lOMoARcPSD|11232395
HHS Public Access
Author manuscript
AORN J. Author manuscript; available in PMC 2018 March 01.
Author Manuscript
Published in final edited form as:
AORN J. 2017 March ; 105(3): 267–275. doi:10.1016/j.aorn.2016.12.018.
Nurses and Health-Promoting Behaviors: Knowledge May Not
Translate Into Self-Care
Alyson Ross, PhD, RN,
Nurse Investigator, National Institutes of Health (NIH) Clinical Center, Nursing Research and
Translational Science, Nursing Department, 10 Center Drive, Room 2B07, Bethesda, MD 20892
Margaret Bevans, PhD, RN, AOCN, FAAN,
Author Manuscript
CAPT, United States Public Health Service; Clinical Nurse Scientist; Program Director, Scientific
Resources, NIH Clinical Center, Nursing Research and Translational Science, Nursing
Department, 10 Center Drive, Room 2B13, MSC 1151, Bethesda, MD 20892, Contact telephone:
(301) 402-9383
Alyssa T. Brooks, PhD,
Post-doctoral Fellow, NIH Clinical Center, Nursing Research and Translational Science, Nursing
Department, 10 Center Drive, Bethesda, MD 20892, Contact telephone: (301) 496-5805
Susanne Gibbons, PhD, AGPCNP-BC, and
Assistant Professor, Daniel K. Inouye Graduate School of Nursing, Uniformed Services University
of the Health Sciences, 4301 Jones Bridge Road, Building E, Room 2039, Bethesda, MD 20814,
Contact telephone: (301) 295-1350
Author Manuscript
Gwenyth R. Wallen, PhD, RN
Chief Nurse Officer (Acting), Deputy Chief Nurse, Research and Practice Development, Chief,
Nursing Research and Translational Science, NIH Clinical Center, 10 Center Drive, Room 2B13,
MSC 1151, Bethesda, MD 20892, Contact telephone: (301) 496-0596
Abstract
Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy
eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships.
However, this knowledge may not translate into nurses’ own self-care. Nurses may not follow
recommended guidelines for physical activity and proper nutrition. Long hours, work overload,
and shift work associated with nursing practice can be stressful and contribute to job
dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances. The
Author Manuscript
purpose of this article is to provide an overview of research examining nurses’ participation in
health-promoting behaviors, including intrinsic and extrinsic factors that may influence nurses’
participation in these activities. This article also provides recommendations for perioperative nurse
Corresponding Author Information: Contact telephone: (301) 451-8338, .
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our
customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of
the resulting proof before it is published in its final citable form. Please note that during the production process errors may be
discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Downloaded by Purity Kimani ()
, lOMoARcPSD|11232395
Ross et al. Page 2
leaders regarding strategies to incorporate into the nursing workplace to improve the health of the
Author Manuscript
staff nurses by increasing health-promoting behaviors.
Keywords
self-care; health-promoting behaviors; healthy workplace; burnout; stress
Noncommunicable, lifestyle-related diseases including obesity, cardiovascular disease, and
type 2 diabetes have reached epidemic levels in the general population,1 and perioperative
nurses may be at risk. Nurses are at the forefront in the battle to fight this epidemic, and with
nursing as the most trusted of all professions,2 they are in a key position to counsel their
patients regarding the importance of engaging in healthy lifestyle behaviors such as eating a
nutritious diet, participating in regular physical activity, getting adequate sleep, reducing
Author Manuscript
stress, and avoiding tobacco and excessive alcohol intake. However, the knowledge that
nurses possess regarding health-promoting behaviors may not translate into nurses’ own
self-care. The following case study describes a nurse who is struggling to practice health-
promoting behaviors and how her particular job requirements specifically add to the
difficulty of adopting and adhering to a healthy lifestyle.
CASE STUDY: IDENTIFYING THE PROBLEM
Ms Y is a 52-year-old perioperative nurse working 12-hour shifts in a busy, 800-bed
academic medical center. As a 25-year veteran, she is one of the most experienced members
of the OR team. She is married and has three teenage children at home, in addition to her
aging parents. All three of her children are on multiple sports teams, consuming nearly all of
her free time, and she is worried about her 81-year-old mother who has recently begun
Author Manuscript
showing early signs of dementia.
During the past two years, administration changes have occurred at work, causing morale to
drop and several nurses to leave. As the demands of her job and family have increased, Ms Y
rarely has time for the activities she finds personally rewarding, such as attending yoga or
spinning classes with her two closest friends, cooking healthy meals, and traveling with her
family. Because of the complexities of the surgeries to which she is assigned, it is common
for her shift to extend past 12 hours, leaving her limited time with her family and making it
nearly impossible to get a good night’s sleep. On those nights, she usually grabs fast food on
her way home. At work, her busy OR schedule leaves her feeling like she is always eating on
the run, and if she misses the narrow window during which the hospital cafeteria provides
full service, she is left with few healthy options. At those times, she grabs something from
Author Manuscript
the vending machines or the collection of empty-calorie snacks supplied by coworkers. Not
surprisingly, Ms Y has gained 20 pounds in the past five years. The weight gain coupled
with long hours standing in the OR and lifting heavy patients has contributed to chronic low
back pain. She is motivated to make some healthy behavior changes but is struggling with
how to begin the journey to a more balanced, healthy lifestyle.
AORN J. Author manuscript; available in PMC 2018 March 01.
Downloaded by Purity Kimani ()
HHS Public Access
Author manuscript
AORN J. Author manuscript; available in PMC 2018 March 01.
Author Manuscript
Published in final edited form as:
AORN J. 2017 March ; 105(3): 267–275. doi:10.1016/j.aorn.2016.12.018.
Nurses and Health-Promoting Behaviors: Knowledge May Not
Translate Into Self-Care
Alyson Ross, PhD, RN,
Nurse Investigator, National Institutes of Health (NIH) Clinical Center, Nursing Research and
Translational Science, Nursing Department, 10 Center Drive, Room 2B07, Bethesda, MD 20892
Margaret Bevans, PhD, RN, AOCN, FAAN,
Author Manuscript
CAPT, United States Public Health Service; Clinical Nurse Scientist; Program Director, Scientific
Resources, NIH Clinical Center, Nursing Research and Translational Science, Nursing
Department, 10 Center Drive, Room 2B13, MSC 1151, Bethesda, MD 20892, Contact telephone:
(301) 402-9383
Alyssa T. Brooks, PhD,
Post-doctoral Fellow, NIH Clinical Center, Nursing Research and Translational Science, Nursing
Department, 10 Center Drive, Bethesda, MD 20892, Contact telephone: (301) 496-5805
Susanne Gibbons, PhD, AGPCNP-BC, and
Assistant Professor, Daniel K. Inouye Graduate School of Nursing, Uniformed Services University
of the Health Sciences, 4301 Jones Bridge Road, Building E, Room 2039, Bethesda, MD 20814,
Contact telephone: (301) 295-1350
Author Manuscript
Gwenyth R. Wallen, PhD, RN
Chief Nurse Officer (Acting), Deputy Chief Nurse, Research and Practice Development, Chief,
Nursing Research and Translational Science, NIH Clinical Center, 10 Center Drive, Room 2B13,
MSC 1151, Bethesda, MD 20892, Contact telephone: (301) 496-0596
Abstract
Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy
eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships.
However, this knowledge may not translate into nurses’ own self-care. Nurses may not follow
recommended guidelines for physical activity and proper nutrition. Long hours, work overload,
and shift work associated with nursing practice can be stressful and contribute to job
dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances. The
Author Manuscript
purpose of this article is to provide an overview of research examining nurses’ participation in
health-promoting behaviors, including intrinsic and extrinsic factors that may influence nurses’
participation in these activities. This article also provides recommendations for perioperative nurse
Corresponding Author Information: Contact telephone: (301) 451-8338, .
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our
customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of
the resulting proof before it is published in its final citable form. Please note that during the production process errors may be
discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Downloaded by Purity Kimani ()
, lOMoARcPSD|11232395
Ross et al. Page 2
leaders regarding strategies to incorporate into the nursing workplace to improve the health of the
Author Manuscript
staff nurses by increasing health-promoting behaviors.
Keywords
self-care; health-promoting behaviors; healthy workplace; burnout; stress
Noncommunicable, lifestyle-related diseases including obesity, cardiovascular disease, and
type 2 diabetes have reached epidemic levels in the general population,1 and perioperative
nurses may be at risk. Nurses are at the forefront in the battle to fight this epidemic, and with
nursing as the most trusted of all professions,2 they are in a key position to counsel their
patients regarding the importance of engaging in healthy lifestyle behaviors such as eating a
nutritious diet, participating in regular physical activity, getting adequate sleep, reducing
Author Manuscript
stress, and avoiding tobacco and excessive alcohol intake. However, the knowledge that
nurses possess regarding health-promoting behaviors may not translate into nurses’ own
self-care. The following case study describes a nurse who is struggling to practice health-
promoting behaviors and how her particular job requirements specifically add to the
difficulty of adopting and adhering to a healthy lifestyle.
CASE STUDY: IDENTIFYING THE PROBLEM
Ms Y is a 52-year-old perioperative nurse working 12-hour shifts in a busy, 800-bed
academic medical center. As a 25-year veteran, she is one of the most experienced members
of the OR team. She is married and has three teenage children at home, in addition to her
aging parents. All three of her children are on multiple sports teams, consuming nearly all of
her free time, and she is worried about her 81-year-old mother who has recently begun
Author Manuscript
showing early signs of dementia.
During the past two years, administration changes have occurred at work, causing morale to
drop and several nurses to leave. As the demands of her job and family have increased, Ms Y
rarely has time for the activities she finds personally rewarding, such as attending yoga or
spinning classes with her two closest friends, cooking healthy meals, and traveling with her
family. Because of the complexities of the surgeries to which she is assigned, it is common
for her shift to extend past 12 hours, leaving her limited time with her family and making it
nearly impossible to get a good night’s sleep. On those nights, she usually grabs fast food on
her way home. At work, her busy OR schedule leaves her feeling like she is always eating on
the run, and if she misses the narrow window during which the hospital cafeteria provides
full service, she is left with few healthy options. At those times, she grabs something from
Author Manuscript
the vending machines or the collection of empty-calorie snacks supplied by coworkers. Not
surprisingly, Ms Y has gained 20 pounds in the past five years. The weight gain coupled
with long hours standing in the OR and lifting heavy patients has contributed to chronic low
back pain. She is motivated to make some healthy behavior changes but is struggling with
how to begin the journey to a more balanced, healthy lifestyle.
AORN J. Author manuscript; available in PMC 2018 March 01.
Downloaded by Purity Kimani ()
