Developing Healthier Nursing

Students

Jane Wills

Professor of Health Promotion

Muireann Kelly

Research Assistant

London South Bank University

The Health of Nurses Levels of physical activity among nurses is low, with

many nurses failing to meet the UK government’s

recommended minimum of 30 minutes exercise five

times a week

The Nurses and Midwives e-Cohort Study (NMeS)

sampled 5000 nurses in the UK, Australia and New

Zealand, and found that 61.87% exceeded the healthy weight range

(Bogossian et al, 2012)

One-third of nurses are thought to drink more than the recommended limits

(O’Dowd, 2006); this ranks nursing as one of the top 10 professions that suffer most

from alcohol abuse (Servodidio, 2011)

The project at London South Bank

University

1. Health assessments every six months

2. A wellness portal to support personal wellbeing

3. Monitoring health promotion opportunities on placement

Student nurses’ self-reported health [n=160]

48% were overweight or obese

17% were current smokers

77% use alcohol, and of those who do drink, 17% report having 7 drinks or more on an average night out

40% reported that they rarely or never engage in vigorous or moderate exercise for at least 30 minutes (i.e. meet government recommendations for physical activity)

30% regularly skip breakfast and approximately 20% do not eat 5 a day regularly

Possible explanations for student nurses’

health behaviours

There are high levels of health literacy amongst student nurses and some

motivation to improve their health. Yet there is a neglect of physical activity

[although half intend to get fitter], an over-reliance on convenience foods, a desire to

relax and maintenance of smoking.

To what do they attribute their health lifestyles?

• Heavy study schedules

• Financial restraints of nursing students

• Demands of placement

• Lack of opportunity e.g. distant canteens

• Lack of focus in the curriculum

Why does nurses’ health matter?

Impact on health system: sickness

absence

2. Impact on patient safety

3. Impact on health promotion

The wellness portal

Helps student nurses to identify personal risk

Allows student nurses to compare individual health status results against recommended health messages

Connects student nurses to an interactive web wellness portal with tools and resources for optimal health based on specific risks and interests

The wellness portal

The wellness portal

Health Promotion on the

agenda “Nurses and midwives play important roles in health

promotion, disease prevention and maintaining health

and wellbeing. In future all nursing and midwifery staff

will think and act ‘health’ whenever and wherever they

provide care, and be ever alert for health promotion

opportunities – making wellness everyone’s business.

They will also be encouraged and supported to make

healthy changes in their own lives.”

The Prime Minister’s Commission on the Future of

Nursing and Midwifery in England 2010

Making Every Contact Count

There is a link between nurses’ health practices and

their tendency to raise lifestyle issues with patients:

• Nurses who engage in regular exercise are more likely to promote physical activity among patients than nurses who were physically inactive (McDowell et al, 1997; Rush et al, 2005).

• Nurses who are smokers themselves are less willing to promote cessation among patients who smoke than nurses who are not current smokers (McKenna et al 2001; Chalmers et al, 2002; Lenz, 2008; Radsma and Bottorff, 2009)

• Nurses who are overweight are less likely to raise this issue with patients who are obese and the public have more confidence in the ability of normal-weight nurses to provide education about diet and exercise when compared with overweight nurses (Hicks et al, 2008)

The curriculum

UK Nursing and Midwifery Council competencies for entry to the register (for all fields of nursing)

Domain 2: Communication and Interpersonal Skills

“All nurses must take every opportunity to encourage health-promoting behaviour through education, role modelling and effective communication.”

Student nurses’ views on themselves as role

models

70% felt that it was difficult to promote healthy

behaviours if they did not carry them out themselves.

90% felt that it was their responsibility as a nurse to

model healthy living.

80% of participants felt that it was important to talk to patients about topics such as diet, physical activity,

smoking and alcohol, although only 30%

reported that they felt very confident talking to

patients about nutrition.

91% of participants agreed with the statement ‘My

nursing curriculum emphasises health

promotion in nursing practice’, although over

30% stated they had received no training on

alcohol, nutrition or physical activity.

Conclusions • The health behaviour of pre-registration student nurses is poor and

these individuals will join the NHS at a time when workplace sickness absences are at an all-time high, and nurses are increasingly being recognized as role models for the health behaviour of the public.

• This not only has implications for their role as future health promoters, but may also impact on individual health and well-being, and the quality of care the NHS is able to provide to its patients.

• Improving the health and lifestyle behaviours of nursing staff, especially concerning weight management practices such as healthy eating and regular physical activity, is therefore an important area for intervention.