Nursing Notes

December 20, 2009

Health Promotion in Nurses: Is There a Healthy Nurse in the House?

This article is a survey summary from Medscape Psychiatry and Mental Health.  I found this interesting and thought you might enjoy it also.  Caregivers, as a rule, do not ever take care of themselves; they are “other” focused and this can lead to burn-out and illness.  As nurses, we are failing at “walking the walk” but we are great at “talking the talk”.  We frequently give our patients education on stress reduction, good diet, exercise, and healthy lifestyles.  This study seems to point out that we nurses must not be listening.

Working in healthcare is very stressful and very demanding, both emotionally and physically.  We should be looking for ways to support and strengthen our nurses to facilitate the ability to continue doing the work they love.

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McElligott D, Siemers S, Thomas L, Kohn N
Appl Nurs Res. 2009;22:211-215

Study Summary

As nurses focus on the health of their patients, families, and communities, are they practicing health-promoting behaviors for themselves? Is there a healthy nurse in the house?

Pender’s Health Promotion Model is a framework often used in nursing research to examine the factors that promote health. This framework integrates nursing and perspectives from behavioral sciences into factors that may influence health behaviors. Health promotion is defined as a behavior that is “motivated by the desire to increase well-being and actualize human health potential.” This actualization is possible through competent self-care, goal-directed behavior, and harmony with the environment, including interpersonal relationships. Health promotion is differentiated from disease prevention as a result of its motivational dynamics. Whereas prevention is disease or injury specific in its approach, health promotion seeks to expand the potential for health.

The model has 2 dynamic and reciprocal phases. The decision-making phase includes the individual perceptions and modifying factors. The action phase includes the barriers and cues that trigger activity. This conceptual framework targets characteristics for assessment and suggests interventions to alter perceptions and improve health-promoting behaviors. Nursing self-care may easily be influenced by several of the model’s propositions: (1) perceived barriers can hinder commitment to action; (2) peers and situational influences in the environment can increase or decrease commitment to participation in health promotion behavior; and (3) commitment is less likely to occur when uncontrollable competing demands require attention.

The purpose of this pilot study was to examine the health-promoting lifestyle behaviors of acute care nurses using the health promotion model.

This study used an anonymous, convenience sample of registered nurses (RNs) working in a tertiary hospital. The sample included the nursing staff working in the cardiac and neuroscience services in medical, telemetry, and critical care units. Surveys were available to 500 RNs working on the cardiac and neuroscience services. In 1 month, 149 surveys were returned (a 30% return rate).

Statistical analysis of 149 returned Health-Promoting Lifestyle Profile II surveys indicates areas of weakness in stress management and physical activity. No significant differences were found in unit, demographic factors, and subscale scores at the .01 level of significance, but medical-surgical nurses consistently scored better than the critical care nurses on health promotion.

These findings support the need for the development of holistic nursing interventions to promote self-care in the identified areas. Strategies include educational/experiential classes in holistic nursing; individualized unit-based activities that foster stress management, such as massage, reflexology, and imagery; and development of an employee wellness program.

Holistic caring and nurturing of self support a healthy balance and increase productivity and a fuller participation in the life experience. Support of this paradigm shift to an emphasis on self-care provides the energy for nurses to enhance their care of patients, families, and communities.

Viewpoint

This article tackles directly the question of whether nurses do as they teach. It is nurses who talk to patients about “taking care of themselves” and how to manage stress, and reduce risk factors by exercising and losing weight. This article documents what nurses themselves have often said: “We need to do the same things we are telling our patients.”

Why don’t nurses exercise and manage stress better? For the same reason that patients don’t do it — a lack of time. Everyone seems to be stressed in life; no one seems to have enough time to exercise and do the things that mean we are taking care of ourselves. How can we get our patients to be motivated and make the commitment when we ourselves do not?

First, nurses have got to take a good look at themselves. This study takes the first, small step by saying that we have to change. Too often nurses act as though the statistics don’t apply to them, nor do the protocols and guidelines that we expect patients to follow. Too often we are too busy caring for others to care for ourselves.

No one else is going to take care of the caregiver. It is a fundamental lesson, long overdue.

The original article can be found here.

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