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Use it or lose it: Physical fitness for nurses

Mutai Josphat [BScN]

Susan Kyalo [BScN, KRPN]

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Introduction

Chronic lifestyle-related diseases account for most deaths today, with cardiovascular disease the leading cause of all deaths
sedentary lifestyle contributes to development of cardiovascular disease

Why physical fitness?

More than a decade ago, experts concluded that medical science has done all it can for people with chronic lifestyle-related diseases and that additional healthcare expenditures wouldn’t bring the financial benefits that would accrue if Americans improved their health simply by being more physically active.

Baseline research data for nurses

no recent studies on the fitness status of nurses
To date, 25 nursing students have participated in fitness assessments, including a 1.5 mile walk-jog-run used to predict maximal oxygen consumption (VO₂ max)
The average time the students took for the 1.5-mile run was just over 18½ minutes, which corresponds to a VO₂ max of 29.2 mL/kg/minute. Based on norms published by the American College of Sports Medicine (ACSM), this average VO₂ max ranks poorly—between the 10th and 20th percentiles.

Why should nurses improve their fitness?

nurse you must provide an established standard of care, and sometimes this means you need to have at least a minimum level of physical fitness.
Better overall fitness will improve your ability to effectively perform the physical tasks you do every day, such as assisting and transferring patients, transporting equipment, or simply walking to your assigned patients throughout a shift.
One study of 146 RNs over a 12-hour shift found they covered an average of 4 to 5 miles per shift.

Nurses as role models

Being a good role model is another reason to improve your fitness.
You can be a more positive influence on patients if you’re making the lifestyle choices you’re recommending to them.

Training guidelines

The American College of Sports Medicine [ACSM] has established guidelines for promoting health through physical activity for cardiorespiratory and musculoskeletal components of fitness.
For cardiorespiratory fitness, the organization recommends doing activities you can sustain for a prolonged period, such as walking, jogging, stationary cycling, rope jumping, and rowing. Try to engage in these activities 3 to 5 days weekly for 20 to 60 minutes per session, monitoring your exercise intensity through heart rate.

How to monitor intensity of an exercise

Heart rate reserve (HRR) is the difference between the maximum heart rate (HRmax) and resting heart rate (RHR).
According to ACSM, an exercise intensity ranging from 40% to 85% of HRR is necessary to cardiorespiratory fitness, depending on fitness levels.
If you haven’t exercised regularly in more than 6 months, start at the lower end of the range (40% to 60%).
If you have been exercising regularly, you can more comfortably exercise at the higher end (60% to 85%).

Estimating maximum heart rate

If you’re deconditioned or in poor physical condition, start at a lower exercise intensity.
For many nurses who haven’t exercised on a regular basis for a few months or longer, 40% to 60% of HRR may be a realistic starting intensity.
The goal of exercise is to expose the body to an overload stimulus in a safe manner.
With appropriate rest and recovery, the body will improve in strength, endurance, or efficiency in the activity that caused the stimulus

Aim for overload, not reversibility

According to the principle of overload, when demands are made on body systems that these systems aren’t used to, instead of becoming weaker, the systems get stronger—given appropriate nutrition and recovery time. That’s the objective of cardiorespiratory training.
Conversely, the principle of reversibility states that physiologic gains are lost when the load against which a system works is reduced. This is better known as “Use it or lose it.”