “This was an awesome thing you all offered! Thank you so much!” ■ “I have never used VR, and I am now excited to do it with friends. I was too scared to try it, and now I’m glad to have tried it, and loved it!” ■ “Great wellness idea! Thanks!” ■ “I really liked how the art [application] allowed you to be in another place and just be creative. Working at a hospital, there is a lack of creativity within medicine. However, VR lets you see things in different ways and exercise that part of your brain.” Limitations This was a program evaluation and not a generalizable study. The effort was to determine whether VR would fit in a menu of TAB activities. Wellness experiences in VR are plentiful, and this evaluation focused on only four activities that may not appeal to everyone. More education about the use and benefits of VR technology may improve participation across other oncology specialty units. Future studies focused on technology knowledge acquisition will help determine timelines for nurse competence with VR. An instructional design team provided TAB VR without any financial costs for the oncology nursing units. The TAB VR program evaluation did not capture the number of oncology RNs and patient care associates who did not want to participate or their reasons. Overall, the use of VR can support nursing units and departments. VR use has a good rate of acceptance and competence, as well as a good cost–benefit ratio for equipment and maintenance. Conclusion VR technology integrates well into a formal TAB program. Immersive VR combines hardware and software, creating simulations that emulate real-life, participatory, and interactive experiences. Healthcare workers can leverage the computer-generated environment as a work break that distracts from real-world situations. Participants report continued interest, satisfaction, and likeliness to recommend to others. The implementation of VR technology is versatile and has abundant applications for a work break. Many users can share one device to do any number of things, from exercise activities to guided meditation and creative expression. Future research considerations should include the impact on oncology nurse wellness and burnout, and how these effects may support nurse retention. Footnotes The authors take full responsibility for this content and did not receive honoraria or disclose any relevant financial relationships. REFERENCES Eche IJ, Eche IM, Aronowitz TB.

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