By continuing to use the site you agree to our Privacy & Cookies policy

OPINION

Holly Blake: 'Should nurses be role models for health?'

Nurses may be viewed as less “credible” by patients if they appear hypocritical, says Holly Blake

Research has shown that the health behaviours exhibited by NHS staff can be less than exemplary; many are overweight or obese, many are not active enough to benefit their health, are smokers or have a poor diet. Nurses are the largest occupational group within the NHS and similar patterns have been found both for nurses, and for student nurses, who are our next generation of “health promoters”.

Given the rising prevalence of preventable diseases caused in part by poor lifestyle choices, encouraging people to think about their health, whatever their profession, is important. However, the health of NHS staff has received particular attention, especially following the NHS Health and Wellbeing Review, which flagged high levels of sickness absence in the NHS and associated lost working days, which if reduced by one-third would lead to an estimated annual direct cost saving to the NHS of £555m.

So aside from the implications for the health of individual nurses, the resource implications of a healthier NHS workforce are therefore indisputable, particularly given the known link between employee health and wellbeing, productivity and performance, sickness absenteeism, and even workplace accidents and errors, which can have potentially serious consequences for patients.

“There can often be a tension between the nurse’s personal choices, and their role as health educator”

The Prime Minister’s Commission on the Future of Nursing and Midwifery stated that nurses should take responsibility for their own health and should acknowledge that they are public role models for healthy living. The concept of “practising what you preach”, however, is a contentious one, often generating intense reaction and debate.

The current trend of “do as I say, not as I do” does, however, require due consideration, as whether we like it or not, nurses are often viewed by the general public as role models for health, who guide by example.

Research shows that an overwhelming majority of nurses demonstrate self-awareness to this effect, and recognise the potential impact of the image they portray, and the lifestyle choices they make, on the general public. This focus is not intended to be judgemental, but rather a shift in focus from a personal perspective about health behaviours, to viewing an issue through the eyes of a patient.

Having the most direct contact with patients and their families, nurses are in a prime position to exert a positive influence on the lifestyle choices of those in their care, and while part of their role is to “sell” healthy habits, there can often be a tension between the nurse’s personal choices, and their role as health educator.

 There is an issue of credibility here, since nurses may be viewed as less “credible” by recipients of advice if they appear hypocritical, and promote health behaviours that they have clearly not chosen to engage with themselves. Nurses and patients alike have suggested that patients are more likely to listen to, respect and follow the advice of a health adviser who models the same health habits and behaviours that they are recommending, and conversely, will “tune out” to those who do not.

This is compounded by the potential implications for the quality of patient care, since research has shown that nurses who are overweight or obese, for example, have reported feeling less willing, or even less able, to promote healthy diet and exercise in their patients.

Of course, expecting health professionals to be perfect role models may be unrealistic since nurses are subject to the same temptations of sedentary behaviour, overeating, smoking, alcohol and drug use as anyone else. Additionally, the typical nurturing and caregiving role of a nurse all too often means that they invest well in others, but less in themselves, which can result in the development of the same physical and mental health problems that they see in many patients. There is also no doubt that nursing can be a stressful and demanding role, with increasing pressure to deliver high standards of care now coupled with the extra burden of high expectations placed on nurses to be “healthy role models”. While we should always promote personal choice, for those who wish to make changes to health behaviours, balancing pressures of the job role with healthy lifestyle choices is not always easy; diet and exercise, for example, may take a back seat if healthy food is not easily accessible and time away from busy working environments is hard to achieve.

Whether nurses adopt and maintain healthy lifestyle behaviours is a personal decision, but employers also have a responsibility to create environments that reduce barriers to healthy living and provide nurses with opportunities for making health a part of their daily lives. This may include a place to unwind, healthy activities before or after shifts, protected breaks, access to healthy food and more. An example of excellent practice in this respect is Nottingham University Hospitals Trust; a pioneer of workplace wellness, this trust has developed over a number of years, a successful and sustainable programme accessible to more than 13,000 NHS employees across three hospital sites. The service is continually evolving but strives to provide services based on employee needs and preferences, and is an exemplar for NHS health and wellbeing.  

Holly Blake is lecturer in behavioural sciences at University of Nottingham

 

Do you want to learn more about obesity management? Learn online with our training course on Obesity - an introduction to management in adults

 

today.

Readers' comments (10)

  • michael stone

    I'm not at all sure about the concept of 'role models' (but I'm male).

    I'm not sure how effective HCPs all looking slim and fit would be, in encouraging patients to become the same.

    But I am certain, that an HCP who was obviously overweight and smoking 30 fags a day, would get at the very least some strange looks from me if he/she said 'being overwight and smoking are bad for you, you know' ! And it would probably be very unwise to tell me that twice, as that would probably evoke a more analytical verbalised response than 'just an odd look' !

    Unsuitable or offensive?

  • DH Agent

    I am sure you would make a very good role model for somebody!

    The young doctors on our ward were a prime example of 'role modelling'!

    Having just completed a ward round with them, one of our patients was missing. He was found outside the ward in the hall (in the days when it was permitted, enjoying his fag). He had advanced lung disease and the young intern told him in no uncertain terms that another one would kill him!

    A few minutes later after the round I went to the doctors' office to get some notes and they were all, with the senior registrar, crowded round the x-ray viewing box (about six of them) pointing at a most appalling chest x-ray which on closer examination through the fug I saw it was the very one of what was left of this patient's lungs. They were all standing there commenting on it and nearly every one of them was puffing away on a cigarette! Apart from the hypocrisy, I was astonished with such experience they would even dare to carry on smoking, fit young sportsmen they all were.

    At least smoking is now banned and yes, I do think the professions should practice what they preach and be good role models for their patients and the general public as well as for each other!

    Unsuitable or offensive?

  • michael stone

    Anonymous | 4-Jan-2013 3:39 pm

    It would be good if professionals practised what they preach - my point was simply the almost impossible position you (typically people from on high) put professionals in, if you tell them to preach something they (personally) so obviously do not practise.

    The 'role model' issue is an aside - my instinct is that females are more influenced by role models than males, but that would be another debate.

    Unsuitable or offensive?

  • DH Agent - as if ! | 5-Jan-2013 11:47 am

    you obviously have very high ideals but please don't forget that healthcare professionals are also sentient human beings!

    Unsuitable or offensive?

  • michael stone

    DH Agent - as if ! | 5-Jan-2013 11:47 am

    It is sentience, that would make me bothered by having to preach about the benefits of losing weight if I myself were very over-weight.

    I'm not sure about my 'high ideals' - or even what that means: I just get very irritated by what I would term 'obvious logical absurdities' and I think that is not connected to ideals, but is connected to my awful memory and my need to 'understand' things (instead of just remebering stuff). I also get very annoyed by evasive or two-faced politicians !

    Unsuitable or offensive?

  • I don't believe in preaching to others anyway except perhaps for the clergy to their flocks on Sundays. I prefer an educative and informative role and believe that the best possible information should be made available for adults to make their own decisions.

    Unsuitable or offensive?

  • Since I am perfect in every way - it would be impossible for patients to match me on anything and cruel to expect it of them!

    Unsuitable or offensive?

  • This subject has intrigued me for some time. I was obese when I started nursing in the 80's but was told in no uncertain terms to do something about it. Over 20 years later I wonder how some of my colleagues can be effective in their role. I have seen morbidly obese nurses leaning over patients and squirm. Surely we should be able to impose some sort of direction for health and behaviour?
    My hospital in Brisbane Australia has numerous programs for weight/fitness management yet few take it up.

    Unsuitable or offensive?

  • Of course Nurses should be role model. It is wrong for a morbidly obese nurse to advice patient to loose weight. Nurse should also be aware of their own health issues and outlook before embarking on the role they play. Therefore, it is vital to have the right person to do the right task. On the other hand, one could be accused of discrimination.

    Unsuitable or offensive?

  • This subject has intrigued me for some time. I was obese when I started nursing in the 80's but was told in no uncertain terms to do something about it. Over 20 years later I wonder how some of my colleagues can be effective in their role. I have seen morbidly obese nurses leaning over patients and squirm. Surely we should be able to impose some sort of direction for health and behaviour?
    My hospital in Brisbane Australia has numerous programs for weight/fitness management yet few take it up.

    Unsuitable or offensive?

Have your say

You must sign in to make a comment.

Related Jobs

Sign in to see the latest jobs relevant to you!

newsletterpromo