The 4-mile Shift: Why Nurses Walk So Much

See which factors influence how far nurses walk on a 12-hour shift

By Megan Murdock Krischke, contributor

Have you strapped on a pedometer or FitBit at work lately? If so, you won’t be surprised to know how much walking a nurse puts in during a 12-hour shift. A 2006 study published in MEDSURG Nursing, “How Far Do Nurses Walk?”, found that the 146 nurses studied walked an average of 4–5 miles during a 12-hour shift. For comparison’s sake, most Americans walk just 2.5–3 miles during the course of an 18-hour day.

While a lot can be said for the health benefits of walking, the kind of walking nurses do at work has very little cardiac or stress-relieving benefits. In fact, walking that far during a shift can lead to fatigue, which could potentially reduce the quality of patient care.

Health care leaders and nurses alike would prefer to reduce the number of steps a nurse takes during a shift in order to increase efficiency, decrease fatigue and increase time at the bedside.

Herman Miller Healthcare, a company specializing in workplace design, published a white paper in 2012 that explained the two major components influencing the total distance nurses walk during their shift:

1. Physical design – This involves the distances between destinations, such as patient room to medication room, patient room to documentation station(s), and soiled linen to clean supply. A number of factors influence these distances including the size of the unit, the mix of single-patient rooms and semiprivate rooms, the amount of decentralization of nursing support spaces, and unit shape and traffic configurations.

2. Frequency of activities – The frequency of activities that require nurses to walk determines the total distance traveled on a given shift. Operational factors that affect the total frequency include the nurse-to-patient ratio, staffing, the type of patient population, and whether it is a day, evening or night shift.

According to John Welton, PhD, RN, professor and senior scientist for health systems research at The University of Colorado College of Nursing, and lead author on the “How Far Do Nurses Walk?” study, the most an individual nurse can do to reduce steps taken is to be prepared when he or she enters a patient room.

“There are a number of things, however, that hospitals can do to help nurses be more efficient with their work,” he said. “For example, optimizing medication dispensing to the unit to be sure nurses don't have to spend extra time getting meds. Also, we saw in our study that assignment could influence how many miles a nurse walked each shift, for example assigning a nurse patients in adjoining rooms, rather than having patients at either end of the hall,” he said.

Travel nurses may find that more facilities are moving toward storing additional supplies within patient rooms and placing computers in patient rooms, either on a mobile cart or permanently, so that nurses can chart at the bedside rather than returning to the nurses’ station.

The study also found that day-shift nurses walk a bit more than night-shift nurses and that caring for more patients does indeed lead to taking more steps.

“Our study only looked at medical–surgical units, but I would suspect that ICU/CCU nurses walk less,” reflected Welton. “However, they could be standing for long periods of time which may lead to problems such as low back pain.”

“The top advice I would offer to nurses is to wear good fitting shoes and two pairs of socks! I'm a hiker and struggled with plantar fasciitis until I tried two beefy pairs of socks with my hiking boots. This may not be a practical solution for many nurses, but it does raise the point about potential orthopedic problems with frequent walking on hard surfaces,” he noted.

Another simple step nurses can take to care for their feet is to replace their shoes more often. While shoes may still look neat and clean, the support they offer diminishes over time. It is recommended that runners replace their shoes every 400-600 miles; similarly, if nurses are walking 4 miles during each of three 12-hour shifts a week, they should replace their shoes every 8-12 months.

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