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Sometimes, individual nurses look for ways to keep themselves and their co-workers healthy. Some start walking clubs or group exercise sessions. A nurse in the intensive care unit at Childrens Hospital Los Angeles helped start a yoga program, said Beth Maldonado, employee assistance program manager there.

Although the nurse no longer works there, a group of ICU nurses faithfully attends the 7:30 a.m. yoga class after working the night shift.

Finch started a Weight Watchers At Work program a year and a half ago at her hospital, after losing considerable weight on the program herself. Employees collectively lost 2,400 pounds in a year, she said, and she herself has lost 100 pounds.

But whether the programs are formal or informal, nurse-driven or hospital-organized, involving nurses is their greatest challenge, organizers say.

"On the whole, nurses are a hard group to motivate," Schlessinger said. "It's a tiring job and it's hard for them to find that little extra time to do physical activity."

'Who has time?'

Nurses' round-the-clock shifts, irregular days off and demanding work schedules also contribute to the difficulty of finding time to exercise or attend wellness classes.

Finch said her Weight Watchers program received great response from housekeepers and clerical workers, but few nurses participated because they couldn't get away from their jobs for half an hour to attend weigh-in sessions and meetings.

Maldonado originally scheduled three yoga classes-at 7:30 a.m., 5 p.m. and 7:30 p.m.-to catch the nurses as they ended their shifts, but only the 7:30 a.m. class attracted enough participants to continue.

Part of the problem is the increasing demands of an industry in which people often are forced to do more with less, Maldonado said. She used to look forward to attending the 5 p.m. yoga class each Friday as a refreshing start to her weekend.

But as her job demands became greater, she found herself at her desk until 6 or 7 p.m. Or when she did finish earlier, she found she didn't want to stay at work another instant-even to attend a relaxing and beneficial class.

After a 12-hour day, many nurses need to rush home to their families, said Mary Genna, RN, a cardiac rehab nurse at Valley Medical Center in Renton, Wash. "I've noticed that the nurses who use the fitness center don't have little kids."

Part of the problem for nurses, Pineda said, is that many still believe their primary job is to take care of everyone but themselves. As a younger nurse, Pineda said, she always put her family and her work first. But as she's grown older, her attitude has changed.

"Now I know I need to take care of myself," she said.

Cash carrot

Valley Medical Center used to offer employees a cash bonus for participating in its wellness program, said Anne Grimes, MN, RN, director of the hospital's wellness services. Employees who exercised three times a week, ate five servings of fruits and vegetables daily, participated in various classes on lifestyle habits, read certain health materials and recorded their progress in a diary received up to $350.

"That program was very popular," Grimes said. "We had at least 60 percent of the staff participating in it." The nurses especially liked the stress reduction classes, she recalled, and came bringing blankets and pillows to spread on the floor. But last year, the hospital cut the cash incentive and the nurses stopped coming.