Working long and busy shifts can make it difficult for nurses to get proper nutrition during a workday. Many factors influence this. One study found that nurses did not take enough breaks for adequate nutrition due to patient load, unpredictability of patient needs, reluctance to burden other nurses, and a tendency to prioritize patient care over self-care (Monaghan, Dinour, Liou & Shefchik, 2017).
Sound like you? It definitely reminds me of myself and the culture of the hospital I work at. Other influential factors include unhealthy food options at work, regulations that restrict eating or drinking at the nurses’ station, and a shortage of staff.
Though many nurses work longer than 8 hours per shift, more than one third of nurses rarely or never take meal breaks. Furthermore, working 12.5 hours or longer per shift puts the nurse at increased risk for needle stick injuries, musculoskeletal disorders, and three times the rate of errors made during an 8.5 hour shift (Monaghan, et al., 2017).
Skipping meals can cause irritability, fatigue, dizziness and can impair critical thinking. While long shift hours will likely not change, we must shift the culture in our workplace to improve healthy eating opportunities, including meal breaks!
Utilize your days off by planning meals in advance and meal prepping. Make meals that you love and will look forward to eating! Bring healthy snacks and light meals that include fiber and protein with you to work. If you can’t get a break long enough to eat a meal, make smoothies, protein shakes, or carry nutritious granola bars. Drink plenty of water throughout your shift. Eat breakfast. Challenge your mentality about taking breaks and fueling your body. Be a role model for your patients and colleagues! Help change the culture in your workplace to embrace healthy eating and living by encouraging others to take breaks to eat and hydrate.
Plan Meals in Advance
If you’ve read some of my other articles, you know that I highly advocate meal prepping! This is one of the best ways to ensure you’re eating high quality ingredients and the best way to control what you consume. Make double or triple batches at dinner and use leftovers for lunch. If you don’t like eating the same thing for multiple meals in a row, be creative and make new meals out of the same ingredients.
I like to throw roasted vegetables on my salads for interesting flavor and texture combinations. Add extra grains such as rice or quinoa to soups and stews. Chicken or shrimp from tacos the night before can easily turn into protein sources for a grain bowl and chopped vegetables can be thrown into a stir fry or steamed as a side dish.
An easy, healthy breakfast that can be made into countless variations is oatmeal! Make a big batch of oatmeal to last you throughout the week. Add dried fruit and nuts one day and stir in peanut butter and chocolate chips the next. Fresh, sliced fruit is an awesome, fibrous oatmeal topping. I’ve even stirred hot chocolate powder and trail mix into my oatmeal for a dessert. My new favorite is my high protein egg white oatmeal… don’t dig it until you’ve tried it!
When you plan your meals and snacks for your workday, think about convenience and how satisfying it will be. Fiber is an important piece of well-rounded nutrition, as it keeps your digestive system regular and helps keep you full. Typically, fiber is abundant in colorful fruits and vegetables, which also have a higher water content (helping you stay hydrated).
Pick veggies you love the most, chop them into bite-sized pieces, and pair with something high in protein, such as string cheese, mixed nuts, hummus, or a hardboiled egg. Plan snacks that are high in protein and fiber. See this list of quick, healthy snack ideas for the busy nurse.
Eat Breakfast
Fuel yourself for the day with breakfast! Get adequate nutrients early in the day before your shift or a few hours after waking. While intermittent fasting is trending heavily right now, some studies show that you can receive similar benefits (controlled blood glucose, reduction of cancer risk, weight control) from fasting for just 12 hours – making it easier to eat a healthy meal earlier in the day.
Breakfast has been shown to help control weight, improve mental clarity and decision making, and reduce nighttime snacking. If you’re not used to eating early in the morning, try a smoothie or a protein shake – they can be easier on the stomach. Other good options are yogurt with berries, eggs and a slice of toast, or a hearty bowl of oatmeal. A small meal should help fuel you for the next couple hours.
If you work an “off shift”, eat breakfast like you normally would during the day – when you wake up. Since many mornings can be hurried or rushed, plan your breakfast just like you would your lunch and other snacks – the night or day before.
You can make large batches of smoothies in advance (freeze, then place a single serving in your fridge the night before), pack a protein shake to go, or create a routine that allows you to get up a few minutes earlier so you can cook a few eggs, make oatmeal, or have your favorite breakfast cereal. Plan ahead to be successful at eating nutritious, healthy meals which will make you more productive at work and give you a jump start to your day!
Eat Small Meals
Plan on eating a small meal and snacks throughout the day instead of two to three large meals – this will help prevent the mid-day “slump” and steady your blood glucose and energy levels. Most people should eat 4 - 5 meals a day for proper nutrition and sustained energy levels.
Waiting too long between meals can lead to irritability, fatigue, and poor food choices (we’ve all been grocery shopping while hungry, right? Remember all the random things we bought?). Prevent this by planning your meals in advance, making them easily accessible and choosing foods that you look forward to eating!
If it’s hard to get away from work or your patients to have a snack, keep a granola bar or small package of nuts in your pocket. You can also pour a smoothie into a coffee container with a covered lid. These are healthy, quick snacks that you can eat or drink discreetly. They can also be easily tucked away into a pocket or placed out of sight if you need to run into a patient’s room.
Skip high fat or ultra-spicy foods, as they can irritate your stomach and cause indigestion. Sweet snacks tend to leave you craving more, and though they may give you a short burst of energy, levels typically plummet later. If you always crave something sweet after a meal, try subbing your current dessert with fresh fruit or a stick of gum.
Some people curb their sweet tooth by adding Crystal Light or other beverage enhancer to their water after a meal. Have a snack or dinner when you get home but treat it the same way you did breakfast – a smaller meal that will be easy to digest.
Another important part of staying healthy at work is staying hydrated! I know it can be hard to take bathroom breaks but getting adequate water throughout the day can preserve your metabolism and maintain critical thinking.
Be a Role Model and a Change Agent
We likely teach our patients how to maintain a healthy lifestyle on a daily basis. We teach our diabetic patients how to track carbohydrates. We teach our heart failure patients how to read nutrition labels and what foods are high in sodium. Our rehab patients are coached to exercise and move daily. Progressive mobility is a term many of us are familiar with, as nearly all patients are encouraged to get up to the chair or walk daily. We teach stress reduction techniques to our stroke and heart attack patients, and coping strategies to our behavioral health patients. Shouldn’t we be leading by our actions as we explain to our patients proper nutrition and stress reduction strategies?
I challenge you to be a role model for both your patients and your peers by testing your unit’s current culture and advocating for change. If your unit is anything like mine, it likely includes minimal breaks, hurried lunches, and inadequate hydration. In one study, 100% of nurses reported that they did not take their full allotted break time, and 65% of nurses said they addressed their patient needs before their own (Monaghan, et al., 2017). While this altruistic attitude is certainly admirable and praiseworthy, time should be set aside for each nurse to take the breaks they’ve earned.
One way to start this change for yourself is to begin slowly. If you’re worried about being away from your patients for a lunch break, start with a 10-minute break and work your way up to 15 or 20 minutes. Encourage your peers to do this same. Give your charge nurse or another nurse you work with a quick report of your patients before lunch if this will help you separate yourself. Offer to do the same for your coworkers.
Involve your supervisor or nurse manager and tell her your goals for yourself and your unit. Feel free to cite this resource! Tell him or her what you plan to do to improve the habits of yourself and your colleagues and ask if he or she is willing to support you. Ask what has worked in the past or if she has any advice or ideas. Getting management on board will be a further selling point for colleagues who feel like they must be busy all the time.
Remind your colleagues to stay hydrated and eat healthy by placing flyers and notes in common areas that encourage healthy living habits. You might be the change agent that your unit needs!
What changes do you plan to make in your work environment that will promote healthy eating habits?
References
Monaghan, T., Dinour, L., Liou, D., & Shefchik, M. (2017). Factors Influencing the Eating Practices of Hospital Nurses During Their Shifts. Workplace Health & Safety, 66(7), 331–342. doi: 10.1177/2165079917737557
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