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Modern-day nursing has come a long way since the days of its founder, Florence Nightingale.

Today, the 400,000 nurses in health-care facilities across Canada include nurse practitioners, registered nurses, psychiatric nurses, and licensed practical nurses. With Monday marking the beginning of National Nursing Week, they are drawing attention to the challenges they face — such as finding time to stay healthy and encountering violence on the job.

Jennifer Reed, a scientist at the University of Ottawa Heart Institute, and colleagues just published a study in the International Journal of Nursing Studies that shows ​77 per cent of hospital nurses do not meet current physical activity guidelines, which recommend 150 minutes of moderate to vigorous activity a week.

A "disquieting proportion" of Canadian nurses overall do not meet the standard, she said in an interview.

"I think we need to take care of those who take care of us," said Reed, referring to nurses. "They are very selfless individuals. They work day and night for patients. They put their health on the back burner."

Reed got a total of 364 nurses in 14 hospitals in eastern Ontario to wear monitors on their hips that measured their activity over nine days. The majority, 94 per cent, were women.

"You can't assume because you're a nurse with a physically demanding profession that you're going to meet the guidelines," said Reed.

Part of the problem is the shift work. Nurses routinely clock in long hours, whether on rotating shifts or 12-hour shifts.

"They work extremely long shifts and the mental toll being with patients is quite taxing," said Reed. "They stand for really long hours on cement floors so they are exhausted at the end of the day."

When a break comes along, Reed said nurses aren't looking for a brisk walk outside. "They're headed somewhere to get food. It leaves very little time to get enough physical activity."

'We're stressed and we're burning out'

Lesli Richmond isn't surprised. She's been a nurse for 30 years, the last 10 as a community care nurse for Bayshore Health Care. The 50-year old from Perth, Ont., clocks in about 250 kilometres a day in her car to get to her clients, some of them in palliative care. A light day is 10 to 12 clients, she told CBC News.

"I'm usually in my car about 7:30 in the morning, and I'm usually on the road until 6 at night. Then at night I usually do anywhere from two to four hours of paperwork. So I don't get a lot of chance for exercise."

She said her blood pressure is "through the roof" and her knees are shot. "I'm probably 20 years older than I should be." But despite all of these health challenges, she says she "absolutely loves" her job.

This latest study confirmed for Richmond what she's known for some time. "We're tired, and we're stressed and we're burning out. But it's nice for the public to know that, yeah, we work our asses off."

Jennifer Reed, co-author of a study on nurses' physical activity, found 77 per cent of hospital nurses in Ontario do not meet current physical activity guidelines. (University of Ottawa Heart Institute)

Reed said lack of activity puts nurses at greater risk for cardiovascular disease, and the risk factors that come with it, such as obesity and high blood pressure. A surprising number of nurses — 58 per cent — are overweight or obese, Reed said.

She says interventions are needed to address this alarming low physical activity problem. "I think what needs to happen is that workplaces, senior management, policy-makers need to be aware of these findings and to develop strategies where we almost inject physical activity as part of the daily routine."

The study also found that more nurses suffered from depression and anxiety than Canadian women in general.

'Hit, slapped, punched, kicked'

The Public Services Health and Safety Association (PSHSA) is also drawing attention to the violence nurses face on the job.

It's become a high-risk profession, says Henrietta Van hulle, executive director of PSHSA, which provides occupational health and safety training for Ontario nurses.

"Nurses have been hit, slapped, punched, kicked, stabbed with a variety of objects. They've been spit on, not to mention the psychological trauma of being verbally abused," says Van hulle.

The Public Services Health and Safety Association represents 60,000 nurses in Ontario. This year, for National Nurses Week, its executive director, Henrietta Van hulle says the focus is on violence against nurses. (PSHSA)

Statistics Canada reports that in 2005, 34 per cent of nurses said they were physically assaulted by a patient. In Ontario, more than half of all injuries from violence in hospitals happened to nurses.

And acts of violence and aggression are severely underreported, the group says, because there's a general belief that "it's part of the job," she said.

Hospitals are taking steps to reduce violence. In Ontario, for example, Van hulle said the health ministry has for the first time made it mandatory for hospitals to report all cases.

The profession has changed greatly since the days of Florence Nightingale, shown in this watercolour ministering to soldiers at Scutari, a suburb of Istanbul, during the Crimean War. (Everett Historical/Shutterstock)

In some hospitals, nurses wear personal alarms. Other facilities may just have panic buttons on the wall. It's a work in progress, she said.

National Nursing Week is May 7 to 13 and coincides with the May 12 birthday of Florence Nightingale, who died in 1910.

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