The objective of this research is to assess the effects of engaging in coloring activities on patients' self-reported pain and anxiety scores while they wait to be seen by a physician in an emergency department (ED). The current literature on patient visits in the ED highlights the significance of anxiety, stress, and frustration in patient experiences, especially when accounting for long wait times before the physician-patient encounter. The study will address this common problem by looking at the potential impact of nature-themed or geometric shape coloring activities on the ED patient experience as it relates to self-reported anxiety and pain scores. Given that long wait times are increasingly being reported across the country, this study may offer a possible meaningful low-budget, low-resource intervention which could be offered to patients.

Inclusion Criteria:

• Triage Pain Score > 3
• Age >18
• Able to provide informed consent
• English-speaking
• without concern for aggressive behavior
• Glasgow Coma Scale (GCS) of 15
• Hospital Anxiety and Depression Scale-Anxiety (HADS-A) Score > 6

Exclusion Criteria:

• Concern for aggression risk, including active concern for suicidal or homicidal ideations
• Glasgow Coma Scale (GCS) <15
• triage acuity requiring critical care evaluation