Much has changed on the face of the earth since Florence Nightingale was born 200 years ago. She defined nursing as a profession, which pays attention to the environment and uses scientific data to drive change. As nursing celebrates the centenary of the RN, wild fires, tornados, melting glaciers, and environmental illnesses are on the rise. Within a relatively short time, such as one's lifetime, there have been significant changes that can be attributed to anthropogenic causes (Veidis et al., 2019). As we celebrate nursing and all that it is, we cannot ignore the calls to action on climate change, for the sake of our patients and our profession. As the most trusted profession (Reinhart, 2020), we are the ones who can show the world what caring about climate change looks like through our lenses, through our patient's lives, and through our everyday work.
It is not always possible to predict life-altering patterns. Changes in the earth's climate have occurred so rapidly that predictions are no longer relevant, and often nurses find themselves dealing with the aftermath of the effects posed by changing patterns in temperatures, rainfall, and water and food contamination. People sensitive to these threats may have health conditions, such as asthma, heat exhaustion, and gastrointestinal illness, yet some less obvious consequences to climate change are unequivocally as serious (Schnur, 2019). One of the biggest threats of climate change is the often invisible burden it places on vulnerable populations and the difficulty of health care professionals to recognize it. How often does a nurse consider domestic violence to be a consequence of climate change? How might someone in a state of depression react to all-consuming news of fires and floods? Why are more premature deaths occurring? In 2018, the World Health Organization (WHO) outlined examples of health impacts to environmental changes and ecosystem impairment that vary from direct effects, such as floods and heat waves, to indirect effects, such as population displacement and loss of livelihood. For years, the WHO has advocated for ways to cut carbon emissions and increase investment in preventive health.
There are numerous examples of public health issues related to components of climate change, and recently mental health issues have also been included, such as reports of patients, especially youth, feeling increasingly helpless and hopeless in the rapid progression of climate change (Majeed & Lee, 2017). Agencies across the globe are addressing the issues with various adaptive strategies, including education, advocacy, and public service, but it is often nurses who see patients who are least prepared to deal with consequences of climate change. The Intergovernmental Panel on Climate Change (IPCC; 2018) regularly publishes scientific reports related to the impacts of global warming of >1.5°C, which tends to disproportionately threaten susceptible populations, including children and pregnant women, the poor and older adults, as well as people with disabilities and chronic illnesses. Certain minority groups, immigrants, and outdoor workers, not to mention future generations, are particularly affected.
With approximately 4 million RNs in the United States, we are well-positioned to fully understand and influence efforts to minimize the effects that climate change disasters have on the health and well-being of our patients and communities. Following social media sites, such as the Centre on Climate Change & Planetary Health (access https://www.lshtm.ac.uk/research/centres/centre-climate-change-and-planetary-health) and the Climate Change & Global Health Research Group (#ClimateChange; access https://www.climatechangeandglobalhealth. com) is a good way to start, as is reading human narratives of the effects of climate change, such as out of control fires and cold frozen animals falling out of trees in the tropics. Heeding calls to action, such as that from the American Academy of Nursing (Leffers & Butterfield, 2018) and the Clinicians for Planetary Health Working Group (Veidis et al., 2019), helps us focus on globally concerted actions for human health.
Nurses care because they want to do something to make their patients feel better. Nurses care because they may know what the problem is but do not always have a way to immediately affect it, and nurses care because they understand leadership and policy-driven decisions that affect their patients. Aside from biological aspects, social factors are harder to manage unless we care more about climate change, understand the undeniable evidence and scientific data, and get involved in sustainable initiatives—which can simply be done by being role models for society through energy efficiency, recycling, and preferential sustainable purchasing methods.
It is imperative more nurses get involved in interdisciplinary teams to address the consequences of climate change. The IPCC (access https://www.ipcc.ch) produces summaries for policymakers and practical strategies that include advocacy and developing opportunities for the workforce to care effectively for patients, not only in times of disaster, but year-round to mitigate climate change catastrophes. At the very least, we as nurses should know the impacts of climate change and potential mitigation strategies we can get involved in as a whole to protect the health of our patients and communities.
Michal (Miki) Goodwin, PhD, RN, CNE,
Associate Dean of Clinical Practice
Johns Hopkins School of Nursing
Mona Shattell, PhD, RN, FAAN
- Intergovernmental Panel on Climate Change. (2018). Global warming of 1.5°C. Retrieved from https://www.ipcc.ch/sr15
- Leffers, J. & Butterfield, P. (2018). Nurses play essential roles in reducing health problems due to climate change. Nursing Outlook, 66(2), 210–213 doi:10.1016/j.outlook.2018.02.008 [CrossRef]
- Majeed, H. & Lee, J. (2017). The impact of climate change on youth depression and mental health. The Lancet, 1(3), PE94–PE95. doi:10.1016/S2542-5196(17)30045-1 [CrossRef]
- Reinhart, R. J. (2020, January6). Nurses continue to rate highest in honesty, ethics. Retrieved from https://news.gallup.com/poll/274673/nurses-continue-rate-highest-honesty-ethics.aspx
- Schnur, M. (2019, November5). Nursing's role in climate change. Retrieved from https://www.nursingcenter.com/ncblog/november-2019/climate-change
- Veidis, E. M., Myers, S. S., Almada, A. A. & Golden, C. D. (2019). A call for clinicians to act on planetary health. The Lancet, 393(10185), 2021 doi:10.1016/S0140-6736(19)30846-3 [CrossRef]
- World Health Organization. (2018, February1). Fact sheet: Climate change and health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health