If you’re like many nurses, you may think that completing nursing school or responding to a code blue is easier than maintaining a healthy lifestyle. Coping effectively with stress and making good nutrition, fitness, and weight management part of your daily life can be difficult.
That’s why I created a comprehensive, integrated health and wellness program designed to help nurses reduce their stress and improve their quality of life. Recently, I completed a 6-month pilot program at Children’s Memorial Hospital in Chicago.
Doing everything for everybody
During the pilot program, I had the opportunity to shadow and observe nurses during their shifts and talk with program participants about their work and personal stresses. When participants filled out their proactive wellness goals, many placed healthy nutrition, regular fitness, and weight management high on their lists.
To examine the challenges nurses face and explain some simple, effective ways to implement a healthy diet and maintain or lose weight, let’s use Jane Nelson, RN, as an example.
Jane loves being a nurse, but she is frequently exhausted and stressed out at work because of dealing with an overload of patients, floating to different floors, doing endless paper work, rotating shifts, dealing with difficult doctors and family members, and coping with the emotional toll of losing a patient. At home, her responsibilities seem even greater. She handles the housework, takes care of her children, and serves as a caregiver for an ailing parent.
In short, she’s a type E personality. She does everything for everybody but herself. Sound familiar?
Eating comfort food on the run
Jane frequently skips meals and eats comfort food, which makes her feel guilty and physically uncomfortable. Finding the motivation and time to place fitness in her daily life is somewhere way over the rainbow. She has unconditionally surrendered to the battle of the bulge.
When Jane’s energy levels go down, her inability to effectively cope with stress goes up. That’s because her blood glucose level plummets when she skips meals on the job, and her diet is heavily loaded with added sugars. To maintain an optimal energy level, she must face the importance of keeping her blood glucose level as balanced as possible.
My estimate is that she consumes about 2 to 3 pounds of added sugar a week. This figure may sound impossibly high, but consider what she eats. Besides white sugar, Jane also consumes other highly refined sugars in the form of high fructose corn syrup, dextrose, sucrose, and the like. All these sugars are in the many processed foods she chooses when she is looking to grab a quick meal.
The food in the hospital cafeteria and the food her co-workers bring to work are often loaded with added sugar. Her co-workers use any excuse to bring in donuts, ice cream, cookies, and cakes. The nurses even have a code dark-chocolate day, in which everyone brings pieces of chocolate!
Jane’s blood glucose level is on a roller coaster ride. She gets on the roller coaster after eating a high-sugar food, such as a white bagel or a donut, and the roller coaster starts rapidly rising. Suddenly, insulin is released onto the tracks, and the roller coaster does a dive. As more insulin is released, the roller coaster dips lower than when she stepped aboard.
These wildly fluctuating blood glucose levels, of course, can be a recipe for disaster.
Wild swings in glucose levels produce low energy, mood swings, irritability, high stress levels, poor concentration, insomnia, and headaches. This nurse also experiences hormonal imbalances, which can cause more severe premenstrual syndrome and, later in life, menopausal symptoms.
And the roller coaster ride certainly doesn’t help her in the battle of the bulge. In fact, it causes food cravings that can trigger hunger, so she overeats, thus disrupting her metabolism and gaining more weight.Dear diary: Let’s eat
Let’s examine Jane’s food diary and fitness log for two typical days.
• Breakfast: 3 cups of coffee
• Mid-morning snack: Donut
• Lunch: Skipped—too busy
• Mid-afternoon snack: Can of soda
• Dinner: Big Mac, fries, and soda
• Dessert: Pint of chocolate-chip ice cream
• Fitness: Crawling into bed
• Breakfast: High-sugar cereal, banana, 2 cups of coffee
• Mid-morning snack: M&M’s® and a diet soda
• Late lunch: Salad with high-calorie dressing and a soda
• Dinner: Huge plate of pasta and a diet soda
• Dessert: Chocolate-chip cookies
• Fitness: Just getting through the day
Obviously, Jane has a problem. But her unhealthy eating and lack of fitness are only symptoms of what is really going on in her life.
New top priority
To place healthy nutrition into her daily lifestyle, this nurse needs to take two proactive steps. She has spent a lifetime living an unhealthy lifestyle, so her first challenge is to transform her thought process regarding her lifestyle. This transformation will require a transformed priority list: She must remove herself from the bottom of the list and put herself at the top. This change may make her feel selfish at first because she has spent her life taking care of everyone’s needs but her own. But she must do it. She must change her lifestyle by making herself a priority, meeting her own needs, and embracing her own happiness. If she doesn’t, her stress will increase, and she will remain unhealthy.
She needs to implement a daily eating schedule at work. And she must follow it. No skipping meals because she’s too busy and no fast food because she didn’t effectively plan her meals.
This nurse can accomplish this change in her lifestyle. But the transformation would be much easier and more beneficial if her hospital would also change and make the health of its nurses its priority. After all, the health and wellness of nurses are vital to the overall strategy of the hospital. Such a hospital-wide change would encourage proactive self-care, which leads to nurses feeling more valued and empowered. It would also make the transformation to a healthy lifestyle easier for nurses and may produce a positive ripple effect on the nurses’ families. Plus, a hospital-wide program could improve recruitment, retention, and quality of care.
Use the energy plate
The second step is to follow these three simple but extremely effective rules of my proactive healthy nutrition plan:
1. Make sure the sugar content on the food label is
6 grams or less per serving on every food product you buy. If you want to be more restrictive, make sure sugars, such as high fructose corn syrup, dextrose, sucrose, and honey, are listed fourth or lower on the ingredient list.
2. Buy two or more new foods that are healthy and low in added sugar every time you shop. You won’t like and won’t eat about half of the new healthy foods you buy. But you will like the other half, and if you continue buying two or more new health foods every time you shop, in a few months you’ll have a new and healthier diet, and you won’t get bored with it.
3. Use an idea, created by a nurse, called the energy plate to incorporate smaller, nutritious meals throughout the day and curb your comfort eating. Buy a 10-inch divided paper plate at any grocery store. The energy plate provides 400 to 500 calories per meal by dividing the plate into ¼ healthy protein (such as fish or lean meat), ¼ whole grain (such as brown rice and whole grain bread), and ½ vegetables or fruit. If you’re still hungry after eating the energy plate portions, add another portion of vegetables or fruit.
To complete the proactive nutrition plan, follow these suggestions.
1. Stop drinking beverages that contain added sugar and caffeine. They can cause an artificial rise in your blood glucose level followed by a fast drop. Keep in mind, soft drinks can have as many as 9 teaspoons of added sugar. Brewed coffee contains 120 mg or more of caffeine per cup.
2. Don’t skip meals. You actually burn calories when you eat smaller, nutritious meals throughout the day.
3. When your blood glucose and energy levels are spiraling down in the afternoon, eat a snack of 150 calories or less that contains protein and fiber.
Keep in mind that the first step toward better health is reordering your priorities. So start moving yourself from the bottom of your priority list to the top today. And try to improve your diet, using the energy plate. Remember, you—and your patients—deserve a healthy you.
Gary Scholar, MA, is the Health & Wellness Consultant for the employees of the American Hospital Association, Chicago, Illinois.