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Nurses are role models for health in manynations, and as we make health choices, the public iswatching! Are we really doing our best to live thehealthy lives we recommend to our patients? Noreader needs to be reminded that more women die ofcardiac disease than of any other cause, or that obe-sity, a prime risk factor for cardiac disease and dia-betes, affects more than half of American adults. Weroutinely advise our patients on healthy diet, exer-cise, and smoking cessation. Maybe it’s our turn toget serious about living well.

Nurses face particular challenges in changing ourhealth behavior. First, we have a shortage of timeand an excess of stress. Quick ways to release thattension are eating, drinking, or unwinding in frontof the TV. Second, we are excellent nurturers of oth-ers, but we sometimes nurture ourselves inunhealthy ways (Kearney, 1998). After all, nurseswork hard and give much, shouldn’t we reward our-selves? Third, we are intelligent, which makes usgreat at rationalizing our less-than-ideal behavior.We all “know” that broken cookies have no calories,taking the elevator up a flight or two is faster thanwalking, and borrowing cigarettes is less harmfulthan buying our own.

There are no effortless ways to develop healthybehavior. It’s very difficult to face physical discom-fort, whether hunger, nicotine withdrawal, or fatigueduring exercise. However, research on changinghealth behaviors such as overeating, smoking, sub-stance use, or lack of exercise (Kearney & O’Sulli-van, 2003) reveals some key steps to success.

The first step, strange as it sounds, is to beextremely dissatisfied with where you are in com-parison to where you really want to be. When thediscrepancy between your reality and your goalbecomes intolerable, you will find a way to start achange (Miller & Rollnick, 1991). So start by col-lecting some real data. Get on the scale, or tally upyour exercise for last week. Take a hard, realisticlook at yourself, and ask yourself if you are the bestrole model you can be.

The next step is to use your dissatisfaction to take“one small step” toward change. Don’t attempt a

revolution. Choose something that is so easy thatyou have no doubt you can do it at least once. Forexample, collect information about nearby weightloss groups. Don’t buy cookies this week. Park far-ther from the store. Take the stairs.

Pick something small and do it. Then spend aminute thinking about it and find the reward. Wasthere a tiny sense of satisfaction? Don’t expect phys-ical results early on; the first rewards are psycholog-ical. You will start to feel better about yourself.Making a small change in one part of your life cangive you the confidence to make further changes.Only do what you can sustain for the foreseeablefuture. After all, a lifestyle change is not a short-termdeprivation, followed by the old kind of unhealthyrewards. Rather, your ultimate goal is to find andmaintain a “new normal.” Once you discover thatthe discomfort of an early alarm, a daily powerwalk, or having no chips in the house is only tem-porary, then you are empowered.

Women who sustain a healthy lifestyle changereport a gradual shift in their identities. Over time,they feel they have come too far to go back to theirold selves. Their tastes and preferences slowly shift.Backsliding will happen, but these women face thefacts and get right back on track, which becomeseasier with practice. Let’s take an honest look at ourhealth, and by making one small step, increase thelikelihood that we will be here to see the brightfuture we are helping to build.

Margaret H. KearneyAssociate Editor, JOGNN

REFERENCES

Kearney, M. H. (1998). Truthful self-nurturing: A ground-ed formal theory of women’s addiction recovery.Qualitative Health Research, 8, 495-512.

Kearney, M. H., & O’Sullivan, J. (2003). Identity shifts asturning points in health behavior change. WesternJournal of Nursing Research, 25, 134-152.

Miller, W., & Rollnick, S. (1991). Motivational interview-ing: Preparing people to change addictive behavior.New York: Guilford.

September/October 2004 JOGNN 539

EDITORIAL

Choosing Healthy Behaviors: One Small Step for Womankind