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This month, ANA’s Department of Health, Safety, and Wellness launches the HealthyNurseTM Health Risk Appraisal (HRA) and Web Wellness Portal in collaboration with Pfizer Inc.—online tools for all registered nurses (RNs) and RN students to assess their health and wellness.

“How are you feeling today? Did you enjoy a good night’s rest? What is your stress level currently?”

As RNs, we ask patients these questions every day. We need to ask this of ourselves as well. By practicing self-care, we build the physical and emotional stamina and strength to provide the best care possible for our patients, families, and communities and within our work environments.

So this begs the question: How are we doing? And how does the health of the nursing profession compare to the health of the nation?

In search of nurse health data

As ANA began to develop the HealthyNurse program, we sought RN-specific health data and discovered that no real-time data exist; nor do demographic comparisons to national health benchmarks. The closest existing data are from the Nurses’ Health Study conducted by the Harvard School of Public Health and Brigham and Women’s Hospital in Boston, Massachusetts. This survey consists of three longitudinal age cohorts. More than 238,000 female licensed practical nurses and RNs have participated since 1976. It provides excellent nursing data on female risk factors for cancer, heart disease, nutrition, and lifestyle risks and recently expanded to include the topics of fertility and pregnancy, and environmental and nursing exposures. However, it is female-specific, topic-specific, and based on differing age cohorts during 2-year retrospective surveys. (To participate in the third cohort of this study, females between ages 20 and 46 can sign up at

According to, male nurses comprise 9.6% of the nursing workforce. Practicing RNs span all ages from the late teens to well into the 80s. ANA’s purpose for implementing the HRA is different from that of the Nurses’ Health Study, with the need for a broader wellness focus and real-time data to discover the health, safety, and wellness of RNs and RN students of all ages and both sexes. In addition to personal health, the data would include occupational health, since nurses are exposed to work-environment risks, such as ergonomic injuries, sharps injuries, and bullying and workplace violence.

A nursing-specific solution

In 2012, in collaboration with Pfizer Inc., ANA developed the ANA HealthyNurse HRA and Web Wellness Portal as online tools for measuring nurses’ level of health and wellness. The purpose is to help identify the health, safety, and wellness risks RNs face in their daily professional and personal lives. These tools allow you to compare your personal results against ideal benchmarks and national averages. As the number of survey respondents increases, you will be able to compare your results with those of other nurses in specific demographics, such as age, sex, geographic location, and nursing specialty. Finally, the HRA builds a nurse-specific, aggregate, real-time database of personal and occupational health risks, including data not currently available through other sources. It does not provide health care, medical treatment, or diagnoses. Nor does it address or identify all nurses’ health, safety, and wellness issues or risks. It is fully HIPAA compliant and can be accessed at any time from any computer with a personal access code.

About the survey

To develop the survey, ANA conducted a national literature review and worked with a health contractor group of subject matter experts to identify topics and specific questions to align with national benchmarks. Focus groups of RNs, ANA members and staff, and employees of Pfizer Inc. vetted the questions. ANA conducted beta testing at its Membership Assembly in June 2013.

The assessment has three sections and takes approximately 20 minutes to complete. The first section gathers demographic information. The second section focuses on the work environment. Questions are asked on such topics as safe patient handling and mobility, sharps safety, workplace violence, bullying, respect, shiftwork and fatigue, absenteeism, and worksite wellness. The final section centers on personal health and wellness. The topics cover current health and history, immunization, tobacco use, nutrition, physical activity, alcohol use, skin cancer risks, and distracted driving. (See What exactly is a healthy nurse? by clicking the PDF icon above)

Benchmarking results

After taking the HRA, survey participants can view their confidential results in an interactive, “stoplight” color-coded graph: Green indicates no to low health risk, yellow indicates a medium health risk, and red indicates a high health risk. Grey indicates a response was not answered, not applicable, or currently not rated with a benchmark or goal. Within the graph, participants can compare individual results with U.S. national averages and benchmarks from evidence-based sources, such as Healthy People 2020, the Behavioral Risk Factor Surveillance System, National Health and Nutrition Examination Survey, and Health Indicators Warehouse. Also, they can compare themselves to nurses by specific demographics, including age, sex, ethnicity, nursing specialty, and geographic location.

Next steps

After completing the HRA, participants can click on specific topics within the interactive Web Wellness Portal. The website contains quizzes, tools, and other resources on immunizations, tobacco cessation, stress relief, and healthy weight. The portal also links to ANA resources on such topics as safe patient handling and mobility and sharps safety.

ANA values RNs as role models, advocates, and educators promoting health, safety, and wellness for themselves, their families, their coworkers, the community, and ultimately their patients. The HRA and Web Wellness Portal are among important resources ANA provides to nurses through the Healthy¬Nurse initiative.

Beginning in November, all registered nurses and RN students are encouraged to take the free HRA at Not only will you kick start your wellness journey by identifying your personal and occupational risks, but you will help to build a real-time, comprehensive, national database on the health, safety, and wellness of the nursing profession.

The authors work in the Department for Health, Safety, and Wellness at ANA. Holly Carpenter is the senior staff specialist and Suzy Harrington is the former director.

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