Hydration for Nurses

A nurse's hydration status has a major influence on career performance. Check out my personal science experiment lessons.

Hydration for Nurses

Feeling Like A Raisin

There is nothing like a long shift at the hospital to make a nurse feel like a raisin. The struggle to maintain hydration during a ten hour shift has been getting the best of me. I noticed toward the end of my ER shift a few worrisome symptoms: cottonmouth, headache, foggy brain, leg cramps and joint pain. My brain struggles to remain engaged and body feels like it's moving through molasses.

The Problem

Usually, I went into very shift with my gas tank nearly empty. I drank fluids when I felt thirsty or needed a caffeine jolt. The few times I drank water, I found myself constantly rushing to the restroom. We all know we cannot keep rushing to the restroom when caring for sick patients. I am expected to react promptly to a dynamic work environment that is constantly influx. Response to a demanding work environment relies on having a full gas tank. Nurses can survive without food and voiding but, they cannot live without water.

Looking for Answers

The search was on to find a few interventions to correct the hydration problem. The goal is to find a few small changes that produce maximum results. After a literature review I unearthed some compelling research based practices. Dr. Stacey Sims is a forward thinking scientists that is changing the sports world's views about hydration. She is environmental exercise physiologist and nutrition scientists. Dr. Sims helps elite endurance athletes reach their professional goals. Her research highlight the factors that influence the small intestine water absorption. The main message is the majority of water is absorbed when the small intestine contents register just above plasma osmolarity. The balance of protein, high-water content fruits/vegetables, and lightly salted meals facilitate water transport into the bloodstream. Do not underestimate power of osmosis and the osmotic gradient. Dr. Sims recommends a few changes to boost one's optimum performance. I could not just take a scientist's word for it. I had to see it for myself. So I put a few hydration and nutrition tweaks into action.

Do's

  1. 10ml x individual's weight (kg)= ml of water with a pinch of himalayan salt (night prior to work or 2.5 hours prior to work)
  2. Protein drink (15-30 gm) within 30 minutes from waking up
  3. Each meal includes fruit or vegetable with high-water content ie: grapes, strawberries, raspberries, peaches, zucchini, peppers, celery, broccoli, cabbage
  4. Lightly salt meals if you have no dietary restrictions
  5. Drink lightly salted water with every meal (add pinch of himalayan salt to your water bottle)

Becoming the Guinea Pig

After a few weeks of implementing these interventions, I was reaping the physical benefits. I thought these improvements were all in my head. So, I decided to go back to my old ways. I drank water only when thirsty and guzzled the soda down before I could think twice. I paid for these hasty decisions for the rest of the shift. The fog rolled over my brain. It took ten times the energy to care for my patients. Driving home I kept asking myself was it worth it? Nope. The sugar high didn't last as long the foggy brain.

Don'ts

Avoid drinking high sugar drinks ie: sports drinks, soda, coconut water.

Juicy Grape

Today, I felt like a juicy grape. I am more agile to attack the mental and physical demands of my work day. The physical gains makes it easier to multi-task and move swiftly throughout the work day. The focus is to keep my hydration and nutrition on point during the workweek. I love looking at the ER experience as a fun obstacle course full of twist and turns. The well prepared professional has the best race.

My Massive Gains

  1. Decrease fatigue
  2. Decrease headaches
  3. Decreased joint pain
  4. Heightened multi-tasking capacity
  5. Improved career satisfaction when feeling physically strong

Sharing Life Hacks

Maybe you have the same struggles and looking for some answers. I'd like to pass on any tools that can help your professional performance. I encourage you to try these small interventions and see how you feel.

Reference

  1. Sims, ST. L vanVliet, JD Cotter, and NJ Rehrer. "Sodium loading aids fluid balance and reduces physiological strain of trained men exercise in the heat." Medicine and Sciences in Sports and Exercise, 39(1). 123-130. 2007
  2. MobilityWOD. (2015, August 25). Negotiating the Hydration Science Matrix . Retrieved from Current Concepts and Thinking in Hydrating Athletes w/ Dr. Stacy Simms | Community MWod Video - MobilityWOD
  3. Matt McNamara. "Cutting-Edge Hydration Strategies." Active.com [article]. Retrieved from
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vgyore

About vgyore

Pediatric ER CPNP. My name is Victoria Gyore. Currently, my professional playground is a busy California Pediatric Emergency Department. I am driven to help RN students, NP students, and new grads. The days of nurses eating their young are over. I have lived in the nursing trenches and want to share my lessons and encouragement. Look forward to talking to you @ www.nursingventure.com

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Specializes in IMC, school nursing.

Very interesting. Thanks for sharing. I have to admit that I rolled my eyes when I read the title (sorry, I was SO wrong) as another whine that we can't keep drinks because of JCAHO or any of the other numerous whines. There are now numerous studies saying most post op complications are related to the NPO status and dehydration. Why I always told my pts. to tank up the night before.

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Specializes in Home Health, Mental/Behavioral Health.

Awesome take on an all too familiar subject. Like the PP mentioned I was also sceptical of how unique this information could possibly be, but I was immediately drawn in and would love to start implementing these strategies myself!

I wanna be a juicy grape too:woot:

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

I'm a brand new believer in adequate hydration while at work. This is because, I've suffered 2 UTIs this year... My first 2, I might add, even though I have 3 kids and am almost 40. I understand JHACO has its rules...

But... My 1st dx UTI was asymptomatic, the Urine dip simply showed some signs.

But it this most recent UTI caused me pain!! I now aim to drink water before, during, and after work. Because we don't always get the opportunity to void Urine at work...at least I haven't always had the opportunity.

The pain was real!!

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I am constantly dealing with the hydration problem at work. I also cannot eat or drink much that early in the morning. I will vomit and it only compounds the issue. I have gone 14+ hours at work without time to eat, drink, or even go to the bathroom. The thing that concerns me the most is I'm driving home and realize I don't even have the urge to urinate. The problem often brakes down to being short staffed and not being allowed to have a water bottle anywhere but the brake room. I wouldn't have one in patient care areas, but there are several places that are sanitary that a bottled could be tucked away with a cap on it to make it closer to my whereabouts during the shift.

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This is why we need a change in the rules. Healthy caregivers don't call off as frequently, so staffing is better. Better staffing leads to better patient outcomes.

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Specializes in Pediatric Emergency Medicine.

I really appreciate the feedback. This seems to be a pressing issue in our work setting. If each of us can overcome this obstacle, the gains are huge! Maybe think about pre-hydrating the nights before work to create a good foundation. If your stomach is delicate in the early am, one can consider introducing a protein shake with some high water content fruit later in the am. I encourage you to tinker with these ideas and make it work for you. Some interventions are better than none. Have fun learning about your body. I hope you will find the juicy grape inside you!

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Specializes in Med-surg, telemetry, critical care..

I am on both sides of the equation. Now that I am retired(due to numerous health challenges), I am able to keep an infuser water container. I fill it with filtered water and the fruit or veggie of the day. I like mixed berries or cucumbers, and just a rock or three of Himalayan salt. In addition to the extra nutrients, it doesn't have that sharp after taste that regular table salt does. It does the body good. At night I put cucumber in the infuser and fill the bottle with ice so I have a cold drink throughout the night. It occurred to me that a nurse on duty could pack the iced veggie in their lunch and sip on it during your break or lunch.

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This issue is of particular interest to me as I've had acute kidney failure twice due to medication. I cannot tolerate any added salt and need to be conscious of salt in prepared foods.

I also work in the ER and I tackle this problem by downing a large cup or two of water each time I get water for one of my patients. I also start my shift with 2 large cups of water hidden at my station, and I bring enough fruit to work with me to eat several pieces during a 12 hour shift. The fruit helps to solve two problems. One is hydration and the other is being able to eat something when I don't have time for a break, which happens often. I can sit at my station and quickly eat a piece of fruit while charting.

Given that I've experienced AKF twice, I don't give a rats behind about JCAHO. Working nights does make it easier to get away with this, but I also did this on days. I'd gladly fight this issue as far as I needed to if ever called on the carpet for it.

As for bathroom breaks, I go when I have to, usually just a couple of times per shift during the busiest times. I find myself avoiding it for lack of time, but I also never fail to realize when I do go that it didn't take that long and my patients were still alive when I got back.

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Specializes in Pediatric Emergency Medicine.

Great ideas! Love it.

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Specializes in Nephrology, Cardiology, ER, ICU.

Am glad someone brought up the issue with kidney failure. Hydration is important for your kidneys.

I really couldn't find any scientific studies about the effects of Himalayan salt on hypertension - do you have any references?

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Specializes in Pediatrics, Mother-Baby and SCN.

I'm confused about why so many of you seem to have rules against drinks anywhere but break room, etc ? Is this all across the US? I understand obviously not in direct patient care areas, but what's the issue with having drinks at the desk? We have no rules re: this, and even have food at the desk frequently, such as if a patients family brings us a fruit/veggie tray, or a box of chocolates, etc.

So I have no real issue staying hydrated for the most part. I make an effort to have a reusable water bottle with me, and my coffee, and everytime I am charting, or walk back to my computer to get more meds, I have some sips. If I don't take a reusable bottle I find I can end up not drinking enough especially when it's really busy. When it's really busy sometimes I don't make the effort/take the time to refill it as much as I should so that's the main time when I am less hydrated than I should be.

As far as not having time to use the bathroom, there have been (many) times I've had to wait much longer than I would've liked to. There has been at least one shift I realized in the morning I hadn't used the bathroom all night as it was such a crazy night. But to literally not have time to THE WHOLE SHIFT? My god, what is going on in your hospitals down there Americans :( Makes me sad for you all if that is common..

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