Abstract
We're the first generation to feel the impact of climate change and the last generation that can do something about it.
–Barack Obama (2015)
As one of several nurse organization leaders invited to the White House on August 3, 2015 for the announcement of the Clean Power Plan, President Barack Obama's signature plan to address climate change, I was struck by the urgency of this message and the president's call to action. Since the time of Florence Nightingale, nurses have recognized that clean air, clean water, and a clean environment promote healing and health. Nurses have been leaders in significant environmental health movements such as reducing lead exposures in children, eradicating health-care waste incineration in the United States, and legislation to remove toxic chemicals in consumer products.
Now we face the most significant public and environmental health challenge of our lifetimes: climate change. In the same way that we have faced other environmental health challenges, nurses are poised to tackle this challenge in support of the health of our patients, communities, and the world. Through research, education, advocacy, and practice, nurses are already building a movement of climate action and leading the health-care sector in vital activities to address climate change.
The urgency around climate action was recently highlighted in the Special Report on Global Warming of 1.5°C, released in October 2018 by the United Nations Intergovernmental Panel on Climate Change. The report states that in order to mitigate the worst impacts of climate change, significant efforts to reduce carbon dioxide and other greenhouse gas emissions need to occur within the next 12 years. As with other public health crises, nurses have the skills and knowledge to rise to the challenge and play a significant role in mitigating the effects of climate change.
The health effects of climate change can impact any patient population and every nursing specialty, though certain populations such as the very young and very old, those with low incomes, some communities of color, and those with chronic health conditions may be more vulnerable. Many of the health effects we are seeing now are due to changing weather and temperature patterns associated with climate change, such as increased wildfires from drought conditions, increasing frequency and intensity of storms with resultant flooding and damage to homes and infrastructure, sea level rise, food and water insecurity from too much or two little rain, and expanding ranges of vector-borne diseases as temperatures rise. As the climate changes, nurses will be seeing more respiratory and cardiac issues related to poor air quality, increases in vector-borne diseases such as Lyme disease and Zika virus, more heatstroke, worsening of chronic conditions such as cardiac and respiratory diseases and diabetes due to extreme heat, more frequent and severe mental health issues, and decreased access to care after extreme storms and wildfires. The latter effect is especially difficult for patients with chronic diseases that need careful monitoring, oncology patients, and those on dialysis (United States Global Change Research Program, 2016).
In the same way that we have faced other environmental health challenges, nurses are poised to tackle the challenge of climate change in support of the health of our patients, communities, and the world.
The Alliance of Nurses for Healthy Environments (ANHE) is a national nursing organization focused on the intersection of health and the environment whose mission is to promote healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-based practice, and influencing policy (ANHE, n.d.). Our organizational structure is based on the Institute of Medicine report, Nursing, Health, and the Environment: Strengthening the Relationship to Improve the Public's Health (Pope, Snyder, & Mood, 1995), with four work groups: Research, Education, Policy-Advocacy, and Practice. We also have a vibrant international committee focusing on climate change, and have organized the Nursing Collaborative on Climate Change and Health. Through these workgroups and committees, ANHE supports nurses around the world as we build a movement to address climate change.
Research
Nurse researchers can provide vital information on how climate change is impacting health, as well as evaluating the effectiveness of climate change mitigation and adaptation efforts. Many nurse researchers are skilled at community-based participatory research, which is vital to addressing the health needs of communities most impacted by climate change, especially those communities with the fewest resources.
Education
Schools of nursing have an opportunity to train the next generation of nurses to be leaders in addressing climate change. The ANHE Education Work Group has developed Strategies for Incorporating Climate Change into Nursing Curricula (2017) that are being used by nursing faculties throughout the country. Members of the National Student Nurses ‘Association (NSNA) have shown that student nurses are concerned about this issue and are looking to their schools and professional organizations to support their climate change efforts. At the NSNA annual meeting in 2017, a resolution titled “Increased Nursing Student Action on and Awareness of the Effects of Climate Change on Health” passed resoundingly.
Advocacy
A core element of our practice is excellence in advocating for our patients. Now we must use those skills to advocate for strong climate action with our elected officials. Nurses can clearly and strongly communicate the health impacts of climate change and help policymakers make this connection. We can also work within our professional organizations to pass resolutions and policy statements to drive action by our subspecialties. ANHE has provided guidance and support for a number of recent statements and resolutions, including those by the Emergency Nurses Association, the International Council of Nurses, NSNA, and the American College of Nurse-Midwives.
Interest in the health effects associated with climate change has risen consistently over the past 10 years, with increases in both media coverage and number of journal articles (Watts et al., 2018). As excellent communicators, nurses can be leaders in conveying health messages to policymakers and the public.
As the climate changes, nurses will see more heatstroke and respiratory and cardiac issues related to poor air quality, increases in vector-borne diseases, more frequent and severe mental health issues, and decreased access to care after extreme storms and wildfires.
Practice
Throughout their practices, nurses can help their patients and the public make the connection between climate change and health. An example is advising parents to keep their child with asthma inside on poor air quality days, and informing them that the number of these days is increasing with climate change. Nurses can also form or become a part of their hospital's Green Team. These Teams can look at management of waste, purchasing decisions, and other issues within the hospital that have impacts on climate.
The Nursing Collaborative on Climate Change and Health was formed in 2017 and now has 10 nursing organization members. The Collaborative is harnessing the collective power of nurses to elevate climate change as a national priority, educate the nursing profession on climate change, and work together to gain support for protective policies that address the health effects of climate change.
As highlighted in the many articles in this issue of Creative Nursing, nurses from around the world are already seeing the real-life impacts of climate change and are taking a variety of approaches to educate the profession and the public on climate and health, as well as working within the health-care industry to be leaders in addressing climate change. As the largest segment of the health-care workforce, the nursing profession, working together to address climate change, can help avert this potential public health catastrophe.
In closing, I leave you with this message of hope and call to action by Pope Francis from his historic encyclical, Laudato Si' (2015, pp. 18 & 166): “The climate is a common good, belonging to all and meant for all … We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it.”
The health effects of climate change can impact any patient population and every nursing specialty.
Footnotes
Disclosure. The author has no relevant financial interest or affiliations with any commercial interests related to the subjects discussed within this article.
Katie Huffling, MS, RN, CNM, is a Certified Nurse-Midwife and is the Executive Director of the Alliance of Nurses for Healthy Environments. Ms. Huffling works with nurses and national nursing organizations on a variety of environmental health issues including climate change, chemical policy, inclusion of environmental health into nursing education, and sustainable health care.