In these waning days of the pandemic, one of the hottest discussions is whether office workers should physically go back to the office and end the work-from-home alternative. Great arguments are offered from both sides of the divide. Those who favor remote work love the flexibility and convenience. Companies who want their staff back in the office cite productivity as the main impetus—they believe working from home is less productive than in the office. Because collaboration and mentorship can be both organized and random, those who work from home miss out on the serendipitous (and at times momentous) encounters on the way to the water fountain. According to a recent New York Times article, many employers simply don’t believe that their staff members work as hard from home, where distractions abound and supervision is almost nonexistent. Of course it can be argued that distractions are also plentiful while in the office, such as nonwork related texting and incessant alerts from social media.

The COVID-19 pandemic continues to be a public health concern from a health promotion and disease prevention perspective. A yearlong study conducted during the height of the pandemic reported that people who worked from home had significantly decreased physical activity (for example, up to 1,400 fewer steps), increased sitting time, and a higher weekday heart rate than on weekends. Remote work also is associated with higher risk of anxiety and depression. The link between chronic diseases and a sedentary lifestyle is well documented in the annals of healthcare. Concern exists that working from home may negatively impact cardiovascular health.

Let your feet do the walking, not your fingers

In the 1970s, a popular Yellow Pages slogan was, “Let your fingers do the walking.” Those of us who actually remember using the Yellow Pages understand that the basic premise of the ad was to remind people to eliminate running around looking for products and services. For the internet age, Google has become the new Yellow Pages. Ironically, the idea of a daily dose of 10,000 steps for overall health was a prelude to the 1964 Tokyo Olympics, which coincided with the time when phone companies wanted us to sit at home. In most jobs today, typing and texting have become proxies of productivity while our collective abdominal girth expands. Wouldn’t it be great if we let our feet do the walking again?

The easiest way to find out how many steps one takes in a day is to count using existing technology. So, a couple of weeks ago, I downloaded an app that cheerfully informed me that on the day I physically reported to my office, I took about 13,000 steps—about 9,000 more than on the days I worked from home. By the way, I’m a full-time nursing faculty member and my commute to work involves a 15-minute walk one way and four flights of stairs. While teaching, I pace around the room, and I make a habit of periodically walking up and down a flight of stairs when I’m working in the office. The added bonus is that the water fountain and the restroom require a round trip of 100 steps from my office. So, in addition to optimizing renal function, hydration also boosts the step count with multiple visits to the bathroom.

Keeping in step with science

For decades, 10,000 steps a day was de rigueur for the health conscious, generating an industry of wearables for step counting. A large prospective longitudinal study reported in 2022 that 10,000 steps per day was associated with a lower risk of mortality, cancer, and cardiovascular disease. The authors noted that steps performed at a higher cadence (>70 steps/minute in peak-30 cadence) conferred additional risk reduction. In other words, the number of steps and speed matters.

Does it have to be 10,000 steps to have health benefits? A 2021 prospective cohort study with a 10-year follow up reported that among Black and White men and women in middle adulthood (average age 45), those who took approximately 7,000 steps a day or more experienced lower mortality rates compared to participants taking fewer than 7,000 steps a day. The authors noted no association between step intensity and mortality.

The subjects of the above studies are community-dwelling adults. In hospitals, ambulating patients and implementing mobility protocols (for example, for ICU patients) remain a challenge. Heavy workload and short staffing prevent nurses and unlicensed assistive personnel from helping patients walk around the unit, or even go to the bathroom. Walking with someone who is ill or convalescing would do a great deal of good for a patient beyond its cardiovascular benefits; it can be a moving picture of empathy. Can you imagine if a delegation of walking companions descended upon every hospital unit every day at 10 am and 3 pm, and walked patients down the corridor while giving them meaningful conversation?

Steps in the right direction

Bedside nursing work is one of those jobs that can’t be done remotely, so staff receive benefits from the unavoidable steps required for travel and the nature of the work itself. A 2006 U.S. study reported that on average, staff nurses walk 4 to 5 miles in a 12-hour shift. Similar numbers were observed in a 2017 South Korean study that reported an average of 9,360 steps (3.5 miles) by nurses in a 9.4-hour shift. A rule of thumb is that one mile of brisk walking uses about 100 calories. This doesn’t sound like much. That’s why step counting should be twinned with calorie counting to optimize its health benefits.

Nurses are known for going the extra mile. Putting in the steps is just the beginning. Getting a good night’s sleep, smoking cessation, regular health check-ups, exercise, eating more fruits and vegetables, and really taking time off are some of the actions that all of us can benefit from. For me, taking a brisk walk to the office and working there is an act of self-care, and a recurring chance to step in the right direction for physical and mental health.

Fidelindo Lim is a Clinical Associate Professor at New York University Meyers College of Nursing

References

Del Pozo Cruz B, Ahmadi MN, Lee IM, Stamatakis E. Prospective associations of daily step counts and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality. JAMA Intern Med. 182(11):1139-48. doi:10.1001/jamainternmed.2022.4000

Paluch AE, Gabriel KP, Fulton JE, et al. Steps per day and all-cause mortality in middle-aged adults in the coronary artery risk development in young adults study. JAMA Netw Open. 2021;4(9):e2124516. doi:10.1001/jamanetworkopen.2021.24516

Welton JM, Decker M, Adam J, Zone-Smith L. How far do nurses walk? Medsurg. 2006;15(4):213-16.