Ep 5 – Conversations in Quarantine – Interview with Nathan Nordstrom – Part 2

A pair of hands in gloves disinfecting a surface with a spray bottle

In Part 2 of our conversation with Hand & Stone’s Nathan Nordstrom, Nordstrom describes changes and considerations to the spa and practice environment, including new cleaning protocols, staggered start times, engaged intake processes, and the ethical dilemmas of reopening and clientele psyche. 

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Author Bio: 

Nathan Nordstrom became a massage therapist in 2001. He is licensed in several states and is a board-certified massage therapist. He has taught massage therapists since 2004 and is a nationally recognized continuing education provider. As a massage therapist, he has worked in many settings over the years. He teaches classes in the application of ethics in daily life and advanced anatomy classes for massage therapists. He has served as a leader in many ways in the massage industry, and he is now the director of massage therapy for Hand & Stone Massage and Facial Spa. 

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This episode is sponsored by ABMP.

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00:00 Speaker 1: As a way to give back to the profession during this challenging time of COVID-19, ABMP is offering non-members free access and CE to some courses in the ABMP Education Center each week for a limited time. Simply register online at abmp.com/ce for access. ABMP members earn free CE for all 200 plus courses in the ABMP Education Center, including the new Ruth Werner course, "Taking The Danger Out of Endangerment Sites."

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00:43 Darren Buford: Welcome to conversations in quarantine. My name is Darren Buford, and I'm the editor-in-chief, Massage & Bodywork magazine, and Senior Director of Communications for ABMP. Our goal here is to speak with luminaries and experts in and around the massage profession, to talk about the effects of COVID-19 on bodywork practitioners, the fears, the frustrations, and more importantly to discuss next steps towards safely reopening our doors when the time is right. How to pivot now, how to prepare for the future, and discussing what the new normal might be. We are joined again by Nathan Nordstrom, Director of Massage Therapy for Hand & Stone Massage and Facial Spa.

01:19 DB: You mentioned the increased time between sessions and the cleaning that might occur. Will the practitioner, who provided the service, be doing the cleaning as well or you have other people who will be doing the cleaning between the sessions?

01:34 Nathan Nordstrom: Great question. Yes and no. [chuckle] That comes down to the franchisee. One of the things that we actually did was we wrote up a protocol that had the therapist doing it and said, "This is how much time there is gonna be between sessions." And then one of the first questions was, "What if we have a spa back person who is doing the change over and cleaning of the rooms?" And then we recreated that whole model, so the room still had the 75 minutes per session, but the massage therapist had a 50-minute turnaround and still have the 10-minute. And so a massage therapist could feasibly still see the same amount of people in a day in the amount of time, but because we're altering or staggering the time people come in, which reduces the likelihood of people sitting in the waiting room all at the same time. All of those tools means that you could have a spa back person, a person in the back of the spa, who is just cleaning rooms and then going to the next room, going to the next room. And if they're taking 15 minutes to do each of the cleanings, they can do four rooms per hour and you've got a good process there.

02:46 NN: Some of the owners are very excited about that option. Other owners really look at it and say, "You know what, as a massage therapist, do I trust that someone else did the quality of cleaning that I would be wanting?" And so a massage therapist may say, "I really do think I need to make sure that everything is sanitized and everything is disinfected to the standards that I know Hand & Stone has, and I know what I need." So, those are both pieces that each owner will be looking at, as well as each owner will be connecting with their massage therapist on.

03:23 DB: Will there be any changes to waiting rooms at all?

03:27 NN: There's a couple of pieces that we've put into effect which we're kinda connecting with and we're playing with in different ways. One of them is that staggered starting time, which is the first piece that I think most franchises haven't done, so having a 9:00... So, a massage therapist or two massage therapists who start at 9:00, and then two massage therapists who start at 9:15, and then 9:30, and 9:45, so that you have people coming in and going out on a regular basis, so there aren't people constantly sitting in the foyer, so that you don't have 10 people come in and sit in the foyer altogether and spread their germs, and then all go back to their massage therapist. That was the first one that we were like, "Yeah, that just makes sense."

04:12 NN: The second one which I thought we've seen in other places was an easy implementation and that is that when the client pulls up in their car, they call the front desk and say, "I'm here," and then the spa associates will call you as soon as your room is ready. And so they don't have to come in to the front desk lobby room at all. They can literally stay in their car and be quarantined in their car until they say, "Okay, your therapist is ready for you." They can walk in and go right back down into their treatment room. Air quality control is definitely something that we're working with and making sure that we have appropriate ventilation and those types of things, and what fans to use for, and what a central heating and air-conditioning unit is good for us. All of those things are definitely being taken into consideration. And the ability to have people not sit and wait is just such a strength to be able to say, "You can go right in to your treatment room and right out."

05:12 NN: Obviously the use of pen and paper, gone. My daughter went to a coffee shop a while ago, and they had their little tablet and they stuck it out on the side, and there was the little swiping so just swipe it right there. They swiped it. They said, "What tip would you wanna hit," and they hit the right tip. For the signature, they just put an X and enter. And that means that is completely touchless. And that's really what most of our members had already, because they already have the system set up and there's no need to pass a credit card across the table anymore to touch someone's credit card or have someone sign with a pen. It's as easy as we can get without passing that, whatever, to our spa associates or front desk staff.

06:02 DB: Have you made a decision yet on whether practitioners would wear gloves, or they would be gloveless and sanitize their hands often and frequently between clients?

06:14 NN: Well, that goes into a couple of different things. First one is, currently, I know a lot of the states say all service providers need to have PPE gear, personal protective equipment. And so that can include gloves, that can include masks, depending on what your local region is saying. And so that is definitely a piece... I'm gonna go internally and say, we all know how this virus gets into the body, the eyes, nose and mouth, and I know... Several weeks ago, my wife and I went to the grocery store to get our stuff, and we saw all these people wearing gloves. And they took their gloved hands, and they were wiping their nose and wiping their mouth. And I thought, "You have a false sense of security," because you've got gloves on your hands so you just think, "Oh, everything's fine." But they're already touching everything that gets into their body.

07:07 NN: The concern with gloves, I don't see as much. Our initial policy is set up to say masks and gloves for every client. And then one of my favorite things is, this policy is gonna be reviewed on an every three or six-month basis. And so, every three months, we'll look at it, and in three months we'll say, "Okay, has all of the concerns reduced? How much more science do we have? How much more research do we have? And is this really still the standard so that we can say, 'Okay, uniformly, now we don't need gloves.'" If you have therapists who still want to wear gloves, that's a completely different issue. But uniformly for the standard, this is what we're setting.

07:53 DB: I know you've brought about a really great point, which was talking about PPE and/or hygiene, personal cleaning, and I'm guessing that Hand & Stone has the supply chain to be able to get those materials. Is that correct?

08:08 NN: Yeah. Just to put any concerns out there, we're not using the supplies. We're not using the N95 masks. We're not using any of the things that we would be taking away from the emergency response people or anything that we've taken away from hospitals. Yeah, our chains are definitely processed and we've actually felt that, and so we pre-ordered a lot of ours from overseas quite a while ago to supply our spas so that they could have it available once they do open. As I said, none are open right now. I can't speak for next Friday, when Georgia currently has a schedule to open. But as of right now, we wanted to make sure that we had enough equipment to prepare so that those first opening spas would be ready.

09:01 DB: And you may have mentioned this already, but I'll circle back around. Will you require clients to wear masks, or is that optional?

09:10 NN: We've actually looked at a couple of different pieces on that, and that goes masks, that goes taking a client's temperature. As a spa, even when we look at a massage spa and in difference from a day spa, or from other definitions of what different spas are, I look at it and say, we have an expectation to make sure that our clients are safe. And so, if we look at it and we say, "Okay, what are the symptoms, what are conditions, and what's the lead time?" A therapist should have enough ability to communicate with their client beforehand to say, "Okay, so have you had anyone in your circle of influence who has had any of these symptoms? Are you experiencing any of these symptoms?" That intake interview is worth its weight in gold.

10:05 NN: I think massage therapists say that, oh, yeah, they do an intake interview, but they don't consciously stand aware during the entire intake interview, and so they'll forget things. I think this is gonna give us a really great opportunity to talk to every client with our minds engaged and our hearts engaged, because we'll want to hear them before we even get closer to them. And so if a client... And I have to go a different direction, massage therapy clients, as a general rule, are very health conscious. They are. They care about themselves, and they care about us. I've had clients who have called up even up to an hour before and saying, "You know what, I'm starting to feel symptoms of the flu," or, "I'm starting to feel this," or, "I just got nauseous." And so that gives us a real good gap to say, "What tools do we have? And what communication skills do we have?"

11:09 NN: So, we haven't said that, yes, every client is needing to wear masks. But that is something that, once again, in the review of our policies, that might be a thing that everyone will say, "Yeah, we should add this." Because truth be said, right now, the governors and mayors are already saying everyone should be wearing masks. So, that would be repetition for no good cause. If they're not gonna wear it for the governor who has told them that they need to do this, why would they do it for the massage therapists who doesn't make them do it? So, being conscious of those pieces and being aware that the society has a standard and we're going to abide by the society societal rules is an important piece.

11:55 DB: Back to the intake, will you be doing the intake over the phone? Or will that be done in person?

12:02 NN: The spa associates are being trained to talk to anyone who's scheduling about specific issues, but the in-depth interview needs to actually be done by someone who holds a massage therapy license. Because I do not believe that a spa associate, who's gone through a week of training, knows what to watch out for like a massage therapist would. And so the deeper questions that you'd be jumping into would be from a massage therapist and needs to be behind closed doors, needs to be in a room where no one else is hearing those types of things. We wouldn't have massage therapists go sit in the waiting room and talk with their client about their pregnancy or their other personal issues or their cancer, so we wouldn't really do that in the same way. Now, we have that personal protective space. You have good healthy spacing, bringing them back into the room, talk to them in the room with a 6-foot gap, and go through that conversation. If there are things that bring to question, perfect, let's have you exit and we'll see you next time. You've got that space, and then we have the sanitation protocols which will process the room just the same way.

13:18 DB: And you also mentioned with regards to the possibility of cancellation. Have you had to alter or change or think about your cancellation policy?

13:28 NN: The Hand & Stone policy and then the personal spa policy are the two things that we are very conscious of. One is, gosh, if a client is coming in on a regular basis and they're saying, "Hey, I need to cancel," cancel them. "I need to reschedule," reschedule them. You know what? They're not generally striving to mess up your schedule on purpose. Most of the time, it's some emergency happened. We wanna make sure that our customers are happy, and so the best way to do that is to work with the customer to make the best experience for them. There have been spas who have created a higher restriction and, "Oh, if you cancel again, we're going have to charge you for the session." And they're having to look at those policies. According to Hand & Stone corporate, you wanna make sure that they know that there's a 24-hour cancellation policy, and if there's some emergency that happens, we're more than willing to work with you.

14:27 DB: This is more of a theoretical question, but how do you prepare for the worst with the best in mind during this time?

14:34 NN: See, this is a beauty that I personally really invest in. The best time to look at the worst scenarios is when you're not in them, because you don't have the emotional turmoil, you don't have the urgency, you don't have the stress, you don't have the anxiety. Now, the second best time is when you're really in that circumstance, and when you're introducing that new circumstance. I talk about ethics an awful lot, and when I talk about people being in an ethical dilemma, and I'm gonna argue, massage therapists right now are in an ethical dilemma. They have their hearts set that they're trying to provide for their family, and they're unable to work, and so they're concerned, and their emotions are getting involved, and so they want to push to get back to work, but yet they aren't really focusing on the greater good. And so when I look at preparing for the worst with the best in mind, the first thing you have to do is mentally get yourself out of the circumstance. You have to separate yourself from the challenge.

15:53 NN: And then the second step is, once you have isolated it, give it a different name. I think that's one of my favorite tools is, instead of COVID-19, we are now concerned about Bubbly Book virus that is happening in the world. And Bubbly Book is this horrible thing, and here's the concerns the Bubbly Book is doing. And it gets it to be fun. You almost giggle about Bubbly Book, but you've taken your mind away from the trauma that you're in. And so being able to create that new identity and say, "Okay, so what are different people gonna be concerned about? What are gonna be realistic concerns? And what are gonna be emotional concerns?" We've talked about many times, do we do things, do we create policies because the community would be concerned about it? Or do we make policies because the science says it's best? If a client won't come in because someone's wearing a some sort of personal shield over their face that's a plastic and they have their mask underneath it, and they've got gloves that go up to their elbows, and they have this gown that's made out of paper, and they're saying, "I'm here for your massage," and they're like, "I'm out. I'm not gonna be getting a massage from you," then we have to be conscious of that as well. It's not just about what our safety is, but it's what the safety perception of the client as well.

17:26 DB: Absolutely.

17:27 NN: Do they feel like you are safe as a massage therapist?

17:31 DB: I'll just throw something out there. Is there any situation where a client might be participating in the cleaning of, like, "I've come in to the room. I'm just gonna give that a wipe down myself"?

17:46 NN: Oh, they can. If they brought their own Clorox Wipes, feel free. One of the best tools that goes into that helping the psyche of the client is we're making a little form that goes at the front desk that says, "Hey, this is how your room is cleaned." These little information pieces to remind people, "Oh, yeah, look. I don't have to worry about bringing my Clorox Wipes, because they disinfect the entire room between every session." " Oh, they've got this special air ventilation system? Oh, great, okay, perfect." That's beneficial. That's really supportive. "I don't have to be concerned, because my spa and my therapist have thought about that ahead of time." If they are at that point where they're like, "You know what, I just need to wipe it all down," wonderful. "Here's where you're gonna be setting your clothes, so I'd suggest you wipe down that area first. Here's the face rest. I will take the cloth off, and you can wipe that down. This is the vinyl cover that we're gonna be on, and would you like me to bring the sheets down so you can wipe that down?" If that's what's gonna make them feel comfortable and safe, who's to say, "Stop now"? If a massage therapist is like, "This is stupid, how dare you," well, they're probably not a very exciting, open, intense massage therapist who's into the best good and support of the client, 'cause that client needs that to feel comfortable.

19:12 DB: It's all about that perception. Has Hand & Stone thought about the possibility of second or third waves of COVID-19? And have you learned anything... If you have, have you learned anything right now that's prepping you for that, or anything you're like, "You know what, we've got this. We're already going through these scenarios right now."

19:32 NN: Mentally, playing with the mental exercise is always fun. Because when someone says, "Hey, guess what, we're in this circumstance, what happens when the doors open?" That, preparatorily, is making you think, "Okay, now more people are getting connected, more people are communicating. How are we going to keep our business safe when those doors open?" Because, truth be said, if we do get a second or third wave, that's going to have to make sure that we're safe and comfortable in all settings. So, creating policies and rules that really go to the top of the food chain and say, "We're gonna make sure that everything is cleaned, and every therapist, and every client is on their A game without any concerns," if that wave starts coming back up and that second wave hits, we're still above the first wave. If we look at tidal waves, that initial wave ruins everything, but the backup waves are the ones that really destroy all the small pieces. We're above that first wave. And so we're creating that standard that, if there is a second or third wave, we're still in a place where people are saying, "If I feel safe and comfortable at home, I feel safe and comfortable at the spa."

20:54 DB: Do you have an answer yet with regards to... A know a lot of clients are, and me speaking as well, "When will doors be opening Hand & Stone in my neighborhood?"

21:06 NN: Here's the two pieces that that answer has to go by. Because we can't answer for every governor... I was just talking to some of the distributors and they were saying, "How do we make sure that we have the right amount of this product or that product going to you?" And I said, "Timeframe is going to be based off of when each governor and mayor in every city and state has said, 'Yes, you can now leave your home. Yes, you can now go into these types of businesses.'" And I can't answer that. And I truthfully believe that every state is going to be different. Georgia was the first one to announce that the other day. And so that's that first step to say, "Okay, we have to make sure that the governing body is on board. Once the governing body is on board, we have to make sure that the local jurisdiction is on board." Let that be the mayor to the governor, or the governor to the township, or the township to the community. All of those pieces have different numbers, but right now, what we're preparing for on the corporate side, on the franchise side is that we're gonna be seeing spas open in June. We're gonna see a good chunk of them.

22:28 NN: Now, there are definitely some states that will not be ready for that, and some locations, that Downtown Manhattan, that may have more concern. And they may be pushed out a little bit more, depending on how the process goes and what those waves look like, the waves that we just talked about, second wave or third wave. Or even in some of the towns, like, let's see, Omaha, Nebraska. We have a spa in Omaha, Nebraska, and I don't think they've hit their first wave yet because they really haven't seen a lot of cases. And so they have this very sheltered state, and they're not getting a lot of access to the outside world. So, we look at that and we say, "Okay, so what are the standards? And when is that gonna happen?" It is gonna happen. Doors are gonna open, and they're gonna open sooner than some massage therapists are gonna feel comfortable going back to work.

23:20 NN: Truth be said, we're gonna have therapists who aren't ready to come back to work, but we're also gonna have customers who may wanna hold off before they come in for their first massage. I truly believe that I'm in need of a massage right now, and I know a lot of people who are sitting at home just waiting to get out to see their favorite massage therapist, and being able to take those steps and really get that taken care of, and get that knot in their back, or that hip problem taken care of is a really important piece for their quality of life. So, as you get into work, well, we're gonna see those doors open. Let it be in May, at the beginning of May, at the beginning of June. But the sooner we can understand COVID, and the sooner that we can really engage the safe practice of massage therapy, the better. The better we can prepare our self, the better we'll be, and we'll be more prepared to fight off any attacks from any viruses, cold, flu symptoms, anything that can be passed to you. We want clients to be safe, and we want therapists to be safe.

24:29 DB: And let's close with one final question. Do you have words of encouragement for practitioners out there chomping at the bit to get back to work?

24:37 NN: Just earlier today I did a mid-week motivation webinar for Hand & Stone. And this is a weekly opportunity for massage therapists to get together. And my guest today was a guy named Dan Schwartz. Dan's one of our trainers, and he's just an amazing guy. He lives in New York, and he came down with COVID-19. And when I was talking to him, I asked him several questions, but one of the questions at the end really made me smile. I said, "What do you have as advice for your massage therapists?" He says, "Be patient, because patients is important when it comes down to things. But second, be conscious and be safe. Be willing to recognize there is beauty in this world." Right now, it's spring out. You may not feel it Tacoma or in Florida. In the center portion of this world, we're actually seeing nice flowers blooming, we're seeing this positive thing.

25:38 NN: I've got four kids and my wife, and we're all at home. And so we're a little bit on top of each other, but really being grateful for the things that you have and for those moments that you have are gonna be very important. I know a lot of people who are trying to get an understanding of how viruses work again, because they completely forgot. But yet now we're getting this opportunity to really introduce our minds to these concepts of how to be safe. You know what, use this time wisely with your family as well as with your study, because that's gonna make you a more successful massage therapist, but also a more successful human.

26:20 DB: I think that's a wonderful way for us to close our conversation today. I wanna thank our guest, Nathan Nordstrom from Hand & Stone, for joining us. Thank you, friend, very much.

26:30 DB: No problem. Thank you so much for having us.

26:34 S1: Thank you for listening. If you haven't already done so, please subscribe to the ABMP podcast on iTunes, Google Play, or wherever you find your favorite podcasts.

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