1. Kennedy, Maureen Shawn MA, RN, FAAN


Exercise may not mitigate the ill effects of prolonged sitting.


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I used to be very physically active. I walked all the time when I worked in a hospital. Up and down the long corridors, and then a few blocks to the subway. When my children were young, I pushed a stroller around the block. When they started school and I worked part time, I still managed to carve out time to be active, playing tennis three to four times a week. Then, things changed.

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

I switched from part-time to full-time work after my children were grown, and I no longer had time for sports. Exercising before work wasn't an option-I was waking at 5 am and didn't want to rise even earlier. My good intentions to walk in the evening often went by the wayside, especially during the early darkness of winter. Most weekdays, I get into my car for an hour-long drive to Manhattan, where I spend most of the day sitting at a desk or in meetings. Then I repeat the hour-long drive home and sit for an hour or so during dinner and while watching television in the evening. I sit for 12 to 13 of my waking hours. I'm more active on weekends, hitting the treadmill a bit. But even those days are marked by significant periods of sitting, because I often use the weekend to catch up on work.


We all know that exercise, eating healthfully, and getting enough sleep are important to staying fit and preventing disease. But nurses, like many of our patients, are working in high-stress jobs and often have more responsibilities than can be realistically managed within a workday-and then we go home to care for our families and maybe even attend school. Our lives are laden with obligations that prevent us from spending time on our own needs, and we are likely to put our needs last regardless.


The outcome of this lifestyle can be seen in the results of a "health risk appraisal" the American Nurses Association (ANA) conducted from 2013 to 2016. More than 10,000 members completed the survey. Key findings included the following: more than half of respondents said they came in early, stayed late, or worked through breaks to complete their work; the average body mass index of respondents was in the overweight range; and fewer than half of respondents did muscle-strengthening activities.


As a result, the ANA declared 2017 the Year of the Healthy Nurse, with the aim of helping nurses incorporate healthy habits into their lifestyles. That has continued in 2018 with the "Healthy Nurse Healthy Nation Grand Challenge" (see This initiative aims to engage nurses in improving their health and serving as role models by focusing on physical activity, sleep, nutrition, quality of life, and safety.


Yet we may need to revisit the way we think about physical activity. Although current recommendations (they vary somewhat among organizations) call for engaging in moderate-to-vigorous physical activity daily, this may not be enough to offset the effects of an otherwise sedentary lifestyle. In an integrative literature review in this issue (see "Too Much Sitting: A Newly Recognized Health Risk"), author Linda Eanes looks at studies that examined the health effects of prolonged uninterrupted sitting (sitting for 30 minutes or more) and high-volume sitting (sitting for seven hours or more each day). She writes that the studies, including several systematic reviews and meta-analyses, come to the same conclusion: "Simply put, too much sitting, with its characteristic reduced energy expenditure and absence of whole body movement, may jeopardize health even in the presence of regular exercise." She points out, however, that early evidence shows that interrupting sitting with short periods of physical activity may mitigate the ill effects.


It's easy to come up with any number of reasons not to exercise-I'm too busy, too tired, too overwhelmed with family responsibilities, or have too much to do. But we can make small changes to break up the amount of time we sit each day. Walk down the hall for a drink of water every 30 minutes (drinking more water is also a good thing); stand and pace while on a call; walk around the block before entering the building or after leaving, and, yes, use a treadmill or stationary bike, or walk in place, while watching television. These small changes can add up.


I have a new determination to change my sedentary ways. I set the alarm on my computer at 30-minute intervals, so I stand and walk about. I also bought a rowing machine and put it in front of the television at home. It's worth a try.