16. Do we practise what we preach?
Matter for discussion submitted by the RCN East Dorset Branch
That this meeting of RCN Congress discusses whether nurses are good role models to their clients when it comes to health-related behaviours
Report on this discussion
BJ Waltho, Chair East Dorset Branch, introduced a lively matter for discussion "Do we practice what we preach" where delegates debated lifestyle choices including smoking, weight and alcohol and how practitioners' attitudes to these impact on patients' perceptions. BJ asked if nurses are being hypocritical when they ask patients to change their lifestyle while continuing their own unhealthy practice. She called for research to identify the reasons behind nurses’ unhealthy lifestyle and employers to invest in their staff by allowing access to healthy choices in food and fitness initiatives as well help with smoking cessation etc.
Supporting voices included Marcelle DeSousa who told of a friend who was being treated for cancer who was so upset by her oncology nurse who ‘stank of smoke and whose fingers were nicotine stained’ that she asked for a different nurse to treat her.
Support was countered with caution, Charlie Sloan asked for nurses to retain their right to choose how they live their life and Kevin Takooree from Greenwich branch asked for nurses not to be turned into ‘health gods’ because he is ‘only human’. David Harding Price asked for the issue to be looked at sensibly as he does not feel his ‘one failing makes him a bad role model’.
Background
It is becoming increasingly apparent that the increase in unhealthy lifestyles across the UK is placing an unnecessary burden ― one that is unsustainable in the long term ― on the NHS. The government has made it clear that the NHS needs to focus on disease prevention as well as treatment. In his speech, given on 7 January 2008, Prime Minister Brown stated: “The NHS of the future will do more than just treat patients who are ill ― it will be an NHS offering prevention as well” (Brown, 2008). In addition to outlining a commitment to enable a greater number of physical activity programmes and incentives to be prescribed on the NHS, Gordon Brown also made it clear he was seeking an agreement on a simple, single labelling system for food to help tackle obesity.
Across the UK, obesity rates amongst adults and children are rising. Projections indicate that nearly 60 per cent of the population will be obese by 2050; in other words, two out of every three of the population will be defined as ‘overweight’. Increasingly, people across the UK are suffering from ‘lifestyle diseases’, and NHS organisations will have to re-orient their services to do more to help people prevent ill-health, and to work with employees to reduce work-related sickness. They will have to support nurses to change any of their ‘unhealthy’ behaviours so that they are better placed to work positively with their patients. This will enable nurses to challenge, rather than be compromised by, patients’ smoking, alcohol consumption, lack of exercise or poor diet.
Organisations have a duty of care to their employees to promote healthy lifestyles at work. Both the NHS and independent employers have a role in supporting healthy behaviours amongst their employees, providing educational materials as well as supporting physical activity and smoking cessation programmes. In 2008, NICE began working on the development of public health guidance that will support nurses and organisations to implement brief interventions that encourage physical exercise in the workplace. Indeed, public health policy across the UK has identified the potential of the health professional to improve and promote health, by virtue of the 1.5 million people who have contact with the NHS every day.
The RCN regularly conducts membership surveys to gauge the health and wellbeing of its members; indeed the findings of its 2005 survey (RCN, 2006) highlighted the fact that nurses leaving the NHS are much more likely to mention stress and workload as contributory factors for changing jobs. In 2005, in support of the Health Challenge Wales initiative, RCN Wales implemented its Nurses as role models for health campaign. Every health trust in Wales participated, nominating nurses that successfully made healthy changes to their lifestyle for an award. Recent initiatives aimed at improving the working lives of nurses looked to both recruit and retain nurses, particularly the newly qualified and the more experienced groups. Enabling nurses to take more care looking after their own health will enable them to become better role models for those who come into contact with them in a care setting.
References and further reading
Brown G (2008) Speech on the National Health Service, London: 10 Downing Street. Available from: www.number-10.gov.uk/output/Page14171.asp (Accessed 17 January 2008) (Internet)
Royal College of Nursing (2006) At breaking point? A survey of the wellbeing and working lives of nurses in 2005, London: RCN. Available from: www.rcn.org.uk/publications