Nurses as Role Models in Promoting Healthy Lifestyle

Nurses as Role Models in Promoting Healthy Lifestyles

Problem Statement

Lifestyle diseases caused by obesity and smoking are preventable. However, mortality rates resulting from lifestyle diseases continue to increase annually. Diseases such as lung cancer and heart attacks caused by smoking and obesity claim the lives of many people not only in the United States but also across the globe. According to the Centers for Disease Control and Prevention (CDC), smoking leads to premature deaths and reduces life expectancy among smokers by up to 10 years. It also estimates that tobacco-related mortality rate among adult Americans’ firsthand and secondhand smokers stands at 480,000 per year. This is because smoking increases chances of suffering from lung cancer and ventricular arrhythmias among other respiratory and vascular diseases and cancer. This is in addition to the high-cost medical services associated with tobacco smoking-related conditions (CDC, 2016).

In 2008, the U.S. spent an estimated $147 billion in medical cost for Americans with obesity which represents 36 percent of the American population. The medical cost for individuals suffering from obesity-related conditions such as stroke, cancer, and ventricular and vascular diseases among others during the same period was estimated at over $1,400 per individual above the amount paid by non-obese individuals. It is estimated that obesity, depending on the severity, reducing life expectancy by up to 20 years. This is in addition to the thousands of obesity-related deaths annually (CDC, 2017).

Despite these worrying trends, the CDC posits that focusing on healthy behaviors is critical in reducing these preventable deaths and costs. Behaviors such as physical activities and quitting smoking can reduce these costs while decreasing the trends. Others include limited intake of alcohol and healthy eating practices (CDC, 2011). Healthy behavior change is critical in tackling these health problems with far-reaching economic and social implications. And with many research studies showing that healthcare professionals are critical in promoting health, it is therefore critical that nurses be at the forefront towards this end as role models (Cipriano, 2013; Popplewell, 2006). The impact they can have towards this end is enormous because they form the largest group in this professional field.

Uniquely positioned, nurses can play this critical role through a variety of ways including participating actively in the development of effective, healthy living models and shaping the values of the society they live in. Other contributions of nurses as role models for healthy living include health education, participation in health policy development and teaching. They can play these important roles despite studies showing that they do not believe they can serve as role models for healthy behaviors among the population. Therefore, there is need to facilitate this role modeling capacity of nurses when it comes to promoting healthy behaviors and tackling obesity and smoking.


Smoking and obesity affect the quality of life while also reducing life expectancy. They cost the federal and state governments billions of dollars annually in medical costs. In addition to the economic cost associated with these conditions, they also lead to deaths of hundreds of thousands of Americans annually. One of the primary shareholders of this problem is the federal and state governments which incur the medical cost associated with smoking and obesity. These unhealthy behaviors lead to poor quality of health that extends beyond firsthand smokers. Smoking and obesity also reduce the quality of health of secondhand smokers too. Also, having nurses who do not embrace their role modeling capability towards tackling smoking and obesity significantly increases the cost associated with the health problem annually.

Nurses, who are set to play even a bigger role in tackling this problem as role models of healthy behavior, are also shareholders. To effectively serve role models, nurses require an enabling professional environment founded on policy, culture and work setting. Therefore, policymakers and healthcare facilities administrators and leaders are also shareholders in tackling the problem. Such an environment will ensure that nurses, as role models, will be given the required resources to educate the public on healthy behaviors. They can also create awareness on healthy living. It will also enable the nurses to actively participate in the development of public health policies geared towards promoting healthy living especially among smokers and obese individuals. Smokers and individuals suffering from obesity are also shareholders in this problem. Their life expectancies reduce manifolds in addition to increased mortality rate. While as role models nurses are expected to influence and change societal values, the primary target population they will need to influence are smokers and obese individuals whose lives are on the line.

Background Information

Smoking and obesity are some of the leading causes of deaths globally. Obesity is associated with several co-morbidities. Studies have shown that obesity increases the risk of suffering from type 2 diabetes mellitus. A study conducted by Hartemink et al. (2006) established that the risk of suffering from type 2 diabetes mellitus increases by 100 percent for individuals with a body mass index (BMI) range of 27.2 to 29.4. The risk increases by up to 300 percent for individuals with a BMI of over 29.4. According to Riobo (2013), type 2 diabetes mellitus is associated with long terms health complications such as stroke and other vascular diseases such as hypertension and a trial fibrillation. These long-term complications are also associated with high mortality rates among individuals suffering from obesity. Other conditions associated with obesity include obesity-hypoventilation syndrome, chronic kidney disease, and nonalcoholic fatty liver diseases (NAFLD) such as liver cirrhosis and fibrosis among others (Loomba & Sanyal, 2013). Mu et al. (2012) also established that insulin resistance associated with type 2 diabetes mellitus also increases the risk of endometrial cancer, while other studies establish a link between breast cancer in the obese post and pre-menopausal women (Chan et al., 2014).

Narbro et al. (2002) established that over a half of individuals living with obesity were taking medications due to increased risk of diseases compared to over a third of the rest of the population under observation. Obesity also impairs physical functioning and associated musculoskeletal problems such as osteoarthritis, pain and postural and gait problems (Peltonen, Lindroos & Torgerson, 2003). Other problems associated with obesity include depression, low self-esteem and increased mortality rates (Flegal et al., 2005). According to epidemiological studies, cigarette smoking is one of the leading causes of mortality and morbidity in both developed and developing countries. It is estimated that tobacco smoking, directly and indirectly, caused the death of up to 100 million individuals globally in the 20th century at the height of the practice (White, 2007). Projections for the 21st century show that figures are bound to increase.
Other similar studies have also shown that smoking increases the risk of coronary heart disease which is associated with high levels of mortalities among firsthand and secondhand smokers and tobacco inhalers and chewers. Other diseases associated with tobacco exposure include ischemic heart disease, atherosclerosis, tuberculosis, chronic obstructive pulmonary disease, and cancer. According to CDC, tobacco smoking not only increases the risk of these diseases; it also increases the risk of dying from these diseases. In addition to health problems, smoking has economic implications. Tobacco and obesity-related co-morbidities and mortalities can be prevented through lifestyle or behavioral changes, which can be spearheaded by nurses as role models dedicated to changing and influencing societal values.

Nurses offer critical services within the healthcare sector. Their large numbers in the sector mean that they are at the forefront of important healthcare initiatives in any country or jurisdiction. This includes implementation of policies and industry and facility standards. One area within the profession whose ideologies and concepts have continued to generate conflicting research results is the role of nurses as role models of healthy behaviors. A study by Rush, Kee and Rice (2005) on how nurses serve as imperfect health promotion role models established that nurses reacted indifferently to the concept. Other nurses had a negative perception of the term and held that they were driven by professional expectations and guidelines and not societal anticipations of what their role encompasses. However, other nurses interviewed during the qualitative research noted that societal expectations in their duties also guided them. As role models, the nurses held that the term ought to humanize them. In return, these nurses were expected by the society to value the health of the society and self-reflect on the impact they can have in the society. Other authentic representation parameters, as the nurses pointed out, included accepting the blemishes of the society. This is in addition to their professional obligations (Rush, Kee & Rice, 2005).

Other studies have provided some of how nurses can serve as role models in promoting healthy behaviors. Darch, Baillie, and Gillison (2017) outlined several fundamentals avenues through which nurses can serve as role models. One avenue is becoming champions and symbols of healthy living and wellness. Others include being non-judgmental and knowledgeable and innovative when it comes to healthy living and highly motivated. Nurses should also have a positive image of themselves (Darch, Baillie, & Gillison, 2017). However, a study conducted by Kelly et al. (2016) showed that practicing and student nurses perceived the societal and professional expectation that they can be role models for healthy behaviors as unreasonable. The study noted that the nurses perceived such expectations as unrealistic.

Narrative Summary

To effectively perform as role models of healthy behavior and help in reducing the mortalities, morbidities, and costs associated with smoking and obesity, it is imperative that such societal expectations are framed within the human context. Rush, Kee, and Rice (2005) established that nurses were more willing to embrace the role model idea if the society humanized it. These findings were also corroborated by Kelly et al. (2016) which established that despite the fact the practicing and student nurses terming the expectations unrealistic, they noted that nurses ought to be perceived as humans. Therefore, changing the perception of nurses to accept the role modeling perception of the society requires first changing the expectations of the society towards the same.

In Darch, Baillie, and Gillison (2017), it was established that being knowledgeable and innovative was key personal attributes required for nurses to serve as effectively role models of healthy behaviors and consequently help in curbing mortalities and morbidities associated with smoking and obesity. Therefore, it is imperative that nurses are equipped with the prerequisite knowledge on interpersonal skills, and obesity and smoking. This will build their self-confidence and self-image which the study established were also critical in being nurse role models (Darch, Baillie & Gillison, 2017). As role models, nurses can only effectively be exemplars and champions of something they understand properly.

Moreover, they can only teach and educate the public on healthy living and the dangers of obesity and smoking if they can internalize the knowledge and the ideas through proper training and availing of required materials. Besides, developing the nurses’ knowledge base on these health problems is critical in ensuring that they actively participate in the designing, monitoring and assessing of these healthy behaviors parameters and indicators. Policy development, which is also part of being role models calls for the development of nurses’ knowledge base on the problem and their role in curbing them.

A 2013 study by Kemppainen, Tossavainen, and Turunen on the role of nurses as health promoters established that various challenges at the organizational level face effective health promotion by nurses. Nurses’ health promotion competencies and expertise were hampered by organizational culture (Kemppainen, Tossavainen, & Turunen, 2013). Therefore, for effective delivery of this role in modeling expectation, there is need to realign organizational cultures towards promoting such expertise and competencies.


Smoking and obesity are health problems associated various morbidities and mortalities annually. The government spends billions of dollars annually on medical costs to cater for the needs of individuals affected by these problems. Obesity and smoking are associated with diseases such as cancer and various heart and liver diseases as well as psychological and physical problems including depression and movement. However, these morbidities, mortalities and economic losses are preventable through behavioral changes. Studies have shown that adoption of healthy living practices including physical exercises, quitting smoking, and healthy eating practices can go a long way in preventing these problems.

Health practitioners, due to their closeness to the patients and professional profile, can influence healthy behavioral changes that can help in stemming the widespread smoking and obesity in the globe. One of the largest professional groups with a huge potential of influencing these healthy behavioral changes is nurses. Nurses provide critical services in the sector which, if tapped efficiently, can extend beyond the professional expectations. In addition to their professional role as caregivers, nurses can also serve as role models of healthy behavior promotion. It is a role borne out societal expectations and founded on their professional duties. However, the ingraining of such a concept within nursing practice has been met with skepticism with some nurses terming such societal expectations as unrealistic. Moreover, the lack of enabling organizational culture has also hampered such efforts.

Therefore, it is imperative that health promotion in role modeling capabilities are promoted from a multidimensional perspective that targets various stakeholders involved in the problem. Changing the public perception of such roles and realigning organizational cultures can improve the effectiveness of nurses’ health promotion and role modeling. This will also improve their competencies and interpersonal skills as role models.




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