Analysis

Nurses and unhealthy eating: is your job putting you at risk?

Poor diet and disordered eating patterns can become habit for nurses lacking the time or space to enjoy proper meals or healthy snacks in the workplace

Obesity and other health risks increase if you work long hours without breaks, and lack the space and time to enjoy healthy meals. Here's how to make improvements

  • Too often nurses have no time for a break, never mind the headspace for meal planning – and that’s when disordered eating can become an unhealthy habit
  • Find out what steps your employer can take to help you maintain healthy eating patterns at work and at home
  • Practical, realistic tips about how to keep your best intentions for healthy eating on track

Skipping meals during long shifts, grabbing take-aways on the way home and craving sugary treats are likely to be familiar experiences for many

Obesity and other health risks increase if you work long hours without breaks, and lack the space and time to enjoy healthy meals. Here's how to make improvements

  • Too often nurses have no time for a break, never mind the headspace for meal planning – and that’s when disordered eating can become an unhealthy habit
  • Find out what steps your employer can take to help you maintain healthy eating patterns at work and at home
  • Practical, realistic tips about how to keep your best intentions for healthy eating on track
A nurse lying on a sofa after a shift, eating pizza from a box
Picture: iStock

Skipping meals during long shifts, grabbing take-aways on the way home and craving sugary treats are likely to be familiar experiences for many nurses.

A survey by Nursing Standard found almost six in ten respondents are turning to unhealthy and disordered eating as a result of work-related stress. Almost half (46%) of the more than 1,200 respondents said work pressures made them overeat, while 10% said they undereat.

46%

of more than 1,200 survey respondents said the pressures of working made them overeat

Source: Nursing Standard health and well-being at work survey 2021

How lack of time can make healthy eating habits feel too hard to manage

As an overstretched workforce, nurses can find shopping for food and eating healthily difficult. Long, stressful shifts lead many to eat poorly, with one nurse saying they binge-eat because of stress.

Another may speak for many when they say they turn to chocolate. A further respondent said they end up comfort-eating ‘wrong things or quick things’.

Weight problems are common among nurses – a study published in BMJ Open found that one in four nurses in England is obese.

‘There is a tendency to reach for quick energy fixes when the chance to eat finally comes. It is important nurses are supported to break these patterns’

Duane Mellor, dietitian

As nurses know all too well, body mass index of 30 or more can lead to a number of serious and potentially life-threatening conditions, including type 2 diabetes, coronary heart disease, some types of cancer and stroke. It can affect quality of life and lead to depression and low self-esteem.

Worryingly, one survey respondent said work-related stress had led to bulimia, while some simply feel too exhausted by work to eat.

‘Often if a shift has been extremely busy, I come home and go straight to bed, missing out on a meal. I feel too tired to even care about eating,’ one nurse told the survey.

A nurse exhausted after a busy shift, contemplating cooking
When you are exhausted after a busy shift, cooking may be the last thing you want on your plate Picture: iStock

Another said: ‘I cannot eat when I am stressed, which is not really helping, so I have to force myself to eat and sometimes [this] is unsuccessful.’

For others, stress causes a cycle of events that affect their eating and overall health. One nurse described how stress exacerbated their rheumatoid arthritis and diminished their appetite.

Nursing Standard podcast: Stress relief for busy nurses

Impact of disrupted eating patterns on health

These poor eating patterns could be storing up trouble for nurses’ future health, says Duane Mellor, dietitian and senior lecturer at Aston University medical school.

‘When we are busy, eating healthily can often slip down our priorities,’ he says. ‘However, to eat a healthy diet, which supports both physical health and general well-being, it helps to have a regular meal pattern.

There needs to be support from managers, backed up with robust guidance, to support staff to take breaks’

Kerri Fleming, clinical services manager at eating disorders charity Beat

‘Not having a healthy diet can lead to a range of health issues. But in the short term, perhaps it is more important to consider how a hectic working pattern, particularly shifts, can lead to an unhealthy relationship with food.’

10%

of survey respondents said workplace pressures made them undereat

Source: Nursing Standard health and well-being at work survey 2021

Nurses may need protected meal times, in the same way hospital in-patients do, he suggests.

‘Instead of being able to enjoy healthy food, there is a tendency to look at food as a fuel, often reaching for quick energy fixes when the chance to eat finally comes. It is important that nurses are supported to break these patterns.’

Changes to improve diets involve some time and commitment, says Dr Mellor. ‘There are no magic fixes,’ he says. ‘Planning is the key, and trying to get regular meals.’

Tips on improving your eating habits

A nurse in uniform putting a homemade meal into their bag to take to work
Picture: iStock

Advice from Duane Mellor, dietitian and senior lecturer at Aston University’s medical school:

  • If possible, plan When food is not easily available at work, try to bring your own
  • Think beyond sandwiches Consider homemade soups, which help to increase your vegetable consumption, lentils or beans to add protein, fibre and some iron, and salads made with pasta, potatoes or rice
  • When you can’t take a full break getting at least ten minutes to refresh and refocus is important. Take this time to eat and refuel
  • Breakfast in a hurry? Porridge or muesli with seeds and fruit can be filling and give a steady energy release
  • If a snack is what you need a fruit bowl could be an option, if there are enough people to join in and ensure the fruit is eaten while still fresh
  • Cook a little extra, so one healthy meal becomes two Leftovers are good for lunch and dinner. Cook a little more pasta and make a pasta salad with peppers, chickpeas, a little cooked meat and a simple dressing of olive oil, torn basil and white balsamic vinegar
  • Don’t forget to hydrate Although tea and coffee can help keep you going, remember to drink water too
  • Try not to depend on energy drinks They are likely to be a short-term fix and the caffeine can disrupt sleep
  • When you’re ordering a takeaway look for healthier options with less fat – oil, cheese and fatty meats – smaller portions of rice, chips and bread, or go for a side portion rather than a main course

Even if you have time, is there somewhere you can go to eat?

Finding a space to eat can be difficult too, the survey found.

Fewer than two thirds (63%) of respondents had an area to eat while at work, and many reported having to eat in their car or at their desk – when they did get the chance for a meal.

‘There is a vicious circle where short-staffing prevents people from getting breaks, meaning they can’t look after themselves’

Lewis, second-year nursing student with history of anorexia

One nurse said they sometimes had to sit eating in a corridor due to a lack of space, while another pointed out that nurses in their area often worked 12.5-hour shifts without a break at all.

A lack of hot food was also an issue, with canteens often shut, even in larger hospitals.

‘Our canteen closes at 2pm and doesn’t open at all on weekends,’ said one respondent.

Closed shutters on a hospital canteen during a night shift
Closed shutters at the hospital canteen can be a dispiriting sight for staff working nights Picture: iStock

37%

of respondents to our survey had no access to an area to eat at work

Source: Nursing Standard health and well-being at work survey 2021

Workplace pressures that can lead to disordered eating

Mental health nurse Kerri Fleming, who is clinical services manager at eating disorders charity Beat, says our survey findings suggest worrying eating habits are becoming normal for many nurses.

‘While the kinds of things talked about in the results will not be an eating disorder, it is disordered eating, which is not healthy,’ she says.

‘I worked for years on wards and I can understand this. Nurses can work long days without a break or may not have access to a staff room to eat their lunch. This can lead to some binge-eating later on, or not eating as they are so tired.’

The complexity of eating disorders and the role of stress in triggering episodes

Eating disorders are estimated to affect around 1.25million people in the UK, according to Beat. A number of survey respondents said they had bulimia, or binge-eat.

For those affected, work stress can be a contributory factor, says Ms Fleming.

‘Eating disorders are complex, it is never just one factor. But research has shown that as people are recovering from an eating disorder, and getting back their lives, stress can can cause them to go backwards.’

What nurses’ employers can do to stop disordered eating becoming normalised

Employers need to consider the well-being of their nursing staff and make changes that support healthier eating, says Ms Fleming.

‘In the longer term, there needs to be work around staffing issues so that nurses can get their breaks and have adequate rest and time to eat,’ she says. ‘In the shorter term, there are things employers can do. Having representation from all levels of nursing staff when decisions are being made, and regular open discussion to make sure their suggestions are taken seriously, is important.

‘Having well-being leads and groups, along with support from managers to attend them, can help. There needs to be support from managers, backed up with robust guidance, to support staff to take breaks.’

I have history of anorexia and I can spot disordered eating

Lewis is a second-year nursing student who had anorexia in his early twenties.

Now in his mid-thirties, he worries about how to eat well as a nurse. In his experience on placement and working as a bank healthcare assistant in a hospital, he has seen staff frequently miss breaks and how unhealthy habits can creep in.

‘I sometimes find I end up bingeing on sugar, and having treats all day. But we can’t survive on biscuits,’ he says.

Long nursing shifts back to back don’t make sensible eating easy

Long shifts close together can be particularly challenging when it comes to making healthy food choices.

‘When I was doing two long back-to-back shifts recently, I got home at 9pm on the first day, I was too tired to make dinner and just went to bed,’ he says.

‘Then I was back into work at 7am and did a 14-hour shift. I hadn’t had breakfast and just had a snack at 11am, by 5pm I was shaking and my head was spinning.’

A nurse looking at a hospital vending machine full of sugary snacks
Sugar can feel like a quick fix when you are busy and tired Picture: iStock

How we fuel ourselves is so important

Lewis says he is keenly aware of the dangers of disordered eating, in light of his own experience.

‘I was working as a hairdresser at the time, I wasn’t living at home, or looking after myself very well, and when I skipped meals and lost weight, I noticed people started complimenting me. It escalated into an eating disorder.

‘There is a vicious circle where short-staffing prevents people from getting breaks, meaning they can’t look after themselves, potentially making them unwell and burnt-out,’ he says.

‘How we fuel ourselves is so important. I want to be part of changing that culture, so that we get breaks and can eat properly.’

Survey method

When Nursing Standard asked nurses to share information about their health and well-being at work:

Nursing Standard well-being centre


Further information and support


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