The American Nurses Association (ANA) said that nurses, as trusted messengers in healthcare, have a responsibility to mitigate and help others adapt to the impacts of climate change in a position statement released on Thursday.
Nurses are “expert systems thinkers” and as such are well-poised to help raise awareness around climate change, the ANA said. “From the function of cells to the function of Earth’s natural systems, nurses know that humans are deeply interconnected and part of the entire ecosystem. We recognize that what we do to one part of the system has direct consequences on other parts. This holistic orientation positions nurses to grasp the impact of social, structural, and environmental determinants of health.”
“As advocates for the health and safety of individuals and communities, nurses have vital roles to play in addressing this global issue and its consequences on human health and all life on Earth,” the organization added.
Educating Patients, Future Nurses
At the professional level, nurses can help communities to both mitigate future climate health harms and adapt to current conditions by educating patients, supporting decarbonization efforts, and supporting research and innovation efforts.
Nurses can also help to teach families about the impacts of heat, mold, and smoke on their health and how best to protect themselves from these conditions.
In areas of the country where tornadoes, fires, and floods happen often, nurses can help prepare patients for those events, including the possibility of having to evacuate their homes by asking the right questions, Holly Carpenter, BSN, senior policy advisor for the ANA, told MedPage Today. “If the worst happens, do you have a safe place to stay? Do you have your medications and other essential supplies with you? Do you have emergency health kits, ‘to-go’ bags … clean clothes and the right shoes? Do you know how to get and make fresh and clean water?”
It’s also helpful, Carpenter noted, to give patients a printout or brochure from the local health department or the CDC, so that they can carry all of these tips home and keep them as a reminder.
One way to scale up education is to take advantage of opportunities in the community, she said, adding that “nurses are everywhere” — elementary schools, local health departments, prisons, and parishes. They can leverage that time and their proximity to different communities to bring awareness and education about these issues to scale.
As for educating future nurses about climate change, there are a handful of nursing schools that have integrated climate health into their curricula, but its inclusion isn’t widespread. Faculty face challenges in adding any more course work to an already tight curriculum that often is heavily focused on preparing students for the National Council Licensure Examination (NCLEX), on which climate health is not included.
“So it’s a big gap,” Carpenter said, though she noted that the Alliance of Nurses for Healthy Environments and other groups are working to address that issue.
Decarbonizing Health Systems
Healthcare is a carbon-intensive industry that accounts for 5.2% of carbon emissions worldwide and 8.5% of emissions in the U.S. alone. So, it’s fitting that the largest group of health professionals — there are 28 million nurses globally and 5 million nationally — play a role in decarbonizing the healthcare sector, the ANA said.
On an individual level, nurses can carpool or use public transit, Carpenter said. They can reduce waste by only ordering what’s needed and ensuring that each item is thrown away in the correct disposal stream.
At the institutional level, nurses can collaborate with others in their health system to advocate for “preferred purchasing” strategies. This approach requires looking at a product’s “footprint” for the whole span of its life cycle from “cradle to grave” that’s generated during manufacturing, delivery, use, and upon disposal.
One example is choosing supply companies that let health systems customize operating room kits to exclude those items that are never used. Another is thinking critically about whether it’s better to use a single-use tool or something that can be reprocessed.
“Maybe the chemicals to sterilize that [item] are super harmful, and then you have to worry about what to do with them,” Carpenter noted.
Or it can mean taking a closer look at how equipment is powered. Some items require batteries and others are fully electronic. It’s important to examine the pros and cons of each with an environmental lens, Carpenter said.
“One of the best things that nurses can help to decarbonize healthcare is to run for office, or serve in key leadership positions,” she suggested. But for those who aren’t quite ready for that step, there are other options. “You certainly can serve as co-chair for your ‘Green’ committee or your safety committee or your purchasing committee,” she added.
Climate Change Research
Another way that nurses can help mitigate climate change is through their research.
Carpenter highlighted the work of Daniel Smith, PhD, AGPCNP-BC, of Villanova University in Pennsylvania, who is studying the impacts of heat waves and other climate-related weather events on farm workers, and exploring ways this community can stay cool and decrease their risk of injury from heat while they work.
In addition, Jessica LeClair, PhD, MPH, RN, of the University of Wisconsin-Madison, is examining the experiences of climate justice among nurse community partnerships and organizations. She’s determining what works, what doesn’t work, and what people believe are the causes of climate inequities, Carpenter explained.
“Of course, the big research questions are how to effectively mitigate climate change [and] how to adapt to it so that we can still enjoy our best health,” as well as “how to promote and enforce equitable access to assistance, prevention, and education” related to climate change and health, Carpenter said.
In the policy statement, the ANA also stressed the importance of nurses advocating for policies that “advance just and equitable climate responses in public health and healthcare, and direct adequate resources to communities that are overburdened by climate-related conditions,” including individuals who are made more vulnerable due to their race, gender, income status, or disability.
“There are things that we can do to mitigate [the impacts of climate change] and there are things that we can do to adapt,” Carpenter said. “Nurses are sources of hope for all of this and they’ll be there every step of the way helping.”