Shiftwork and Healthy Eating

By Holly Carpenter, BSN, RN
Ann is a 23-year-old registered nurse (RN). Since her graduation a year ago, she has been working the night shift in the pediatrics unit at General Hospital. During this time, she has gained 30 lb, moving from the high end of a normal body mass index (BMI) to the low end of an obese BMI. With the hospital cafeteria closed during her shift, Ann faces unhealthy vending-machine choices, with only fast food restaurants and greasy diners open after her shift. Patients offer Ann cookies and candy, and hospital events provide fruit punch, soda, pizza, cake, and donuts. Ann is ravenous and exhausted after her shift; she eats a large meal and then goes to bed. She feels she has no time to shop for healthy food or prepare nutritious meals and has limited access to fresh produce. Ann is frustrated by her weight gain and frightened about her health.
Unfortunately, Ann's situation is not unique. Nurses struggle with their weight like anyone in the general population. The U.S. had 21 million shiftworkers in 2007, according to the Bureau of Labor Statistics, and research demonstrates that rotating shiftworkers and night shiftworkers have a greater likelihood for obesity than those who work day shift. Studies show that disruption of the normal circadian rhythm as experienced by shiftworkers can lead to increased risk of cardiovascular disease, obesity, diabetes, and weight gain. The National Institute for Occupational Safety and Health reports that shiftwork stress can aggravate digestive disorders
RNs can make a difference in reversing the trend. Broadly, ANA's Code of Ethics for Nurses addresses being a healthy nurse and role model in several statements: "The nurse owes the same duties to self as others." "For the nurse, virtues and excellences are those habits that affirm and promote the values of human… well-being, …health…." And finally, "the nurse…fosters healthy lifestyles and participates in institutional and legislative efforts to promote health." Specifically, ANA's 2008 House of Delegates resolution "Healthy Food in Health Care" asks nurses to promote nutritious foods to improve patient and public health. Nurses and employers can take the actions below.
Shiftworkers:

• Pack healthy foods for meals and snacks, such as fruits, vegetables, and salads; proteins, such as roasted turkey, chicken, or fish; whole-grain breads; and low-fat cheeses and yogurts.
• Use quick, easy meal preparation. For example, use a slow cooker, use only three to five ingredients, and freeze extra portions.
• Pack nutrient-dense foods, such as kale, blueberries, and salmon.
• Stay hydrated.
• Avoid sugar-sweetened beverages.
• Practice portion control.
• Avoid fatty, fried, high-sodium, and processed foods.
• Say no to cookies and candy.
• Advocate for healthier foods in the workplace.

Shiftwork employers:

• Provide healthy foods during all shifts.
• Offer healthy foods in vending machines.
• Provide free, accessible drinking water for all shifts.
• Serve healthy foods and beverages at events.
• Offer weight-loss programs and support groups.
• Start an on-site farmer's market or a community garden.
• Supply the cafeteria with healthy options at equitable prices.
• Mark calorie content on menus and menu boards.

Prologue
Ann knows that as a nurse, she is a role model, advocate, and educator for health and wellness. So she minimizes her intake of sugar-sweetened beverages, because eliminating just one can of soda daily saves 10 lb per year. Ann researches foods that increase energy and satiate hunger. Using recipe websites, she prepares large quantities of healthy entrees weekly and freezes portions for later use.
She then approaches her employer. Working with her hospital's purchasing committee and employee wellness department, Ann gets fresh and dried fruit, low-fat yogurt, and nuts added to vending machines. Healthy bagged meals are now available from the dietary department, since the cafeteria still closes at 8 PM. Once a month, a farmer's market sets up in the hospital's courtyard in the morning as Ann leaves her shift. She loads up on nutritious produce at a great price.
Join Ann in her healthy lifestyle. To learn more, visit anahealthynurse.org.