Nursing a Nurse’s Heart

There’s an old proverb that states, “Physician, heal thyself.” A similar admonition can be applied to nurses who, too often, fail to take care of their own health—especially their heart health–while freely lecturing their patients about the perils of lack of self-care. Cardiovascular health risks for nurses fall into three main categories: sleep, diet, and substances.

Sleep and sleep patterns

In the Journal of Clinical & Diagnostic Research’s article, “Effects of Sleep Deprivation on the Cognitive Performance of Nurses Working in Shift,” the authors state “Shift work poses significant cognitive risks in work performance of nurses.” Unfortunately, sleep deprivation seems endemic to nursing. There are still many facilities that mandate nurses to work “swing shifts” as part of their contract. Other facilities require nurses to work a “double” – two full shifts back-to-back. In the Medical Review’s article, “Health Effects of Sleep Deprivation on Nurses Working Shifts,” the authors note “Too long or repeated shifts reduce the opportunity for sleep…thus endangering their safety and health as well as the quality of care and patients’ safety.” When those nurses are not working, they are trying to catch a few hours of sleep.

Some nurses with school-aged children choose to work the night shift, arriving home in the morning just in time to take the children to school. Their plan is to catch some sleep before school ends for the day. However, if a child is home sick or school is on a break, they are lucky to catch even a nap. I once worked back-to-back with a night nurse who was in that childcare situation. She would stagger into work every evening and brew a full pot of coffee to stay awake. One day, I came in and noticed coffee grounds all over the floor in the med room; in her sleep-deprived state, she had missed the wastebasket without even noticing.

Sleep deprivation has been connected to a host of chronic health conditions such as obesity, type 2 diabetes, sleep apnea, and hypertension. According to the Medical Review, it is specifically the change in the circadian rhythm of blood pressure that contributes to the development of atherosclerosis and eventual cardiovascular disease. Many nurses reach for a cup of coffee or candy as a way to ward off their fatigue; unfortunately, candy is a diabetogenic agent which can lead to diabetes or disrupt the management of the disease.

When a person is chronically exhausted, they are too tired to exercise, which increases their stress levels. Lack of exercise contributes to numerous conditions that negatively impact cardiovascular health.

Food and fluid intake

Nutritionists advise us to eat primarily a plant-based diet for optimal health. However, when nurses spend most of their time at the workplace, they begin to rely on what can be grabbed from the vending machine, such as candy and potato chips. These highly processed foods are laden with sodium, fat, and sugar. As a result, many nurses develop hypertension, hyperlipidemia, blood glucose instability, and weight gain.

Sufficient water intake is essential for good heart health. However, when bathroom breaks are almost non-existent on many nursing jobs, nurses restrict their fluid intake to avoid discomfort. Research from the Journal of the American College of Cardiology suggests consciously reducing fluid intake at work is in response to work pressure. For nurses, this translates to not having enough time to complete work activities, so they avoid the intake of fluids. Also, it would be inappropriate to walk from patient room to room while carrying a bottle of drinking water. As a result, many nurses function in a perpetual state of mild dehydration, which can lead to ailments such as headaches.

Substance use

Despite knowing the dangers of smoking and having frequent encounters with cancer patients, many nurses are regular users of tobacco. Although a legal substance, nicotine can be as addictive as cocaine. Nurses who smoke may plan breaks around when they need their next nicotine dose, causing them to be late with patient meds or treatments. In addition, the odor of tobacco on their clothes or breath will be noticeable to the patients they treat.

Nicotine is a vasoconstrictor, contributes to atherosclerosis, and is a leading cause of cardiovascular disease. According to “Psychiatric mental health nursing: Concepts of care in evidence-based practice,” it also contributes to peripheral vascular disease, chronic lung disease, and several forms of cancer. In short, there is no health benefit to tobacco use.

Similarly, a nurse may arrive home after working a lengthy shift and pour an alcoholic beverage to “unwind.” The occasional evening or weekend off may involve socializing with friends at facilities or events where alcohol is served. Consequently, it would be easy for a nurse to arrive at the next shift under the effects of alcohol without even realizing it. Being under the influence of alcohol would impair a nurse’s judgment and put patients in danger. In addition, “Psychiatric mental health nursing: Concepts of care in evidence-based practice,” reports chronic alcohol use contributes to peripheral neuropathy, alcoholic myopathy, thiamine deficiency, Korsakoff psychosis, cardiomyopathy, esophagitis, gastritis, pancreatitis, and cirrhosis of the liver.

Substance abuse of narcotics and opioids has become a huge problem for nurses. After all, they often work in a place with easy access to controlled-substance medications. Access can lead to addiction. Statistics reported in the article, “The sneaky prevalence of substance abuse in nursing,” suggest that one out of every five to seven RNs in the United States is affected by substance abuse.  The Journal of the American College of Cardiology reports cocaine use, in particular, is a significant risk factor for cardiovascular complications due to its vasoconstrictive response.

Strategies for good heart health for nurses

• Minimize stress by learning to say “no” to unreasonable requests on your time, such as working frequent double shifts.
• Choose the healthiest options offered from vending machines, such as nuts or protein bars.
• Drink extra water after ending a nursing shift.
• Don’t smoke. If you currently smoke, begin a smoking cessation program.
• Don’t drink more than two servings of alcohol daily. (e.g., a serving is a 5-ounce glass of wine or a 12-ounce beer)
• Don’t use any illegal substances. If you are currently using them, seek out a substance-abuse program intended for healthcare professionals.

You only have one heart – and it must last you a lifetime. So, protect it at all costs!

Disclaimer: The views expressed here are solely those of the author(s) and do not necessarily represent or reflect the views of Excelsior College, its trustees, officers, or employees.