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Why ‘Just Do It’ Doesn't Cut It

Kennedy, Maureen Shawn MA, RN, FAAN

AJN The American Journal of Nursing: April 2016 - Volume 116 - Issue 4 - p 7
doi: 10.1097/01.NAJ.0000482122.46490.86
Editorial

Like most people, nurses need support in adopting healthy behaviors.

AJN Editor-in-Chief E-mail: shawn.kennedy@wolterskluwer.com

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You might wonder why this month's cover shows the 1924 basketball team of Grace Hospital School of Nursing, Detroit (see On the Cover). Indeed, AJN’s early archives include several stories about nursing schools’ athletic teams, orchestras and choral groups, and other extracurricular programs aimed at creating healthy, well-rounded nurses. But such stories are no longer as common. Somewhere along the line, things changed.

In the 1970s, I was in the first cohort of students in the newly merged Hunter College–Bellevue School of Nursing in New York City, and I lived in the nurses’ residence at Bellevue Hospital's former diploma school. The residence had an indoor swimming pool, a basketball court, a bowling alley, and an outdoor tennis court. There was also a spacious lounge with a piano, where students often gathered for impromptu folk singing. Within a couple of years, though, the tennis court had been turned into a parking lot; the pool hours had been cut back severely; and the lounge was locked, opened only for faculty meetings and special events. Such barriers made both exercising and finding time for relaxing activities like music more difficult, and I soon stopped trying, as did many of my classmates. After graduation, even more barriers arose: rotating shifts, graduate school, family obligations. Finding time for ourselves got pushed further down the priorities list. Those of us who were working moms seemed to have even less time, and claiming any for ourselves was difficult and often guilt inducing.

We know so much more now about the importance of a healthy lifestyle that incorporating some form of exercise has become de rigueur. Data from the Nurses’ Health Study—which, since 1976, has surveyed over 238,000 nurses about their health and lifestyles—have demonstrated correlations between factors such as diet, weight, and physical activity and the risks of developing coronary heart disease, stroke, breast and colon cancers, and cognitive impairments. A meta-analysis published in the Lancet last year showed an association between long work hours (more than 40 hours weekly) and the risk of stroke. And in this issue of AJN, Karen Thacker and colleagues report on a survey exploring the health-promoting behaviors of nearly 500 nurses in six Pennsylvania hospitals. The researchers found that for participants overall, physical activity and stress management scores were low. A majority of participants also reported having “too many competing priorities,” which may hinder their inclination and ability to pursue health-promoting activities.

There's an abundance of research demonstrating that how nurses feel has an impact on their work. We've published some of it, including findings from a study by Letvak and colleagues (February 2012), which indicated that nurses’ health affects the quality of care they provide. This should concern all nurses, from those providing direct care to those in supervisory or administrative positions, since we're all responsible for ensuring a safe, healing environment for both patients and staff. It should concern us as consumers, too. If the nurse caring for you or your loved one is suffering from fatigue and stress, she or he may be more apt to make an error or to sustain a workplace injury.

The health care sector has lagged behind the rest of corporate America in offering employee wellness programs and perks such as onsite gyms and massage therapists. But health care facilities are catching up. The American Nurses Association (ANA) recently surveyed more than 3,700 nurses for its HealthyNurse campaign; almost 70% of respondents indicated having access to wellness programs at work, and about half said they had access to workplace exercise and weight management programs. But I wonder, given nurses’ work habits, how many find the time to use these resources. The ANA also noted that about 60% of respondents “reported working through their breaks and coming in early and/or staying late to accomplish their work,” and more than half reported working regular shifts of 10 or more hours. Eighty-two percent reported being at a “significant level of risk for workplace stress.”

Organizations need to create workplaces in which adequate staffing and reasonable work hours are the norm. In short, onsite wellness programs can't make a difference when system barriers prevent nurses from using them.

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