1. Kennedy, Maureen Shawn MA, RN,


Now is the time.


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It's true that the rates of preventable chronic illnesses such as diabetes and heart disease continue to rise-but the key word in that sentence is preventable. So I want to make sure you don't miss this month's CE feature by Todd M. Ruppar and Vicki S. Conn. They explain the findings of a meta-analysis of 163 reports on studies evaluating interventions to promote physical activity in adults with chronic illnesses. Then they describe the practice implications and identify which strategies are most likely to be successful. This information couldn't come at a better time.


On International Nurses Day, May 12, the International Council of Nurses called on nurses to lead the fight against preventable chronic diseases. As fate would have it, on May 13 the United Nations' General Assembly unanimously adopted a resolution summoning international leaders to convene in September 2011 to address the increasing prevalence of noncommunicable diseases and to raise the priority of prevention efforts. According to the World Health Organization, four preventable noncommunicable illnesses-cardiovascular disease, cancer, chronic respiratory disease, and diabetes-account for 60% of all deaths worldwide; of these deaths, 80% occur in low- and middle-income countries. We know that reducing risk factors can help prevent such diseases.


Of course, preventing illness in our patients is only part of the story; we need to prevent it in ourselves, too. We all know how important proper diet and adequate exercise are to maintaining health; yet we often make ourselves our last priority, putting families and jobs before our own physical and mental well-being. Several colleagues have recently told me that they're working harder than ever, and my own schedule feels increasingly frenetic. One of my New Year's resolutions was to take a daily 30-minute walk; "daily" has dwindled to three times a week, or less.


In January, writing for the Web site of the British journal Nursing Times (, Jill Maben voiced concerns about the effects of 12-hour shifts on patients and nurses, observing that long shifts "may have implications for staff wellbeing in terms of stress, burnout and physical injuries." In a follow-up post, Maben reported that the piece prompted 116 comments and that many nurses said, in effect, "Hands off our long days!" But although nurses liked the convenience of 12-hour shifts, many admitted that it took considerable time to recover from them.

Figure. Maureen Shaw... - Click to enlarge in new windowFigure. Maureen Shawn Kennedy

Two recent studies focusing on the health effects of work hours and work-related stress are worth noting. One, published May 11 on the European Heart Journal Web site, bolsters the argument for eliminating 12-hour shifts. Researchers followed more than 6,000 middle-aged British civil servants for 11 years and found that, compared with those who worked no overtime, those who worked three to four hours of overtime per day had a 1.6-fold higher risk of coronary heart disease. In another study, Danish researchers followed more than 12,000 middle-aged nurses for 15 years, investigating the effects of work-related stress; the findings appeared in the May issue of Occupational and Environmental Medicine. The researchers found that, among nurses who were younger than 51 years at baseline, those who reported workplace pressure as "too high" had a 1.4-fold higher risk for ischemic heart disease, even after adjusting for other factors.


Would any of us argue that nurses' jobs aren't stressful, especially given this uncertain economy, an increasingly older and sicker patient population, and a looming nursing shortage? We need to pay attention to what the evidence and our bodies are telling us. I once read somewhere that if you keep promises to others, you're considered dependable, but if you keep promises to yourself, you're considered selfish. It's time more of us became a bit more selfish.