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Holly Blake: 'Nurses recognise their own health can affect care quality'


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


Readers' comments (6)

  • I'm overweight, I should be about 72 kg, ideally. I'm actually 85kg, but I'm very aware of what I eat, I exercise regularly. I have an exercise bike in my flat ( I use it regularly). I am quite fit and healthy, but one might not get that impression from looking at me. I'm an active person, but also overweight. I have tried every trick in the book to lose those pounds. In the end I gave up and decided to live a normal life. I'm overweight, that's it, get used to it.

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  • in other words, thou cannot be a nurse unless you are a saint

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  • There are many nurses, as above, who are intent on leading a healthy lifestyle outside of their work, or have the intention to do so.
    However, having 'given out' for their hours of work in an unhealthy environment, whether it be physically unhealthy or politically unhealthy, where there is not a great deal of 'caring' being returned, then it is difficult to then go home and 'care' for oneself, naturally the least line of resistance is followed, which may include over indulgence of substances that are not considered part of the 9 per day.
    I personally would encourage fellow nurses to save some of their 'output' to others for themselves, and find an activity or style that is nurturing for them and healthier. Perceptions of nurses need to be examined, but also how the NHS is politically managed and if it is seen nationally as a drain of finances certainly by the current PM and Government, then the nurses belief of not being valued and worthless is triggered daily, and the behaviour resulting is to seek instant ways of feeling 'better'.

    Be good to yourselves........then you can be good for and to others

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  • michael stone

    This one is complicated.

    About the only clear thing, is that 'preaching at others to lose weight if you yourself are obese' isn't likely to go down well.

    But if the very job of nursing tends to make nurses 'overweight', that isn't easily countered by individual nurses.

    And personally, as I'm now fairly old, was never all that 'upbeat' about life even before I became depressed a few years ago, which seems to have left me even less 'enthusiastic about life' than before, I can only say that I'm now probably much less receptive to 'healthy living advice' than I might have been (my memory is going, as well) when I was 20 or 30. Although, of course, '20 yr olds are immortal - so they don't bother, either'.

    Perhaps there is a 'golden time slot' - aged 40 to 50, perhaps ? - when people really do pay attention to these 'messages' (ignoring the 'just after a heart attack' one).

    Or perhaps most other people, are different from me.

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  • Fall in lurve and the weight will drop!! Guaranteed!

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  • michael stone | 25-Sep-2014 2:49 pm

    complicated because it is an issue you know nothing about but obviously feel compelled as usual to place a comment!

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