Recently I saw a list of the top 10 most unhealthy occupations. Terry and I were both right on the top of the list with nursing and construction. Nursing certainly comes with many risks: exposure to all manner of contagious diseases, needle sticks, lifting and transferring heavy patients, etc. It can be also incredibly stressful and exhausting. I recently made the switch from hospital nursing to home care. One of the many motivating factors is that most people say they find home care less stressful. You are in more control of your schedule and your life. Most of my new coworkers tell me they love the work and would never go back to the hospital.
What I totally didn't expect is that many of my new coworkers are out of shape. One of my coworkers, and occupational therapist, commented to me sadly, that of all the occupational therapists, only he and one other are physically fit. We of all people as health care providers ought to know better and do better!
After three weeks though, I'm starting to figure out why. We do a lot of sitting. Today my preceptor started the day with a list of five patients to see. As we started to call them before we hit the road, three of them canceled for varies reasons. We ended up only seeing two patients, and spent the rest of the day sitting around the office for four hours making phone calls, finishing paperwork, and working on the computer. Even on the days when we do see all our patients, there is all the sitting in the car while you are driving from house to house. In the past three weeks I've done more sitting than I've ever done in my life. Quite a change from my previous job where I lost 10 lbs in the first two months I worked. If I wasn't actively trying to prevent it, I'm sure I would easily gain ten lbs or more in a couple of months. Sitting is problem number one.
McDonalds is problem number two. One of the agencies policies is that you don't use the bathroom in the patient's home. Visiting nurses get to know every single McDonald's in their area. I can see how easy it could be to grab something completely unhealthy while you are taking your bathroom break. (Ice cream cones for $1 could be my downfall...they taste far better than Dairy Queen, and the price is really temping.)
When I worked in the hospital excercise was built into my day. Often I walked the hour and 10 minutes to work (I didn't want to pay the $50 per month for parking, so either Terry gave me a ride or I walked). If I didn't walk, I routinely climbed the eight flights of stairs to my unit. The hospital was so big, it took ten minutes to get to my workplace from the front door. Caring for patients kept me busy running around all day. If I sat down it was usually only for five or ten minutes at a time. Some days you simply didn't have time to eat. Sometimes if thing were a bit slow I would go walk up and down the stairs a couple of times. Most charting was done standing up. I got my exercise whether I liked it or not, and very few of the nurses who worked on my unit where noticeably out of shape.
Nurses are notorious for caring for those around them and not taking care of themselves. We were continuously warned about that in nursing school. I do at least have a couple of things going for me. I am not good at sitting still. Not only am I not good at it, it makes me feel terrible. I quickly figured out in my first week as a visiting nurse that lack of exercise makes me really, really tired and achy. At the end of that first week I can home and I came home and cried. I was so tired from doing practically nothing and hurt all over. The next week I hopped on my treadmill for 20 minutes before going to work. It is amazing what a walking a mile can do for you first thing in the morning. There is a big difference in how I feel at the end of the day when I get my mile in first thing. The few days I've skipped it, I very much regretted it. It has become part of my morning routine. As soon as I brush my teeth, I get on the treadmill, then take a shower. I'm also trying to get a mile in as soon as I get home to perk me up and help me get through the evening. I feel like I want a nap when I get home, but a walk is really what I need. Once I get off orientation and am on my own I am planning take a walk during my lunch break.
I am also a lunch packer. When I was in nursing school and in every job I've had, I've always packed my own lunch. I've always said I do it because I am cheap. I'd rather spend $1.50 on ingredients and make my own than give up $5 or $10 of my hard earned wages for food that someone else prepared. Granted in the past, what I packed was often a peanut butter and jelly sandwich and fruit (in my previous job, food that you could cram in 3 minutes or less was pretty essential!), or leftovers from last night's dinner--but in general it was certainly much healthier and definitely cheaper than Wendy's or McDonalds. As a visiting nurse I can take a full hour for lunch and not feel one bit guilty about it. What a luxury! I can pack food that you actually have to sit down and use a fork to eat. The challenge comes in that food has to be eaten cold. When lunch time comes around, we are usually far from the office and a microwave. It takes a bit of creativity to pack decent cold lunches that use healthy ingredients.
I'm determined to use a least two vegetables from my garden everyday in my lunch. Let's stay away from anything with fat and lots of calories! Cold soups are nice and I am looking for more recipes. Today I had a green soup using kale, purslane, swiss chard and lambs quarters, along with carrot sticks and homemade hummus. I've discovered that cooked greens in potato salad and egg sandwiches are pretty good. Zucchini, tomatoes, eggplant, and peppers are good in pasta salad (heavy on the vegetables please.) Green beans and broccoli are both good cold with a little bit of vinegar.
Eating healthy in this situation does take a bit thought and work. As I'm cooking dinner, I am also making and packing my lunch for the next day. It would be easier to just buy some bread and lunch meat, but them I wouldn't get the satisfaction of doing it myself and knowing that I am taking care of myself as well as I take care of my patients. I wouldn't think of cutting corners and jeopardizing my patients wellbeing. I don't want to become one of those statics that put nursing in the ranks of the top ten most unhealthy occupations. Getting enough exercise and eating well are the two most important things you can do to live a healthy life. There are enough hazards in my job already to not take care of myself!

My lunch for tomorrow...packed and ready to go. Salad from my garden with buttercrunch lettuce, baby kale, arugula, beet greens, mustard, and green beans, organic spelt bread with home made hummus, carrot and pepper sticks, and muskmelon. (Not pictured is a 6 oz container of plain, low fat yougurt--that is the one prepackaged thing I splurge on!)