Key Points

Attention is a finite resource. Emergency medicine heavily taxes directed attention through interruptions, task switching, threat monitoring, and constant high-stakes decisions.
Nature gives directed attention a chance to recover. Natural environments engage “soft fascination”. That’s referring to the effortless, bottom-up attention- which allows our effortful, goal-directed attention systems to rest and recharge.
Nature helps downshift the stress response and may reduce stress physiology, support parasympathetic activity, improve mood, and potentially improve emotional regulation.
Exposure can be brief to reset: even a 40-second view of greenery was associated with improved sustained attention in one study. Windows, plants, nature imagery, and brief outdoor breaks can make a difference. We can even design nature into healthcare.
Nature is a tool but not a treatment for broken systems. Nature exposure shouldn’t become another individual “wellness” obligation or substitute for fixing understaffing, moral injury, or other structural problems. And it’s also okay to go outside simply because being outside feels good, without optimizing anything.

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Previously Covered and Related Content:

- REBEL MIND: Rest is not Sleep: 7 Dimensions of True Recovery

Introduction

Welcome to Rebel MIND, the podcast where we explore concepts that help us understand our minds so that we can take better care of our patients and ourselves. MIND stands for Mastering Internal Negativity during Difficulty. In this episode, Dr. Kim Bambach talks with emergency physician and neuroscientist Dr. Adrienne Taren as well as emergency physician and wilderness medicine expert Dr. Linda Keyes about the Nature Reset: how exposure to nature can restore attention, downshift our stress response, and help our brains recover from the cognitive demands of medicine.

Dr. Adrienne Taren is an emergency medicine physician, clinical neuroscience faculty at the Laureate Institute for Brain Research, and adjunct professor at Oklahoma State University in medical education. She completed her MD/PhD (Neuroscience) at the University of Pittsburgh-Carnegie Mellon University. Her current research focuses on the neural circuit function underlying occupational traumatic stress symptoms in frontline healthcare workers.

Dr. Linda Keyes is a board-certified emergency physician, an adjunct professor at University of Colorado, Vice President of the International Society of Mountain Medicine, and past-president of the Wilderness Medical Society. Since she was a medical student at Yale University, she has travelled the globe in pursuit of science. Dr. Keyes has partnered with researchers and clinicians on five continents to understand the effects of high altitude on the human body. She has authored of scores of original research articles and international guidelines on high-altitude medicine with a focus on women’s health and understanding acute mountain sickness. The mountains are her happy place. She believes in wilderness as medicine and in conservation for the health of the planet.

Cognitive Question

How can nature help us recover during or after a difficult shift?

How does nature exposure affect our cognition?

Clinical medicine keeps our brains in a near-constant state of cognitive and physiologic activation. We sustain attention despite interruptions, track multiple patients simultaneously, make high-stakes decisions with incomplete information, and continuously scan for threats and changes in our environment. This heavily taxes directed attention, the effortful, top-down attentional system we use to deliberately focus on a task. Importantly, attention is a finite neurobiological resource that fatigues with sustained use.

Nature provides a unique form of cognitive recovery. Rather than demanding directed attention, natural environments engage what researchers call soft fascination: our attention is gently captured by things like moving leaves, shifting light, clouds, or water without requiring deliberate effort. This allows our directed attention systems an opportunity to rest and recover. Through soft fascination, nature gives our directed attention a break and creates space for the default mode network (DMN) which allows our minds to wander, consolidate memories, reflect, and make connections between ideas. Nature exposure may also help downregulate the physiologic stress response, with evidence suggesting reductions in cortisol and increased parasympathetic activity.
Importantly, meaningful nature exposure doesn’t necessarily require a hike in the wilderness.

The 40-Second Reset: In one study, participants who took a 40-second microbreak viewing a green roof subsequently demonstrated better sustained attention than those viewing a concrete roof. This suggests that even very brief nature exposures may have cognitive benefits.
Nature Between Shifts: Longer exposures may allow more complete autonomic downregulation, while outdoor light exposure and low-intensity movement may also support circadian regulation which is particularly relevant for shift workers.
Biophilic Design: We can also bring elements of nature into the environments where we work. Windows, natural light, plants, nature imagery, green walls, and accessible outdoor spaces may offer opportunities to incorporate restorative nature exposure into healthcare design.

Immediate Action Steps for Your Next Shift

**Step Outside**: Try to step outside on your next shift for even a few minutes. Even a brief dose of nature may help interrupt sustained directed attention.
**Look for Nature**: When getting outside isn’t possible, intentionally notice natural elements around you—a window view, trees, plants, daylight, or even nature imagery.
**Let Your Mind Wander**: Give yourself a few minutes with a cognitive task. Allow soft fascination to create space for reflection and the default mode network.
**Write Yourself a Nature Rx**:What would be restorative to you? It might be a hike, a visit to your local botanical garden, or some time in a hammock just to enjoy yourself.

Conclusion

Spending time in nature can provide a meaningful reset for attention and stress. Natural environments give directed attention a break while creating space for reflection and mind-wandering. Even brief, intentional doses of nature like stepping outside during a shift or taking a walk after work may help restore cognitive resources and reduce stress. Building small moments of nature into your day can support your well-being and resilience. Nature isn’t a “fix-all” for system pressures and stressors like understaffing. We still need to advocate for better systems, but nature can be a cost-effective, beneficial, and relatively simple adjunct that can improve well-being.

Clinical Bottom Line

Give yourself permission for a “nature reset” or “nature Rx”. An intentional dose of nature that can reduce stress, restore depleted attention, and replenish the cognitive resources we rely on to think and focus in challenging clinical environments.

Post Peer Reviewed By: Mark Ramzy, DO (X/IG: @MRamzyDO)

Meet the Authors

Kim Bambach, MD

Assistant Professor of Emergency Medicine, Assistant Residency Program Director

The Ohio State University Wexner Medical Center, Columbus, OH

Adrienne Taren, MD, PhD

Emergency Medicine Physician, Associate Investigator at the Laureate Institute for Brain Research, Adjunct Professor, Oklahoma State University School of Medicine

Ascension St John’s, Tulsa, OK

Linda Keyes, MD, FACEP

Adjunct Professor of Emergency Medicine, Past President of the Wilderness Medical Society, Vice President of the International Society of Mountain Medicine

University of Colorado Anschutz Medical Campus, Aurora, CO

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