“I am just one person what I do won’t matter, or what I do won’t make a difference.”
However, the collective efforts of small actions will cause positive change in the world.
The health care profession is in an ideal position to pioneer environmental sustainability because its goal is health and prevention of disease. Moreover, the health care profession has economic clout due to its huge buying power and can thus influence sellers and manufacturers. Health care also has the information to educate patients and the public about the connection between the environment and health or lack of health. For example, the following diseases have a direct correlation to environmental hazards: The rate of asthma has doubled in the last 20 years. At present 1 out of 166 children have autism. In the 1940s breast cancer incidence rate was 1 in 22 women, now it is 1 in 8. Childhood leukemia has increased by over 15% in the last 20 years. Toxins have been detected in fetal cord blood which indicates they pass from mother to child.
However, it is the nursing profession that is uniquely positioned to be in the forefront of positive change to care for the environment. Nurses comprise the largest segment of health care professionals but more importantly they are likely the most trusted of them.
To achieve the big ‘S’ of environmental sustainability there are three smaller S’s Let’s see how nurses are involved in each:
The first S is Safety: It should be a given that health care locations especially hospitals, should be safe havens. Yet the opposite is in many cases for both workers and patients. Studies of volunteer health care professionals have shown that their bodies contain the same chemicals they work with every day.
At Magee Women’s Hospital in Pittsburgh, Pennsylvania, nurses have succeeded in removing PVC a plastic widely used in hospitals, and DEHP from the neonatal intensive care units and nurseries. PVC when manufactured creates dioxin, a known carcinogen. DEHP has been linked to reproductive birth defects. DEHP is often added to PVC.
Hospitals are working diligently on eliminating mercury another poison from hospital and clinic use. This has been a largely successful endeavour in the US.
The second S is stewardship. There is a growing awareness among health care professionals that resources are valuable and that reclamation is possible. US hospitals generate 6600 tons of waste per day. In the past this waste was all discarded into one waste stream either incinerator or landfill bound. Thanks to nurse led initiatives still valuable resources are being separated from regulated medical waste. Some examples are the usual paper and plastic, cardboard, glass, but also silver from X ray films and recycling of batteries. Stewardship will result in less air and ground pollution, because the disposal of medical waste is a big contributor to both those types of pollution. This lessening of pollution can only have a positive impact on Americans’ health for generations to come.
The third S is sharing of resources. The story of the MERCI organization shows how stewardship and sharing create a global positive impact on health care in the world. MERCI was started by Helen French, an OR nurse whose boss gave her the responsibility of reducing the large amount of regulated medical waste from that hospital’s 19 OR rooms. Helen realized that much of the so called waste was still useful clean supplies. From her background as an immigrant from a war torn country she knew those supplies could make life very different for health care workers in developing countries. MERCI stands for Medical Equipment Recovery of Clean Inventory. From 1991-2004 this program has kept 200 tons of ‘gold waste’ from one hospital out of the trash. The idea has caught on with other hospitals, and many teaching clinics and medical facilities in the developing world are the beneficiaries.
Health Care without Harm a global coalition dedicated to reducing health care pollution has started the Luminary Project that aims to highlight nurses’ actions that support the environment. The Luminary Project’s website brings to light nurses’ stories of their accomplishments with the goal of inspiring others to take action in their community. Their motto is: Nurses lighting the way to environmental health.
The University of Maryland has a graduate program for nurses in environmental health. Professor Barbara Sattler Director of Environmental Health has been very active in promoting the nursing profession’s role in advancing environmental sustainability. U of M started EnviRN a website dedicated to providing nurses with accurate and credible information on environmental health and nursing; a virtual nursing village that shares tools, strategies and resources to advance environmental health in the whole community. Health is preventing disease by the recognition and reduction of risk factors. Empowerment is obtained through education and policy change.
The Alliance of Nurses for a Healthy Environment was created in 2008. Their four pillars are Education, Practice, Research, and Policy Advocacy.
Education involves developing curricula, and continuing education for example. Practices included both best practices and standard practices and model policy. Research will develop a compendium of environmental health info and sharing information on funding. Policy and advocacy are at the state and national level and aims to mobilize the nursing community.
Practice Greenhealth is another group that operates in conjunction with the American Nurses’ Association. It is a membership and networking organization for health care institutions that have made a commitment to environmental sustainability.
By hearing about those organizations and nurses readers can derive inspiration to help achieve the Millennium Development Goals. Millennium Development Goal number 6 states that nurses will strive for environmental sustainability. Environmental sustainability involves among other initiatives, safer hospitals, clean communities, and children born without exposure to toxins.
The beginning of any initiative is always the most difficult part. Yet small projects when combined have a synergy that creates hope for a nation and world in need of better health care. Nurses are able to combine head and heart knowledge and in the words of Helen French the founder of MERCI : “We all make a difference every day in our patients’ lives. Let’s join our efforts to be a tremendous power.”
Sources:
1. Meyers, N, & Raffensburger, C. (Eds.). (2006). Precautionary Tools for Reshaping Environmental Policy. Cambridge, MA: MIT Press.
2. Centers for Disease Control and Prevention. (2006). How Common are Autism Spectrum Disorders (ASD)? Atlanta, GA: Department of Health and Human Services. Accessed February 1, 2007 from http:// www.cdc.gov/ncbddd/autism/asd_common.htm
3. Evans, N. (Ed.). (2002). State of Evidence: What is the Connection between Chemicals and Breast Cancer? Breast Cancer Action and Breast Cancer Fund. Accessed February 1, 2007 from www.breastcancerfund.org.
4. Trust for Americas Health. (2006). Childhood Cancer. Accessed February 1, 2007 from http://healthyamericans.org/topics/index.php?TopicID=11.
5. National Cancer Institute. A Snapshot of Pediatric Cancer. Accessed February 1, 2007 from http://planning.cancer.gov/disease/Pediatric-Snapshot.pdf
www.enviRN.umaryland.edu
http://.theluminarryproject.org
http://www.reflectionsonnursingleadership.com/Documents/For_Children-opt.pdf
http://www.noharm.org
http://e-commons.org/anhe
http://practicegreenhealth.org
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The Synergy of One Plus One – Environmental Sustainability for Diesease Prevention is a nursing article from the: MNU Blog. Home of Dickies scrubs, Urbane scrubs, Landau scrubs, and more nursing uniforms.
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