Journey into wellness: a call to action.
Nurses as Wellness Models? Not so Much
In comparing the health behaviors and outcomes of nurses to the general population, nurses do not fare well. Zapka, Lemon, Magner and Hale's (2009) study of 194 American hospital-based nurses found that 37% of the nurses' BMI showed that they were overweight and 28% of them were obese. At the same point in time, 32% of the general adult population were classified as overweight with 34% of Americans obese. The authors also found that the nurses ate fewer servings of fruits and vegetables and consumed a higher percentage of fat calories than recommended by government guidelines for a healthy diet. In terms of mental health, Letvak, McCoy and Ruhm (2012) found that 18% of nurses (n = 1171) reported depressive symptoms--twice the rate of depressive symptoms in the general population. While these are just two studies, many more suggest what we already know--nurses tend to put others first before taking care of their own health.
Face the Truth
My moment of truth came in February 2011 when I found myself at a crossroads--either change my lifestyle or face the consequences. During my usual 70-hour work week, I ate high-fat, high-glycemic index foods almost all the time, I did not exercise, my blood pressure was not well-controlled and my lipid profile was concerning. I also felt stressed most of the time and really was not enjoying life very much. When a health risk assessment revealed that I was officially obese, I knew I had to do something different. With the support of my family and colleagues, I have been able to turn my life around in a way I had not thought possible.
Time for Action: You Can Do This
I wouldn't say that my journey into wellness has been easy, but there are some things you can do to make a difference in how you care for yourself:
1. Get a thorough physical and know your numbers. No matter your age or fitness level, you should schedule at least an annual physical with your health care provider and have blood work that includes, at least, a lipid profile, HA1c, CRP and Vitamin D levels (these are basic measures of overall cardiac and metabolic health).
2. Weigh your self, calculate your Body Mass Index (BMI) and consider a body fat analysis. With only your height and weight, you can use a BMI calculator (conduct a search at www.cdc.gov) to get an estimate of what your weight status means for your overall health. If you want to have a more accurate analysis of your body fat, check with your healthcare provider for information about water immersion, air displacement ("BodPod"), fat fold measurement (via calipers) or electrical impedance scale body fat percentage measurement methods. There are pros and cons to all of these methods, so choose the one that is right for you.
3. Eat light, eat often. To adequately fuel your body throughout the day, eat every 3-4 hours. This works out to about three small meals (mostly fruit/ vegetables and whole grains with some lean protein) and three snacks (100-150 calories with at least 5 GM of protein or 5 GM of protein + fiber) a day. Watch portion sizes--our waistlines have expanded with our food habits. For a reality check, visit the National Heart Lung and Blood Institute's website on portion distortion (http://www.nhlbi.nih.gov/health/ public/heart/obesity/wecan/eat-right/distortion.htm).
4. Exercise. I had quit exercise because of back pain, so I had to address that issue first. Yoga was the answer for me and has led to a regular program of weight and aerobic training. The best exercise is the one that you will do consistently at least 4-5 times per week. Get an "accountability buddy"--somebody you can exercise with or someone who will give you a hard time if you don't exercise! Join a gym and have a certified physical trainer plan an exercise program that is customized to you.
The Results ... so far
I am happy to say that I have made some progress over these last few months. I have dropped twenty pounds and counting (no longer obese, just overweight!), my blood pressure is very well controlled, my cardiologist gave me a "B+ to A+" on my blood work (there is still room for improvement) and I feel better than I have in years. If I can do this, you can too. Take action now!
Letvak, S., McCoy, T., and Ruhm, C. J. (2012). Depression in hospital-employed nurses. Clinical Nurse Specialist, 26(3), 177-182.
Zapka, J. M., Lemon, S. C., Magner, R. P., and Hale, J. (2009). Lifestyle behaviours and weight among hospital-based nurses. The Journal of Nursing Management, 17, 853-860.
David P. Hrabe, PhD, RN, Associate Professor of Clinical Nursing, Executive Director, Academic Innovations and Partnerships Ohio State University College of Nursing
Dr. David Hrabe is a long-time member of the Arizona Nurses Association who lives in Phoenix. He is Associate Professor of Clinical Nursing at The Ohio State University College of Nursing and administers a health program for nurses, Health Athlete. To learn more, visit http://healthathlete. org.