VCU news

By Amelia Heymann

Tiffany Lord, who is graduating in May from the Virginia Commonwealth University School of Nursing with a Doctor of Nursing Practice, helped develop a virtual reality program to reduce medical staff burnout.

Lord entered the nursing program in the fall of 2019, but she has worked on and off for the VCU Medical Center since 2003.

“[Virginia Commonwealth University’s nursing program] is one of the top rated, it's down the street, I knew some of the faculty there from the hospital,” she said. “I felt it was the best program for the time.”

Lord works in the Evans-Haynes Burn Center at VCU Health, which is the only nationally verified burn center in the state. She said these units typically have a high turnover rate due to staff burnout. Lord said a lot of her coworkers stay because they love the patients, but she was focused on figuring out what made people want to leave.

Staff told her resoundingly the biggest problem for them is the patients’ reaction to wound care. In her experience with wound care, Lord said patients are often anxious and scared, causing them to lash out at their nurses.

“[Burn patients] are attempting to have some form of control, because we've taken all of that away from them,” Lord said. “They will cry, they will yell at us, they will curse at us. They'll beg us to stop – and that just wears on you over time. … And it's actually a form of trauma to have nurses continue to put themselves into those positions on a regular basis.”

Lord figured a way to make burn treatment better for everyone was to make it more pleasant for the patient. The question was how to do that.

She said there’s a lot of literature about how you can distract a patient from the pain through music, aromatherapy and storytelling. The unit was already using those methods, so Lord thought it would be a good idea to try virtual reality goggles. These would allow patients to be immersed in relaxing settings, such as a tranquil forest or swimming with dolphins, while getting treatment.

Lord received an auxiliary grant to get the goggles for the burn unit. She said staff were trained on how to use the goggles, meaning they were able to use them on themselves. The goggles were then introduced to patients, and then were offered for use during wound care.

She said a majority of the older patients hadn’t even heard of virtual reality and were wary about using the goggles during treatment.

“They're nervous about putting something over their face and not being able to see what we're doing,” Lord said.

She added that other patients embraced it and even asked if they could get VR goggles for their own home.

“So it's been really good to introduce something that people aren't familiar with,” she said.

The program started six months before the pandemic. Once COVID-19 began to spread, Lord said it became a prime cause of burnout, so it was hard to measure how the goggles helped with burnout that was specific to challenges faced in the burn unit.

“So that's when I kind of pivoted a little bit and said, ‘These goggles are available for you guys to use, you know, on your break, or if you need to go sit down,’” Lord said. “I would put them in the break room some days just so that they had access to use them themselves to help out with how everybody was feeling.”

She said the nurses have ended up using the VR equipment the most, but that it’s had a positive impact on both nurses and patients.

“I think the most rewarding part is just seeing that it doesn't just impact our staff, but it impacts our patients,” Lord said. “I think a really important correlation that I've seen with this project is that a happy nurse [means] a happy patient. ... You know, if we can have a happy nurse doing good wound care on a happy patient, we're going to get that patient home quicker.”

Michael Feldman, M.D., medical director of the Evans-Haynes Burn Center, has worked with Lord for about 10 years. He said she has the ability to connect with people to solve problems.

“If we have a problem, we go to Tiffany,” Feldman said. “She has this analytical mind that churns through data and looks at the big picture and figures out a way to solve it.”

Lord said she plans to continue working at VCU’s burn unit after graduation.

“I think it's an amazing team and I have been drawn to burn patients for many years, and I think there's a lot of potential for me to bring what I've learned through this school’s program into our unit as well,” she said. “Not just with this project, but other projects and things that we can move forward to continue to better our team professionally, but also to better our outcomes for our patients.”