Most nurses feel they should be role models for health, says Holly Blake
NHS chief executive Simon Stevens’ recent remarks that nurses and doctors should slim has reopened the debate surrounding obesity in the nursing profession. The debate should be given a positive focus and we need to look at ensuring a healthy public health workforce.
There are many examples of best practice, and Nottingham University Hospitals Trust is an exemplar, having offered a comprehensive wellness programme for staff since 2005. Staff surveys have shown that there is a need for interventions to improve their health. This trust has sustained commitment to providing a range of services and facilities to make is easier to adopt healthy lifestyle choices. While these are popular and highly accessed at three hospital sites, some occupational groups are notoriously hard to reach.
Despite the high rates of overweight and obese nurses, engaging them in initiatives focused on physical activity and diet has presented a considerable challenge for some years.
Amid the controversy surrounding nurses as role models for health, we should not dismiss any perceived lack of engagement as a lack of interest in health improvement before we have understood the complexity of barriers to such engagement; these are likely to involve an array of organisational factors, role issues and individual characteristics.
We need a deeper understanding of nurses’ perceptions of workplace initiatives that are targeted at improving their health; this will better our understanding of how to develop programmes. If services are less attractive to nurses, we need to understand why, so they can be adapted to suit the needs of a busy, often pressured and shift-working profession.
While levels of obesity among nurses have been subject to scrutiny in research and the media, less attention has been paid to the opinions of nurses on whether they should be role models for health.
Cultural change is unlikely to be successful if nurses perceive only harsh criticism and do not believe action is required; we needed to ask their views. Emerging research has indicated that the majority of nurses do feel they should be role models for health, although this idealistic attitude does not always sit comfortably with their lifestyle choices.
Perhaps most significant is that nurses recognise that their health can affect care quality. First, many find it difficult to promote healthy, active lifestyles if they do not have a healthy lifestyle themselves. Second, nurses admit patients may be less willing to follow their advice if they are not observably practising what they preach.
At our trust, nurses often attend staff health and wellbeing campaigns and events, and engage in initiatives to support mental wellbeing and stress management. They are active attendees of personal occupational health checks, reporting benefits for health monitoring, and initiation or monitoring of health behaviour changes.
While nurses may be less frequent attenders of structured exercise classes in the workplace (and other initiatives constrained to specific time and place), their attention has been captured by competitive team-based pedometer step count challenges, individual weight-loss challenges and after-work “learn to run” schemes aimed at building self-efficacy for exercise in a supportive environment.
NHS staff have nominated many nurses as their “health heroes” - award-winning employees who inspire colleagues with their healthy lifestyles and peer support. We are encouraged by the potential for cultural shift and indications that many nurses are choosing health.
Holly Blake is associate professor of behavioural science at the University of Nottingham