1. Tucker, Sharon J. PhD, RN, PMHCNS-BC, FAAN


A second set of 'vital signs' for nurses.


Article Content

Nursing is recognized by the U.S. Department of Labor as a hazardous occupation. In a 2013 report published by the Bureau of Labor Statistics, RNs were ranked fifth in missed work days due to occupational injuries or illnesses (nursing assistants were ranked first). Today's bedside nurse faces rising patient acuity, advanced technologies, and shortened lengths of stay. Couple this with long hours, rotating work shifts, and night shifts, and the result is exhaustion, interruptions in normal biological rhythms, and greater risk of illness. The fact that 90% of the nursing workforce is female increases the likelihood that nurses are also caregivers outside of work-whether they are raising children or taking care of aging parents. Is it any wonder, then, that nurses consistently report suboptimal self-care behaviors?

Figure. Sharon J. Tu... - Click to enlarge in new window Sharon J. Tucker

Discussions about nurses' health and self-care behavior are not new. Many nurse theorists have highlighted the importance of self-care, dating back to Florence Nightingale. Some of today's concerns are about rates of obesity, irregular and insufficient physical activity, poor dietary quality, stress and coping issues, and the effects of fatigue on patient safety. The American Nurses Association recently launched its HealthyNurse initiative to promote the health of the nursing workforce.


Nurses may want to model self-care, but the environment and culture in which they practice makes this difficult. An overhaul is necessary. Bold nurse leaders are needed to take risks and promote evidence-based actions, such as ensuring healthy scheduling patterns that support rest and recovery and limit errors.


I propose launching a campaign that challenges nurses everywhere-including leaders and managers-to take evidence-based action on an important second set of "vital signs" for nurses. I've labeled this the Vital Signs Selfie campaign, in which "selfie" refers to nurses looking in the camera or mirror and committing to promoting important, vital health behaviors, one step at a time. This unique set of vital signs includes the traditional abbreviations-BP, T, P, and R-but with different meanings.


BP = Being present. Am I being present in all my encounters with patients, their families, colleagues, and my own friends and family? Do I truly listen, or do I drift off and only listen occasionally? Am I finding daily moments of calm and stillness?


T = Tracking. Am I tracking my own health metrics and numbers and taking action when needed? This is asking no more than what we ask of our patients, many of whom are weak and frail. Each nurse knows which personal metrics matter most (blood pressure, weight, blood sugar, or lipid levels).


P = Practicing health and wellness behaviors. Every nurse should model health practices. Employee wellness programs exist in most health care organizations, providing nurses with access to facilities and resources for physical activity, strength building, and healthy eating. Tapping into these and other resources should be a priority.


R = Refueling. Refueling is all too often overlooked and not truly attended to. Refueling means getting adequate rest and sleep and stepping away from work, finding meaning, energy, and joy in other aspects of life. This may include being involved in an organized religion, taking meditation or yoga classes, or spending time with friends.


You can help to promote the Vital Signs Selfie campaign by sharing this article and your ideas with colleagues, generating unit-based discussions about self-care goals that can be achieved one step at a time. Nurses may also want to include a self-care goal in their annual performance plans. Nurse managers can make self-care a unit goal, and directors can make self-care a part of the facility's strategic plan. Measurable outcomes include cost savings through less attrition, absenteeism, and worker compensation.


Media attention is needed for this campaign to succeed. Through articles, documentaries, and community initiatives, nurses can discuss shared self-care goals and evidence-based behaviors. I challenge each nurse, nurse leader, and nurse advocate to bring the Vital Signs Selfie campaign to all nurses in all settings.