Dear Nurses,
My name is Lauren D Kagan and I wanted to share my personal struggles & success story of becoming a professional fitness model all while working a stressful night shift nursing job. Both my peers & personal training clients have asked me countless times how I did it, how I dealt with all the struggles related to working as a nurse, while working night shift, while having a "life" or being a spouse or etc. How did I find the time to work out, how did I keep my diet on point, how did I deal with stress at work or unhealthy temptations? Well, here is how I did it - and I hope many of you can relate to my own experiences.
I have been a registered nurse for almost 9 years now. I have been in healthcare since I was 15 years old working as a secretary, a telemetry technician, a CNA, and eventually I graduated with my BSN in nursing. When I turned 21, I started working as a RN on a medical/surgical telemetry floor and fell in love with Cardiology. I went on to work on a cardiac step-down unit learning some very advanced cardiac technology and skills such as how to manage patients with L-VAD (left ventricular assisted device that does the heart pumping even if the patient is in a V-fib electrical rhythm). I cared for cardiac/cardiothoracic surgery patients for about 7 years when I decided to expand my knowledge and skillset to the RN Float position. I am ACLS/AED certified and have been for 8 of my 9 years of nursing. I have worked every shift: days, evenings and eventually settled for nights. I have worked as a charge nurse on all the units I've worked on including when I floated. I wanted to share my story of how my nursing career led to a lot of stress in my life and how I decided to overcome it. I wanted to improve my physical health, my energy levels, aesthetics and overall happiness.
When I turned 28, I was faced with several life decisions: do I go back to school to advance my nursing career? Do I go on to start a family with my husband whom I have been married to for a year? Do I continue to work full time night shift for years to come? Do I succumb to the natural stresses and influences that my job generates? I decided my priority became my health and my physical wellbeing. I noticed all too often that the "life of a nurse" seemed to have somewhat of popular tendency: go to nursing school (where oftentimes health and stress management takes a backseat), find a job (with ANY shift or ANY floor you can find), settle down (with your significant other), advance career further (become a PA, APRN, etc) and/or start a family. This pattern generally did NOT include making health a priority for the nurse. Instead, I witnessed myself and my fellow nurses stressed, overworked, with little to no time for breaks, malnourished, working long hours on very little sleep, low energy levels and making tons of bad food decisions given the circumstances and work environment. I, myself, fell victim to all of the above and woke up one day feeling like I was on a downward spiral. I was extremely stressed, unhappy with my daily diet choices, my physical appearance and everything else you could think of. Mind you that during all of this I was still considered a very "active" and healthy person by many. I mean I had run three Spartan Races, 2 Tough Mudders, multiple 5Ks and I did CrossFit for some 3 years even partaking in a few local competitions. Even though many saw me as being strong & fit, I was far from "healthy". Over the years I had made little to no improvements to my eating habits, stress management, sleep schedule, portion control or etc. I was simply working out to try and offset all the poor decisions I was making on the daily; and it had finally caught up with me. During the holiday season alone I gained some 12lbs. I decided I needed to make some serious lifestyle changes.
I wasn't sure where to start, so I just made a move: I signed up for a fitness competition where I would be "forced" to adhere to a strict workout regimen and diet given that I would be stepping on stage in a bikini in front of hundreds of people in just 14 weeks. So I got a regular gym membership 2 miles from my house, a fitness coach and started my journey. My coach told me I was going to have to eat my meals every 2-3hours a day (5-6 meals a day). I learned pretty quickly the only way to eat my prescribed meals daily, was if I had "meal prepped" prior (cooking large batches of chicken/fish, sweet potatoes, veggies, quinoa, couscous, etc) and packaging them in Tupperware, storing them in the fridge with date labels, and packing them with me for work. Since I worked 3 12-hour night shifts, I decided to divide my day up strategically, on how to get all 5 or 6 of these meals eaten. I usually set my alarm for 3-4pm (if I had worked night shift prior), Ate meal 1, went to the gym, weight trained for 1.5 hours, came home, showered, changed, ate meal 2, packed meals 3-5 with me, and headed off to work the night shift. Most nurses are allotted two "15 minute" breaks, one "lunch" or 30 minute break; but we all know how little of that time we actually get to ourselves. I decided to give myself several options: Since all of my meals were packed, all I had to do was heat one up and eat it, which never took more than 15 minutes. I didn't always eat exactly 3 hours apart, but the main goal was to get the meals in, so I made time to eat my meals while charting, one meal on my lunch break, eat another while charting later, or on my "15 minute" break.
Because it was crucial to achieving my body composition goals (increased lean muscle mass, and decreased body fat) and I noticed how the small frequent meals started to give me so much energy, so I stuck religiously to this schedule. Mind you, I was doing all of this while working as a "float" RN. I had to carry my 3 meals across the hospital to various units, and learn each unit's dynamic or break "policy" but I made sure to get my meals in when convenient, and my work done at the same time. I did not want the excuse "I was too busy" to prevent me from reaching my own personal health goals.
I noticed my co-workers who also worked night shift, many of them, didn't eat at all, or if they did, maybe one small or large meal at night. I totally understand this, as the body's natural circadian rhythm is not chemically inducing eating during nighttime. However, the body is also incredibly good at adapting for survival and will adapt to alternative healthy choices. Small frequent meals (especially with the proper percentages of fats to carbs to proteins) can significantly help reduce insulin spikes, sugar highs and lows, and lead to a more energetic feeling. Another poor decision I noticed was how my coworkers only survived off of coffee. They seemed to thrive off the caffeine to get through the 3am hours and the long shift in general. Caffeine stimulates the adrenal glands to release adrenaline to spike the nervous system into overdrive. Too much caffeine too often over-stimulates the adrenal glands, the heart and other chemicals in the body. This can lead to adrenal fatigue where you don't even "feel" your coffee anymore. In fact, you drink it hoping for an affect, when your metabolism is starting to slow down. Don't get me wrong, I love coffee, green tea, and the effect when needed, but I also know it is not the only way to generate an energetic feeling, and I don't want to feel addicted or in need of it to survive especially if it could damage my metabolism.
I started to notice how the nursing environment led to several struggles along the way. As I was trying to stick to my healthy meal prep, the nurse's break room became my enemy. Every day, donuts, pastries, leftovers, cookies, take-out and cake were found in the break room. Very rarely did I cave to the cravings or pressure to eat the sweets, but when I did, I felt guilty, ashamed, and it restarted my addiction for sugar/sweets. While on my meal prep, my cravings for sugar went down significantly, anytime you break the cycle and eat sweets; you reset your body's cravings to eat more sugar.
I remember several times I was tempted to eat the pastries left in the break room. I avoided it all night, and for some reason seeing it, made me want it. The temptations grew stronger seeing everyone else ordering food to the unit, or indulging in the sweets, and I occasionally caved to the pressure. The guilt was overwhelming. Several times, I found myself forcing myself to throw up the sweets, feeling guilty for succumbing to the pressure. As long as I didn't see or have access to the "bad food," I was doing so well with my meals, my weight loss, and my diet. As soon as someone brought in bad food, which was EVERYDAY, I felt obsessed with wanting to eat it. I had NEVER before binged or purged, but the long hours circling around these treats caused me to either angrily avoid it, or cave to the craving, and feel the need to purge. After about 3 or 4 times of this unhealthy pattern I had only developed at work, I knew I had to stop this cycle. The shame and guilt began to eat at me, so I devised a plan to keep me on track. I started bringing in my own healthy snacks (like quest bars and protein chips) so that every time I saw others eating cheat foods, I could safely indulge in my own healthy sweets.
Another struggle I noticed, was how some of my coworkers would mock me or make fun of me. I almost always ate the same thing everyday: chicken/fish, veggies and sweet potatoes. Sometimes I varied the carbs but everyone saw me eat three meals a day that consisted of about the same ingredients. I got mocked for how bad my broccoli or fish made the break room smell. I got asked why do I always eat the same meal everyday. I was asked why am I still doing this when I have already lost enough weight. Coworkers would oftentimes tempt me to indulge in their tasty meals. I know their intentions were kind, but it was hard when I just wanted to stay on track with my healthy progress and not take steps backwards.
As the weeks rolled on and I got closer to my fitness competitions, my coach put me on lower carb diets. I had never experienced the symptoms associated with this: weakness, fatigue, forgetfulness, confusion, and getting strong cravings. These symptoms were only experienced temporarily to achieve my competition body goals, but it would usually last about 2 weeks and I still decided to stay on track despite the ongoing temptations to give in to sweets or tastier meals at work.
What I quickly noticed was how the general nursing environment did not encourage coworkers to want to eat healthy or even stay on track when people tried. I watched several others try "new healthy diets" and saw how quickly the stress of the job, or the pressure to enjoy fatty/sweet foods became a stress relief. Nurses were not encouraging one another to be healthy and avoid some of the very same long term chronic health disorders that we care for on a daily basis. I couldn't believe I was the only one who discovered how to make time for my health and fitness goals, and it was "weird" and "impossible" to others. Don't get me wrong, I had a full blow cheat meal once a week, so I still got to indulge, but I was achieving my goals at the same time.
I experienced a variety of other obstacles to my success of dieting during my nursing job. If I had an overly busy shift, or a patient that needed constant care and attention, I would have to skip my meals, and eat them all during report (2-3 meal portions at a time). In addition, if I was having a particularly stressful shift or portion of a shift, I felt much more prone to cheating or eating bad food between my prepped meals. I also had to watch both my patients and coworkers eat things I could not have on a daily basis. Most of the time, as long as I ate every three hours, I would not be hungry and my cravings would subside. After awhile, however, I developed food boredom because I was essentially eating the same foods week after week with only a slight variation. I decided to learn how to count my macros in order to substitute more tasty foods and treats into my diet so I wouldn't have to be so strict and still maintain the proper food intake daily.
At first, I struggled with my new schedule to try and train before work. I didn't know if getting up an extra 2 hours earlier would help my energy levels. Normally, when I got home from night shift, I could fall asleep by 8:30-9am, sleep until 5pm, and then get ready for work. Now that I was getting up at 3pm to workout, initially I thought my energy would suffer or that I wouldn't be able to sustain this type of schedule, especially 3 nights in a row. I was surprised to find that this routine lead to immediate weight loss, increased energy levels, and my training was an excellent release of stress prior to starting my shift. I felt control, a renewed sense of pride, and energized having accomplished personal goals before going into a stressful job.
Typically, throughout my nursing career, after working three long exhausting back to back shifts, which usually involved nothing other than sleeping in between, I would "do nothing" on my days off. In other words, my previous routine was to just "rest and recover" on my 3-4 days off of nursing. Now that I changed my routine to working out prior to my shifts, the idea of putting in a 1 hr workout on my day off became a lot less overwhelming. In fact, I felt less strained, more accomplished, and higher energy levels when I trained even an hour a day on my "days off." This new found routine demonstrated that nursing did not need to be a barrier to my personal fitness and health goals.
I have gone through the fitness prep (diet and training) six times while working as a full time nurse, and even working a second per diem night shift nursing job to cover my competition bills. It is possible, and in fact, this brief period of change has propelled my lifestyle into one where health and fitness is no longer something I have to try and squeeze into my schedule. It's a natural inclination and desire of mine to eat healthy 80% of the time, and enjoy treats 20% of the other. I train because I feel strong, healthy, fit and physically more attractive at age 30 than I was at age 24. In addition, I feel more confident, energetic, less moody and in control of my life and my priorities.
It takes small changes at first, going through some trials and errors to find the right solution for each problem that arises but it IS possible, you are NOT alone and you never know how much better you'll enjoy your life, your career or who you will inspire by making health and fitness work with your life.
Most of my clients, especially the nurses, tell me their biggest struggles are getting their meals prepped and in (on breaks) but that once they spoke with their managers, made it a priority, and never let it disrupt their work ethic, they all have been able to accomplish their goals and not feel overwhelmed with nursing so that they can't reach their health aspirations.
One of the most important ways I was able to establish and maintain this healthy routine was through daily support. My husband helped prep my meals daily (spent about 30 minutes in the kitchen cooking three meals for my night). My coach kept me on track with weekly picture check-ins, nutrition guidance, macros goals and developing my fitness workouts. I noticed that my co-workers kindly adapted to my frequent eating schedule and my close friends accommodated my diet needs by always understanding if I came with my food or had to choose healthy meals while eating out. Surrounding yourself with supportive people is extremely important. I did notice several co-workers and units would try to start weight loss challenges but they were very hard to sustain given the struggles I mentioned before in the nursing culture and environment. Therefore, it is extremely important that we start to look out for one another and support the notion to get healthy and be positive influences rather than tempting one another so often at work.
Why should we as nurses put more emphasis on taking better care of ourselves? Most of you might not be interested in fitness competitions or some of the same goals I had. However, I am sure many of you are interested in a healthier lifestyle, to feel more energetic, to feel more in control of your life and body, maybe shed a few stubborn pounds and do it all while feeling less isolated when you attempt to make healthy decisions while at work. We are the future and we are some of the most educated people when it comes to what a poor diet or bad habits can lead to. Why not start now? Why not set an example to our patients, fellow nurses, friends and family and even our children that a healthy balance is attainable even while working an extremely stressful job? I'm not saying one has to avoid all sweets, social events, cravings or temptations. I'm suggesting we increase the frequency of healthy food choices and we make health a priority.
My hope is that those of you who haven't started your health and fitness journey will now be inspired to start, those of you who have put it on the backburner will return with passion to your previous fit life and those of you who are already kicking *** will share this message with those you could help inspire. We do so much to care for our patients day in and day out. We save lives. We perform vital bedside care at the most crucial of moments. We offer all of our care for others. We have to offer a tiny bit for ourselves. We deserve to stay on the nurse side of the bed, not to end up in a hospital bed years down the road due to lack of self-care. Share this message of hope and inspiration for all the loving nurses that you know.
Wishing you all the best! Thank you for all that you do to help others! I am here for you should you need help also.
Lauren D Kagan
-Registered Nurse, BSN
-NASM Certified Personal Trainer
-New York Times Best Selling Author
