This is a pilot feasibility study examining the use of immersive virtual reality (VR) in adult intensive care unit (ICU) patients. The study evaluates whether brief, non-interactive VR sessions delivered using a commercially available standalone head-mounted display with calming, nature-based content can be delivered safely and effectively within routine SICU workflow. Exploratory objectives assess whether VR sessions are associated with changes in anxiety, agitation, delirium, pain, and sedative medication requirements. This research is not intended to evaluate the safety or effectiveness of the headset and/or the specific VR software used for the research

Inclusion Criteria:

1. Aged ≥ 18 years old admitted to the Surgical Intensive Care Unit (SICU) at Penn State Health Milton S. Hershey Medical Center.
2. No significant uncorrectable visual or auditory impairments
3. Estimated ICU length of stay > 48h
4. At the time of each VR session, able to keep eyes open for at least 30 seconds, follow simple commands and able to indicate discomfort or request to stop.
5. English speaking

Exclusion Criteria:

1. Significant hemodynamic instability
2. Known psychotic disorders associated with delusions (e.g. schizophrenia)
3. Severe dementia (e.g. inability to communicate or follow simple commands)
4. History of disequilibrium syndrome or vertigo
5. Acute hyperactive delirium, requiring physical restraints