Hydration for Nurses

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

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
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..

I'm not positive on the drink issue. Hospitals tend to blame it on JCAHO somehow, but I worked at one hospital where the ER was allowed to have food and drinks out in the open behind the nurses' station. Staff would frequently bring in snack type foods and place them in a central area for all to partake (except non-staff). I think it may have more to do with a fear on management's part of appearing unprofessional and also having liquids that could spill too near the computers.

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?

After you posed this question I was curious myself. I didn't try to find studies since you stated that you didn't find any so I just googled Himalayan salt and found an article explaining the differences between Himalayan salt and regular table salt. Granted, this isn't a scientific study, but if the claims are true they provide clues to the answer to your question. The entire article is more lengthy than I want to post here.

Table Salt vs Himalayan Pink Salt: What's the Difference? - Organics.org