Nursing’s Participation in Reducing the Health Impact of Climate Change

Janna Trombley M.S., R.N.

Climate change is one of the largest threats to human health worldwide with a projected increase in 250,000 more deaths annually between the years of 2030 and 2050 (1). Health effects related to climate change include heat-related illness, respiratory effects, water scarcity and insecurity, nutrition insecurity, increased vector-borne diseases, mental health impacts, and injuries or illness resulting from extreme weather events such as hurricanes, floods, and wildfires (1). The most vulnerable populations including children, older adults, indigenous groups, pregnant women, those with disabilities or chronic medical conditions, minority groups, and those living in poverty will be affected the most (2).

Nursing’s awareness of the impact of the environment on health began with Florence Nightingale in the late 1800s. As the largest group of trusted health care professionals, nurses are in an ideal position to help address the consequences of climate change and act to protect themselves, their families, their patients, and their communities (3). Health-related problems associated with climate change are beginning to be addressed by nurses through leadership, education, policy and advocacy, and research (4,5).

Leadership

Healthcare facilities contribute to three to eight percent of fossil fuel emissions in the United States (3). Nurses advocate for sustainable practice by developing interdisciplinary green teams in hospitals to develop sustainable policies regarding energy efficiency, water conservation, proper waste disposal, environmentally friendly food services, use of reusable products, and using environmentally preferred purchasing (6,7).

Patricia Stockwell, R.N. at Dartmouth Hitchcock Medical Center (DHMC) in New Hampshire was concerned with the amount of food waste she was seeing in the hospital. By introducing composting bins along with providing educational materials on composting in common areas of the hospital, she was able to educate both patients and hospital staff on the importance of composting. She became the Chairperson of the OR Green Team at DHMC and her efforts have been recognized in an Environmental Sustainability & Stewardship training module developed by the Johnson & Johnson Institute (8).

Education

It is essential that the health effects of climate change be integrated into the nursing curriculum at all levels (7,9,10). This can be seen at the Massachusetts General Hospital (MGH) Institute of Health Professions where the nursing faculty developed a Center for Climate Change, Climate Justice, and Health in 2018. This initiative is designed to host symposiums and offer educational opportunities with the goal of promoting research and scholarship on climate change and health. The committee is led by eight nurse scholars who are passionate about climate change mitigation, adaptation, and resilience, and identifying climate change as a public health issue (11).

Advocacy

Nurses are in an excellent position to influence policy and advocate for change (4) and many are members of associations or coalitions in addition to lobbying at the local, state, and federal level (7). For example, the Alliance of Nurses for Healthy Environments (ANHE), launched the Nurses Climate Challenge campaign in 2018 with the goal of educating 50,000 health professionals by 2022 on the impact of climate change on health outcomes (12). The Nurses Climate Challenge also provides excellent resources in their expertly developed toolkit to deliver effective climate change education in the workplace (13). With a goal of decreasing the health consequences of climate change, nursing is advocating for policies that address upstream opportunities (i.e., reducing pollution and building resilient communities) and downstream needs such as disaster response and health consequences of climate change (14).

Research

Nurses have become more active in the research of climate change and health in recent years (15). Current research by nursing scholars involves exploring nurses’ perceptions and baseline knowledge of climate change and its impacts on human health (13). Elizabeth Schenk, a nurse researcher from Washington State University, co-developed the Climate, Health, and Nursing Tool (CHANT) with the ANHE to examine health professionals’ awareness, motivations, and behaviors to address the gap between climate action and nursing practice (16). Check out: https://labs.wsu.edu/chant/invitation-to-participate/ to complete a survey on your awareness, motivations, and behaviors related to climate change and health.

Summary

As Nicholas and colleagues (2) suggest, nursing has a responsibility to support climate change mitigation, adaptation, and resilience efforts to protect the health of our patients and our communities and ensure that natural resources will be present for future generations. These efforts are beginning to be addressed by nurses through leadership, education, policy, and research.

References

1. World Health Organization. (2018). Climate change and health. https://www.who.int/newsroom/fact-sheets/detail/climate-change-and-health

2. Nicholas, P.K., Breakey, S., Tagliareni, E., Simmonds, K., & Sabo, K.K. (2021). Climate change and population health: Incorporating stages of nursing’s political development. Nursing Outlook, 69, 65-73. https://dx.doi.org/10.1016/j. outlook.2020.08.001

3. International Council of Nurses. (2018). Nurses, climate change and health. https://www.icn.ch/ sites/default/files/inline-files/ICN%20PS%20 Nurses%252c%20climate%20change%20and%20 health%20FINAL%20.pdf

4. Adlong, W. & Dietsch, E. (2015). Nursing and climate change: An emerging connection. Collegian, 22, 19-24. http://dx.doi.org/10.1016/j. colegn.2013.10.003

5. Castner, J. & Polivka, B.J. (2018). Nursing practice and particulate matter exposure. American Journal of Nursing, 118(8), 52-56. https://dx.doi. org/ 10.1097/01.NAJ.0000544166.59939.5f

6. Anderko, L., Schenk, E., Huffling, K., & Chalupka, S. (2017). Climate change, health, and nursing: A call to action. https://envirn.org/climate-changehealth-and-nursing/

7. Butterfield, P., Schenk, E., Eide, P., Hahn, L., Postma, J., Fitzgerald, C., & O’Neal, G. (2014). Implementing AACN’s recommendations for environmental sustainability in colleges of nursing: From concept to impact. Journal of Professional Nursing, 30(3), 196-202. https://dx.doi. org/10.1016/j.profnurs.2013.10.002

8. Johnson & Johnson. (2019). New module helps nurses lead in environmental sustainability. https:// nursing.jnj.com/nursing-news-events/nurses-leading-innovation/new-module-helps-nurses-lead-in-environmental-sustainability

9. American Association of Colleges of Nursing. (2011). Toward an environmentally sustainable academic enterprise: An AACN guide for nursing education. http:// www.aacnnursing.org/ Portals/42/News/White-Papers/Sustainable-Academic-Enterprise.pdf?ver=2017-08-07-095916-993

10. Leffers, J., Levy, R.M., Nicholas, P.K., & Sweeney, C.F. (2017). Mandate for the nursing profession to address climate change through nursing education. Journal of Nursing Scholarship, 49(6), 679-687. https://dx.doi.org/10.1111/jnu.12331

11. MGH Institute of Health Professions. (2021). Center for climate change, climate justice, and health. https://www.mghihp.edu/climate

12. Health Care Without Harm. (2021). Nurses climate challenge. https://nursesclimatechallenge.org/

13. Cook, C., Demorest, S.L., & Schenk, E. (2019). Nurses and climate action: Opportunities to lead national efforts. American Journal of Nursing, 199(4), 54-59. https://dx.doi.org/10.1097/01. NAJ.0000554551.46769.49

14. Leffers, J. & Butterfield, P. (2018). Nurses play essential roles in reducing health problems due to climate change. Nursing Outlook, 66, 210213. https://doi.org/10.1016/j.outlook.2018.02.008

15. Kalogirou, M.R., Olson, J., & Davidson, S. (2020). Nursing’s metaparadigm, climate change and planetary health. Nursing Inquiry, 27, e12356. https://dx.doi.org/10.1111/nin.12356

16. Washington State University. (n.d.). Climate, Health and Nursing Tool-CHANT. https://labs.wsu.edu/chant/