Thursday September 18th 2014

The power to change

Nurse Athlete program focuses on energy management for better health

Strength training is one element of the Nurse Athlete program. Credit: The Ohio State University College of Nursing

Being healthy and fit may be even more of a state of mind than one thinks.

David Hrabe, PhD, RN, recalled a conversation he had with a trainer at the beginning of the year about the number of people working out at his gym. The trainer noted that in January the gym is always jam-packed, but by February, not so much.

Up until about three years ago, Hrabe considered himself the “poster child” of denial when it came to his health. He saw some of his own colleagues in the same cycle of having the best intentions — often around New Year’s — to exercise or eat better, but then getting caught up in many other aspects of life.

“If people don’t appreciate their health, everything else takes priority until it’s gone,” said Bernadette Melnyk, PhD, RN, FNAP, FAAN, FAANP, associate vice president for health promotion, university chief wellness officer and dean of the College of Nursing at The Ohio State University (OSU). “And according to a recent Gallup survey, nurses tend to prioritize their own health low, resulting in poorer health outcomes than physicians.”

Added Hrabe, an Arizona Nurses Association member, “In our nursing culture, we always put patients first. If we take breaks, we think it may seem as if we’re lazy. If we say we need help, we’re seen as weak. And that’s not right.”

Melnyk noted that a huge amount of money is spent on health care in this country, yet the United States ranks 37th in the world in health outcomes.

“[Unhealthful] behaviors are the biggest killers of Americans, and behaviors are not easy to change,” said Melnyk, an American Nurses Association (ANA) member. “Often it takes a crisis to happen, which then provides the emotional connection to change a behavior.”

She and Hrabe determined that it was urgent to find a way to help nurses and others make that mind-body connection before they end up facing a health crisis.

The workshop offers cardio tips and exercises. Credit: The Ohio State University College of Nursing

First, they both attended the Corporate Athlete program offered at the Johnson & Johnson Human Performance Institute. Impressed with the strategies they learned there, they ultimately teamed up with Wellness & Prevention, Inc., a J & J company, to offer the workshop for nurses through the OSU College of Nursing.

Since December 2011, 441 nurses and other OSU faculty and staff have participated in the program. Melnyk and Hrabe also both conduct Nurse Athlete workshops nationally and are working to further expand the program. They discussed the program and offered healthful tips at ANA’s HealthyNurseTM conference in June 2012.

Inside the Nurse Athlete program

The Nurse Athlete program is in different formats ranging from a four-hour introductory course to a two-and-a-half day executive program.

Workshop content focuses mainly on energy management, nutritional guidelines and physical fitness strategies, with the goal of building personalized action plans to achieve peak performance at work and at home.

For example, the nutritional component includes information on how, what and when to eat; gauging one’s hunger; and eating strategically. The movement content contains guidelines and tips on cardio, strength and flexibility training, as well as information on the effects of movement and nonmovement. Participants also engage in specific exercises and are introduced, or reintroduced, to equipment at the gym.

What differentiates the Nurse Athlete program from others, Melnyk believes, is the energy management component. Many programs talk about boosting energy through exercise and behavior modification techniques, she said. The OSU program provides participants with positive, emotive strategies, such as journaling, storytelling, establishing rituals and creating a mission, which can better motivate them to be more engaged in their own health.

Energy management and physical fitness strategies help participants become healthier. Credit: The Ohio State University College of Nursing

The program requires participants to think about what is important to them through a values assessment, Hrabe said. It helps people examine what has contributed to their health going off course, and how to get realigned so they have the energy and commitment to be more engaged in leading a healthier and more productive life.

“That’s what powers behavior change,” said Hrabe, executive director of Academic Innovations and Partnership at OSU, associate professor of clinical nursing and Nurse Athlete program director.

Dan Weberg, PhD, RN, participated in the inaugural Nurse Athlete workshop at OSU. At the time, he noticed that he was feeling tired and less motivated to exercise, and spending less time with his family than he wanted.

“What I learned about energy management was very useful to me,” said Weberg, who now is using that training to help his colleagues in California. “I learned how to reframe my day so I have enough energy. The program also helps you weed out stressors, figure out how you make choices in life and work, and then make sure that [your choices] align with the goals you want in your personal and professional lives.”

Beyond the energy management component, another simple yet effective strategy that has stuck with Weberg centers on eating habits. During the workshop he learned how to measure appropriate food portions by using one’s hand as a guide.

Parting words to get started

In terms of a broad goal, Melnyk emphasized the importance of developing a culture and environment of wellness in the workplace. For example, she and her wellness team are currently working with 300 wellness faculty and staff innovators across OSU to create healthier workplaces, including having meetings in which people stand instead of sit, and placing treadmills and standing desks throughout campus buildings. By creating a culture and environment of wellness, Melnyk states that OSU is making the healthy choice, the easy choice.

Hrabe urged nurses to advocate for the creation and implementation of workplace wellness committees that can address issues, such as the importance of taking breaks and having access to healthy food choices.

Both Melnyk and Hrabe stress getting started toward better health by making one small change, be it taking the steps once a day instead of the elevator, eating one piece of chocolate and not two, or stopping to think about what really “needs” to get done in a given day or week.

Said Hrabe, “Small, incremental change can make a huge difference [in becoming healthier].”

For more information on the Nurse Athlete program, go to www.healthathlete.org.

— Susan Trossman is the senior reporter for The American Nurse.

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