护理在气候变化中的职责

“I want you to listen to the scientists. And I want you to unite behind the science. And then I want you to take action.” (Thunberg, 2017)

I began writing this on Earth Day, April 22, 2021, and I am finishing this at home in United States Pacific Northwest, which is recovering from an unprecedented ”heat dome” with triple-digit heat and climate change-induced wildfires. I was startled to find very little in the nursing literature regarding climate change even as the popular and scientific press indicate the urgent issues regarding the rapidly warming climate and the effects on health and well-being worldwide (Kalogirou et al, 2020). There are some comments regarding climate change in nursing essays regarding the United Nations Sustainable Development Goals (SDGs) and a very explicit call to action from the International Council of Nurses (Catton, 2020).

Lilienfeld et al. (2018) provide an excellent systematic review of papers and research relevant to nursing's role in policy, practice and advocacy in the context of climate change and the United Nations SDGs. They cite 48 papers that indicate opportunities for active involvement of nursing. The majority of the papers provided action items indicating what nurses as individuals can do for sustainability in their workplaces and their lives. Many encouraged the development of sustainability curricula in nursing education. The authors emphasized the need for nurses to give voice to the concept of “climate justice” and become advocates for equity in the distribution of resources that are dwindling due to climate change (water, arable land, and the like).

Considering the science, as teen activist Greta Thunberg urges us to do, there is little question that human activity has contributed directly to the warming of the planet, rising sea levels, consequent loss of livable coastline, and the potential for areas particularly of sub-Saharan Africa and India to become uninhabitable within 20 years. The negative effects of climate change on habitability and health are worst for the poor in every nation, creating a social justice crisis. The recent crisis of COVID-19 has only added to these problems by requiring the use of disposable personal protective equipment, non-sustainable practices of waste disposal and the like. Nancy Krieger, a former public health nurse, has linked the multiple crises of COVID-19, structural racism, police brutality, plutocracy, and climate change, calling for health professionals as leaders in “embodying health justice” (Krieger, 2020, p. 1621).

Our public health nursing colleagues have already given us a charge to engage in action in light of the SDGs (Rosa et al., 2019). But the urgency of the threat means we must go beyond individual actions.

Individually, we can reduce greenhouse gas emissions by using modes of transportation that have low emissions (e.g., electric, hybrid cars, bicycles, sustainable public transportation). We can avoid the use of single-use plastic water bottles. We can attend virtual conferences and meetings.

Collectively, in our workplaces, we can advocate for low emission waste disposal, rest breaks in areas that promote cooling, advocating for field workers rights to rest breaks in the shade, adequate hydration. We can advocate for the increased use of renewable energy in our workplaces and communities. The massive increase in disposable hospital waste during the COVID-19 pandemic cries for improved workplace practices and policies that segregate waste for reuse, recycling, and composting in addition to simply adding to the landfills.

In our professional organizations, we can advocate for changes to our conferences and gatherings that reduce the use of airplanes and other carbon-heavy modes of transportation. Virtual conferences came about quickly during the COVID crisis to reduce direct contact and protect against airborne transmission. For example, the International Council of Nurses (ICN) opted to have a virtual meeting for the 2021 Congress (https://www.icn.ch/events/icn-congress-2021). This was prompted by the COVID-19 pandemic but will have the added benefit of reducing greenhouse emissions of nurses traveling from all over the world to one site. Multiple general and specialty nursing organizations have made similar decisions over this past year.

Finally, we can become educated about and participate in the work of local and global nursing health alliances working against climate change. Examples include the Columbia University Global Consortium on Climate and Health Education (https://www.publichealth.columbia.edu/research/global-consortium-climate-and-health-education) and the Alliance of Nurses for Health Environments (https://envirn.org/).

The science tells us that climate change is real, is worsening, and imperils the health and well-being of everyone on the planet. Our professional obligations tell us that nurses must act now both as individuals and as members of the wider society.