Addressing Climate Change: We Can't Afford Not To

Elizabeth C. Schenk, PhD, MHI, RN-BC, FAAN


Nurs Econ. 2019;37(1):6-8. 

In This Article

What Role Does Nursing Play?

Nurses have long been faithful to our contract with society, which obligates us to promote the health of the public, through caring service, using knowledge, skills, and competence, even in hazardous service (Fowler, 2015). For us to meet this commitment, it is imperative that nurses understand the risks and challenges associated with a warming planet, including the basic science that leads to the global warming that causes climate change and the health impacts that arise from or are worsened by it. Further, it is crucial that nurses understand their role in contributing to climate change, so they may institute changes in practice and policy to help mitigate climate change by decreasing greenhouse gas emissions.

Nursing is the largest single group of healthcare professionals, with 2.7 million active registered nurses (Bureau of Labor Statistics, 2018). Nurses have tremendous input into decisions that are made in healthcare and hold responsibility for the pollution generated from nursing practice.

U.S. healthcare contributes about 10% of the nation's greenhouse gases (Eckelman & Sherman, 2016). Not only are hospitals and clinics very energy intensive, but the vast majority of energy used is fossil-fuel based (Energy Information Administration, 2018). Nurses can help conserve energy in the clinical setting. They can develop processes that include low-power settings for rooms, lighting, equipment, and computers. Nursing leaders can ask facilities staff to meet energy efficiency goals, measured by tracking greenhouse gas emissions. Nurses may not feel the energy efficiency of the buildings where they practice is their primary concern. However, the burning of that energy is causing health problems, making it the concern of the nursing profession, which is responsible for nursing practice. After all, we are professionally obligated to "practice in an environmentally safe and healthy manner" by our Scope and Standards of Practice (American Nurses Association, 2015). Similarly, nurses can ask hospital and health system leaders to adopt renewable energy sources, which helps ensure nurses are meeting their professional obligations for safe practice.

Further, the massive amounts of waste produced by hospitals and clinics (Practice Greenhealth, 2018a) contribute greenhouse gases in both production of the supplies, and disposal of refuse in landfills or incineration (U.S. Environmental Protection Agency [EPA], 2018a). Because of our wide presence in health care, nurses are involved in almost all clinical encounters. This means that they also touch, literally, most waste streams. Proper segregation of waste is an important aspect of environmental stewardship. Not only is proper segregation of waste required by regulation, it also reduces pollution, can reduce use of supplies, and can save significant dollars for a facility. Nurses need to understand the complex waste stream in health care, and to steward this aspect of their practice until waste is disposed of safely and correctly.

Food systems in healthcare facilities contribute to climate change through non-sustainable agricultural practices (EPA, 2018b). Nurses are often interested in healthier food options. This includes highly nutritious foods for patients, staff, and visitors. More and more, it also means more environmentally sustainable foods, such as locally grown foods, foods with fewer chemicals, less meat, and use of reusable dishware. Many hospitals are planting gardens to grow food for their community or offering Community Supported Agriculture (CSA) shares for staff, or hosting hospital-based farmer's markets. Nurses are often the instigators for these healthy practices.

Nurses make many purchasing decisions for products and supplies; pollution caused by the production, use, and disposal of these products needs to be taken into consideration (Practice Greenhealth, 2018b). Nurses can reduce waste by purchasing more reusable products. Nurses can choose energy-efficient equipment, including beds, monitors, and pumps.

Lastly, the transportation sector, dependent largely on the burning of gasoline and diesel fuels, contributes about 28% of U.S. greenhouse gases (EPA, 2018c). Thus, nurses' and others' choice of transportation methods makes a significant contribution to our profession's greenhouse gas contributions. Commuting to work is a significant part of the workday. In larger cities, public transportation can help reduce the pollution caused by single-occupancy vehicle commuting. Yet it is not available everywhere to meet the needs of nurses and other healthcare staff. Nurses can lead the way for hospitals to develop commuting strategies. By reducing car traffic, pollution is reduced (both long-term climate impacts and shorter-term air quality), parking congestion is relieved, staff gains health benefits from biking or walking, and everyone saves money. Nurses can help translate these benefits to leaders, community members, and other nurses.