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Just before a series of major climate change rallies were held in cities across the US, the journal Creative Nursing published a special issue on climate change. We spoke with special issue editor Katie Huffling, MS, RN, CNM and contributor/editorial board member Teddie Potter, PhD, RN, FAAN to learn more about climate change as a public health issue, and why so many nurses are attending these rallies and speaking out.
On September 20, the Washington Post interviewed them both as part of a major story on the DC climate strike. The headline was, “Why nurses, America’s most trusted professionals, are demanding ‘climate justice.’” That sounds like as good a starting point as any, so let’s begin by asking…
Why is climate change important to the mission of the health and nursing professions?
TP: In nursing we are charged to create environments for people to be the healthiest individuals and communities that they possibly can be. Climate change threatens that. It threatens our patients and communities on multiple levels. The health impacts of climate change are severe and serious, and they’re happening right now. So that why it is important for us to address this as nurses.
It’s no longer happening in some parts of the globe, or in some geographic areas; it’s happening everywhere. Unfortunately, it tends to have the greatest impact on communities that are already struggling to be healthy. If I am already challenged by being homeless, for instance, not having access to AC or heating can lead to real [health] problems, and we see people with such challenges often suffering worst and first from climate change.
And it’s important to point out that yes, the planet is warming but the impacts are very variable. Places that used to be cool are getting hot; some places that were usually dry are getting very wet. It’s the shift in patterns that has definite health consequences. In California, for instance, you might be more apt as a nurse to be aware of the impact of fires on the air quality affecting individuals and families and people who work outdoors.
But isn’t climate change a political issue? Why should nurses get actively involved?
TP: I hope we have made it very clear that climate change is not a political issue, any more than people having adequate food or clean air should be a political issue. It’s a health issue. And we need all people regardless of their political affiliation to be part of finding solutions and part of finding a healthier future for everyone.
KH: The Lancet has been publishing for the past few years an analysis of climate change and health and they are very clear that climate change is the biggest public health challenge that we face today. It’s a health issue, and the future of our children is at stake.
Are nurses already seeing health issues connected to climate change?
TP: In Minnesota, we’re seeing changes in our vectors. We see more [outbreaks of] Lyme disease and West Nile disease; we see more people affected by flooding and loss of housing and livelihoods related to flooding. Farmers can’t get their crops planted on time [owing to flooding] and they can’t get their crops harvested on time, so we’re seeing impacts in that area. Health care providers need to understand that there are things we need to be considering in order to protect our patients and teach families and to ensure that if a disaster is likely, that people have a plan. For example, we need to ask “What are you going to do when category 4 and 5 hurricanes come into your area?”
KH: One thing I would add is that no matter what type of nursing you do—whatever your patient population is—there’s some way that climate change impacts that population. For example, when you have extreme weather events, and you have renal patients, are they going to be able to get dialysis? Nurses working in that area have been real leaders in working on emergency preparedness. The same goes for oncology nurses—are your patients going to be able to get their cancer treatments in a timely fashion. There are some things when you first think of them, you don’t realize how it really does span any type of patient population.
“We need to be planning for these people.”
TP: Also, there are community nurses worrying about patients who are homebound and in need of oxygen and other things that require a steady source of electricity. We need to be planning for those people. What do you do when flood waters rise, and you can’t get out of your house because you’re wheelchair-bound? And your caregiver can’t come because they’re stuck [in the flood] where they are, and you can’t even get out of bed? All of these things have to be thought about.
KH: As an example of that, here in DC it’s gotten better because the local utilities have been addressing it, but there were lots of power outages accompanying extreme weather events during the summer. And when families with children on ventilators at home don’t have electricity for a few days, they end up having to take up an ICU bed because they’re not able to be on just a general floor.
TP: As a state that has a significant rural population, [In Minnesota] we are also concerned about people working outside who harvest and pick the crops. We’re concerned about dehydration. A while ago one of our Minnesota Vikings players died from heat exposure and dehydration at the Vikings summer training camp. This is not something that we’ve had to think about in the past. Hot and humid days can impact even young people in peak condition and we are having more and more days with high heat and humidity.
Are today’s nurses following in Florence Nightingale’s footsteps? Was she the first activist nurse?
TP: She was an activist but also a scientist. She was deeply committed to evidence-based practice and she was a brilliant statistician. She really looked at the environment as doing the healing for patients. As she said in Notes on Nursing, “medicine and surgery can remove obstructions… nature alone cures.” And she was a great believer in and taught about the importance of good food, adequate hydration, mobility, cleanly environments, and exposure to fresh air.
In the Crimean war what got her started was that they were seeing more people dying from the care they received in the hospital than from the injuries they received on the battlefield. So it was a care issue and that was what marshalled her and other women at that time to go to Turkey and set up an alternative way of caring—fresh air, clean sheets, adequate food—and people started surviving. It is deeply at the core of the nursing profession: we work with the environment to put people in a position to recover and have a quality of life. Nurses are on the move following the same principles today.
How can nurses get—and how are they getting—involved in the movement to reduce effects of climate change?
KH: I think there are a number of points of engagement. Nurses are really can-do people. When they find a problem, they want to fix it, and so when you start to learn about climate change and its effects, it is natural to immediately want to get engaged.
I think this is a great opportunity for nurses to get together—you know, strength in numbers—to elevate this issue and use our position as America’s most trusted profession to talk about it. Also, [it’s important to] meet with policy makers—whether it’s at the state, national, or local level—when you can speak with elected officials and help them to make that health and climate change connection. Because a lot of elected officials still don’t understand that it’s a health issue and if they want to protect the health of their constituents it’s an issue they need to be taking on.
And, it’s been very exciting to see so many nurses doing things like going to the different climate marches. It’s another way to show that nurses are leaders in the area around climate change. One of the things my organization (ANHE, the Alliance of Nurses for Healthy Environments) has been doing is we’ve created a nursing collaborative on climate change and health. This came out of a round-table we did at the White House during the Obama administration where we had around 20 nursing organizations and unions at this round table talking about what nurses can do about climate change and health. It was a really historic event. We were the first group of health professionals that they had reached out to at the time to do something like this.
After that, we decided we needed a strong collaborative effort, and that is how we created the Nursing Collaborative on Climate Change and Health. We have 11 organizations, and a couple more really large organizations about to sign on. Working together we show visible leadership among the nursing community as well as among policy makers.
Where can nurses find out more about the impact of climate change?
KH: Well, at ANHE (Alliance of Nurses for Healthy Environments) we have tons of resources on the website, lots of free tools for nurses to engage. We’ve got talking points, academic databases and case studies, resources for pregnant women and children, and much more.
We’re also part of the Nurses Climate Challenge, in which ANHE’s partnered with Healthcare without Harm. Basically in the Nurses Climate Challenge we have Nurse Champions that sign up on the website. The champions then go out and educate their fellow nurses and other healthcare professionals about climate change and health. They have a really robust toolkit with PowerPoints with notes and posters they can customize if they want to make a presentation at their monthly nursing meeting. Then we track each event: if someone does a presentation, they note how many attended. The first year we had a goal of 5,000 nurses and other healthcare professionals educated, but we quickly grew past that so we decided to up our goal to 50,000 nurses educated by 2022. And we just started that a few months ago, and we’re already past 10,000. It’s exponentially growing!
“It’s an amazing opportunity to prevent disease.”Katie Huffling
I’d like to bring in another positive note: this is also the greatest opportunity that we have to impact public health. These things that we can do to affect climate change can have a widespread positive impact on health. It’s an amazing opportunity to prevent disease. And I think that that’s another core feature of nursing practice—that we want to see our patients become healthier and to not have to be treating them for these preventable illnesses. When we address climate change we can have such a positive impact on health.
TP: I’ll just add in that the dean of the Minnesota School of Nursing has appointed me the first Director of Planetary Health for the school, so that nurses can learn to apply what we do to care for the environment so that our patients and our communities will be healthier.