HealthMay 06, 2020

Nurses and self-care: Factors influencing healthy behaviors during COVID-19

Covid-19 has created an unprecedented demand for nurses at the bedside. Caring for the infected is particularly stressful, especially since our understanding of the virus evolves almost daily. As a result, many nurses report feelings of anxiety, guilt, and conflict when performing their duties.

These factors each have a role in a nurse’s ability and desire to practice self-care. And even though nurses are trained to help their patients live more healthfully, they often neglect their own health in the process. Prior research has already detailed unhealthy eating and exercise habits common among the healthcare workforce, but there isn’t a good understanding of why nurses may avoid health-promoting activities.

Analysis of the factors preventing adequate self-care among nurses, especially in the context of the Covid-19 pandemic, is the first step toward a more healthful workforce. Understanding these factors can help promote healthy behaviors and direct future nursing practice.

Themes among barriers to healthy behaviors

Recent research published in Advances in Nursing Science examines several factors that limit or prevent nurses from participating in any number of self-care activities, such as maintaining a healthy diet and exercising regularly. A review of 26 other research studies showed a variety of situational barriers to healthy eating in the workplace, including:

  • Circadian rhythm disruption and fatigue
  • Inadequate storage for healthy, home-cooked meals
  • Long working hours
  • No availability of fresh food

Many of these factors, such as long working hours and fatigue, also influence a nurse’s decision to exercise outside the workplace.

Through an online survey, study authors identified five themes preventing many nurses from participation in self-care:

  1. No time and overwork – The most cited barrier to self-care activities, most nurses involved in the study reported a lack of time available for participation in healthy habits. In many cases, overwork was correlated with poorer health outcomes—and many nurses report being profoundly overworked managing the COVID-19 crisis. Nurses also reported that long commutes to work, unpredictable hours, workload, the pace of work, and inadequate staffing all hinder health-promoting behaviors at home.
  2. No facilities or resources – Over 25 percent of nurses involved in the study mentioned that their workplace provided no access to a gym, exercise classes, or showers and changing facilities. Additionally, many reported that their employers did not provide refrigerators or microwaves for storing and reheating home-cooked meals.
  3. Fatigue – Another quarter of participants noted they were too drained and exhausted to exercise and cook healthy food. Instead of finding the motivation to make healthier decisions, many nurses used their days off to simply recuperate from work.
  4. Other commitments – Almost 50 percent of nurses involved in the study reported outside commitments which interfered with their ability to live more healthfully. Family responsibilities, community activities, and school were all responsible for a lack of down time among nursing staff.
  5. Unhealthy food culture – For some nurses, their workplace only offered expensive and unhealthy foods in institution cafeterias. Additionally, an unhealthy food culture on the floor contributed greatly to many nurses’ unhealthy food decisions.

Self-care techniques for nurses during the Covid-19 crisis

Fortunately, the study also identified ways to encourage nurses to adopt healthier eating and exercise habits so they can best care for their patients. Many nurses involved in the study reported that their peers and managers offered support and help for adopting healthier practices, especially on the front lines of the pandemic. From going on walks together during breaks to sharing healthy snacks, positive role models can be instrumental in the adoption of healthier habits.

The American Psychiatric Association also highlights several techniques to reduce stress and increase self-care activities during the pandemic, such as eating foods which fight inflammation, scheduling time for self-care activities like exercise, and creating supportive connections with colleagues also working on the front lines.

Since nurses must be healthy to properly care for COVID-19 patients, it’s especially important to find ways to support healthy decision making in the workplace. Making good food decisions and exercising can help mitigate feelings of inadequacy, guilt, and anxiety, which in turn helps nurses deliver better patient care.

Lippincott Solutions note: for the latest coverage on COVID-19 by the Lippincott Nursing team, please visit

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