Nurses as Boundary Actors in Sustainable Health Care: A Discussion Paper

Authors

DOI:

https://doi.org/10.25071/2291-5796.105

Keywords:

Nursing's Role, Environment

Abstract

The devastating global health impacts of climate change are becoming more apparent and more frequent. Health care systems are increasingly burdened by the response to these impacts. Paradoxically, as they respond to the negative health effects of climate change, these same resource intense health care systems are contributing to further climate change. Organizations and academics have issued a call to action for health care workers to mitigate climate change and promote environmental sustainability. Nurses are an integral part of health care systems but have been delayed in answering this call. In this paper we argue that nurses are particularly well suited to mitigating climate change in health care systems because their existing role is central to patient care, and as a result they interface with other health care providers and have developed proficiency in articulation work.

Downloads

Download data is not yet available.

Author Biographies

Joanna Law, University of Alberta

Joanna is a Master of Nursing student with a focus in environmental sustainability and health care. Her clinical background is in adult critical care and addictions and mental health. It was during her time working as a bedside nurse that she noticed the amount of waste generated and the lack of waste diversion. This has inspired her to seek further education to learn more about how to create sustainable changes in health care. In her graduate practicum, she led and completed the Green Team Project for the Canadian Association of Nurses for the Environment. This project created the first national picture of health care green teams in Canada. She is excited to build on this project and engage in research to support environmentally sustainable changes in health care systems.

Dr. Kalogirou, Grant MacEwan University

Dr. Maya Kalogirou - Assistant Lecturer, Faculty of Nursing, MacEwan University

Dr. Kalogirou was born and raised in Edmonton, Alberta. She is a Registered Nurse with a clinical background in emergency room nursing and has recently graduated from the University of Alberta with her doctorate in nursing. Her program of research relates to climate change, health, and nursing practice, and her doctoral work examined: 1) Albertan nurses' perspectives on climate change and health, and 2) how the hospital setting influenced nurses' abilities to practice in environmentally responsible ways. She is passionate about finding ways to help nurses get engaged with the climate crisis and plans to continue working on developing nursing leadership in this field. Maya is the Alberta Representative for the Canadian Association of Nurses for the Environment, a nursing group that is a member of the Canadian Network of Nursing Specialties of the Canadian Nurses Association.

Dr. Dahlke, University of Alberta

Dr. Dahlke is an associate professor in the faculty of nursing at the University of Alberta, Canada. She has received international recognition as a Gerontological Nurse Educator, a McCalla Teaching Award, and is a certified gerontological nurse. Her program of research aims to understand how to improve nursing practice with older people, and has been awarded funding from Canadian national funding, as well as other provincial funding bodies. Dr. Dahlke’s program of research focuses on three main themes: (1) how nurses in interprofessional teams can enhance care of older people; (2) examining and improving nursing education related to older people; (3) how nurses’ perceptions of safety and harm and their context influences their practice with older people. For the past three years much of her work has focused on improving how nurses are educated to work with older people. As a result, she has developed and tested three e-learning activities (based on finding from her previous studies) to enhance undergraduate nurses’ education about older people. These e-learning activities have been tested and refined. Student nurses rate them as an interesting and helpful way to learn about older people.

References

Adrian, A. (2020). Climate and health. Journal of Perioperative Nursing, 33(1), 9–11. https://doi.org/10.26550/2209-1092.1077 DOI: https://doi.org/10.26550/2209-1092.1077

Allen, D. (2014). The Invisible Work of Nurses : Hospitals, Organisation and Healthcare. Taylor & Francis Group. https://ebookcentral.proquest.com/lib/ualberta/detail.action?docID=1775363 DOI: https://doi.org/10.4324/9781315857794

Alliance of Nurses for Healthy Environments. (2021). Alliance of Nurses for Healthy Environments. https://envirn.org/

Anåker, A., Nilsson, M., Holmner, Å., & Elf, M. (2015). Nurses’ perceptions of climate and environmental issues: a qualitative study. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 71(8), 1883–1891. https://doi.org/10.1111/jan.12655 DOI: https://doi.org/10.1111/jan.12655

Arnon, Z., Steinberger, D., Attias, S., Grimberg, O., Peterfreund, I., Schiff, E., & Keshet, Y. (2018). Nurses as boundary actors: Promoting integrative medicine in hospital wards. Complementary Therapies in Clinical Practice, 31, 96–103. https://doi.org/10.1016/j.ctcp.2018.01.014 DOI: https://doi.org/10.1016/j.ctcp.2018.01.014

AUTHOR et al. (2020). Nurses’ perspectives on climate change, health and nursing practice. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 29(23/24), 4759–4768. https://doi.org/10.1111/jocn.15519 DOI: https://doi.org/10.1111/jocn.15519

AUTHOR et al. (2020). Nursing’s metaparadigm, climate change and planetary health. Nursing Inquiry, 27(3), 1–9. https://doi.org/10.1111/nin.12356 DOI: https://doi.org/10.1111/nin.12356

Baid, H., Richardson, J., Scholes, J., & Hebron, C. (2021). Sustainability in critical care practice: A grounded theory study. Nursing in Critical Care, 26(1), 20–27. https://doi.org/10.1111/nicc.12493 DOI: https://doi.org/10.1111/nicc.12493

Canadian Association of Nurses for the Environment/Association d’infirmières et infirmiers pour l’environnement. (2021). Canadian Association of Nurses for the Environment/Association d’infirmières et infirmiers pour l’environnement. https://cnhe-iise.ca/

Canadian Coalition for Green Health Care. (2021). Canadian Coalition for Green Health Care. https://greenhealthcare.ca/

Canadian Institute for Health Information. (2020). Nursing in Canada, 2019 — Data Tables. Ottawa, ON: CIHI; 2020. https://www.cihi.ca/en/nursing-in-canada-2019

Canadian Nurses Association. (2008). The Role of Nurses in Greening the Health System. https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/greening_the_health_system_2008_e.pdf?la=en

Canadian Nurses Association. (2009). Joint Position Statement, Toward and Environmentally Responisble Canadian Health Sector. https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/jps_env_resp_e.pdf?la=en

Canadian Nurses Association. (2017). Climate Change and Health Position Statement. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/climate-change-and-health-position-statement.pdf?la=en&hash=5E757EEDA69508F4EEBF797902D6F843E4407EA4

Cook, C., Demorest, S. L., & Schenk, B. (2020). Nurses Climate Challenge: Educating 50,000 Health Professionals by 2022. Alaska Nurse, 71(1), 8–9. https://doi.org/https://doi.org/10.1891/1078-4535.25.3.208 DOI: https://doi.org/10.1891/1078-4535.25.3.208

Crimmins, A., Balbus, A., Gamble, J. L., Beard, C. B., Dell, J. E., Dodgen, D., Eisen, R. J., Fann, N., Hawkins, M. D., Herring, S. C., Jantarasami, L., Mills, D. M., Saha, S., Sarofim, M. C., Trtanj, J., & Ziska, L. (2016). The Imapcts of Climate Change on Human Health in the United States: A Scientific Assessment. https://doi.org/http://dx.doi.org/10.7930/J0R49NQX DOI: https://doi.org/10.7930/J0R49NQX

Eckelman, M. J., Sherman, J. D., & MacNeill, A. J. (2018). Life cycle environmental emissions and health damages from the Canadian healthcare system: An economic-environmental-epidemiological analysis. PLOS Medicine, 15(7), e1002623. https://doi.org/10.1371/journal.pmed.1002623 DOI: https://doi.org/10.1371/journal.pmed.1002623

Harris, N., Pisa, L., Talioaga, S., & Vezeau, T. (2009). Hospitals going green: a holistic view of the issue and the critical role of the nurse leader. Holistic Nursing Practice, 23(2), 101–111. https://doi.org/10.1097/HNP.0b013e3181a110fe DOI: https://doi.org/10.1097/HNP.0b013e3181a110fe

Health Care Without Harm. (n.d.). Leading the Global Movement for Environmentally Responsible Health Care. https://noharm.org/

Health Care Without Harm & ARUP. (2019). Health Care’s Climate Footprint. https://www.arup.com/perspectives/publications/research/section/healthcares-climate-footprint

Intergovernmental Panel on Climate Change (IPCC). (2014). Climate change 2014: Synthesis report. https://issuu.com/unipcc/docs/syr_ar5_final_full_wcover DOI: https://doi.org/10.1017/CBO9781107415416

Intergovernmental Panel on Climate Change (IPCC). (2018). Special Report. Global Warming of 1.5°C. Summary for Policy Makers. https://www.ipcc.ch/sr15/chapter/spm/

International Council of Nurses. (2018). Nurses, climate change, and healthy. https://www.icn.ch/sites/default/files/inline-files/ICN PS Nurses%252c climate change and health FINAL .pdf

Kallio, H., Pietilä, A., & Kangasniemi, M. (2020). Environmental responsibility in nursing in hospitals: A modified Delphi study of nurses’ views. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 29(21/22), 4045–4056. https://doi.org/10.1111/jocn.15429 DOI: https://doi.org/10.1111/jocn.15429

Keshet, Y., Ben‐Arye, E., & Schiff, E. (2013). The use of boundary objects to enhance interprofessional collaboration: integrating complementary medicine in a hospital setting. Sociology of Health & Illness, 35(5), 666–681. http://10.0.4.87/j.1467-9566.2012.01520.x DOI: https://doi.org/10.1111/j.1467-9566.2012.01520.x

Kurth, A. E. (2017). Planetary Health and the Role of Nursing: A Call to Action. Journal of Nursing Scholarship, 49(6), 598–605. https://doi.org/10.1111/jnu.12343 DOI: https://doi.org/10.1111/jnu.12343

Leffers, J., Levy, R. M., Nicholas, P. K., & Sweeney, C. F. (2017). Mandate for the Nursing Profession to Address Climate Change Through Nursing Education. Journal of Nursing Scholarship, 49(6), 679–687. https://doi.org/10.1111/jnu.12331 DOI: https://doi.org/10.1111/jnu.12331

Li, M., Gong, Z., Gilal, F. G., Van Swol, L. M., Xu, J., & Li, F. (2021). The Moderating Role of Ethical Leadership on Nurses’ Green Behavior Intentions and Real Green Behavior. BioMed Research International, 1–7. https://doi.org/10.1155/2021/6628016 DOI: https://doi.org/10.1155/2021/6628016

Nicholas, P. K. (2019). The Economics of Climate Change and the Intersection with Conflict, Violence, and Migration: Implications for the Nursing Profession. Nursing Economic$, 37(1), 23–34. https://insights.ovid.com/nursing-economic/nrsec/2019/01/000/economics-climate-change-intersection-conflict/5/00006073

Pocock, L. (2019). Nursing in an era of climate change. Middle East Journal of Nursing, 13(3), 18–21. https://doi.org/10.5742/mejn.2019.93699 DOI: https://doi.org/10.5742/MEJN.2019.93699

Polivka, B. J., Chaudry, R. V, & Mac Crawford, J. (2012). Public Health Nurses’ Knowledge and Attitudes Regarding Climate Change. Environmental Health Perspectives, 120(3), 321–325. https://doi.org/10.1289/ehp.1104025 DOI: https://doi.org/10.1289/ehp.1104025

Postma, J., Oldenhof, L., & Putters, K. (2015). Organized professionalism in healthcare: articulation work by neighbourhood nurses. Journal of Professions and Organization, 2(1), 61–77. https://doi.org/10.1093/jpo/jou008 DOI: https://doi.org/10.1093/jpo/jou008

Practice Greenhealth. (2021). Sustainability Solutions for Health Care. https://practicegreenhealth.org/

Saber, D. A. (2020). Healthcare’s role in environmental sustainability: RNs are needed to guide efforts. American Nurse Today, 15(10), 50–53. https://www.myamericannurse.com/wp-content/uploads/2020/09/an10-Environment-925.pdf

Sattler, B, & Hall, K. (2007). Healthy choices: transforming our hospitals into environmentally healthy and safe places. Online Journal of Issues in Nursing, 12(2), 12p-12p. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No2May07/HealthyChoices.aspx

Sattler, Barbara. (2011). Environments & Health. The Greening of of a Major Medical Center: An interview with nurse and “sustainability manager” Denise Choiniere. American Journal of Nursing, 111(4), 60–62. http://10.0.4.73/01.NAJ.0000396559.09620.94 DOI: https://doi.org/10.1097/01.NAJ.0000396559.09620.94

Sayre, L., Rhazi, N., Carpenter, H., & NL, H. (2010). Climate change and human health: the role of nurses in confronting the issue. Nursing Administration Quarterly, 34(4), 334–342. https://doi.org/10.1097/NAQ.0b013e3181f60df9 DOI: https://doi.org/10.1097/NAQ.0b013e3181f60df9

Strauss, A., Fagerhaugh, S., Suczek, B., & Wiener, C. (1985). Social organization of medical work / Organisation sociale de la profession médicale. The University of Chicago.

The World Economic Forum. (2021). The Global Risks Report 2021. http://www3.weforum.org/docs/WEF_The_Global_Risks_Report_2021.pdf

Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham, S. R. (1998). Nursing’s metaparadigm concepts: disimpacting the debates. Journal of Advanced Nursing, 27(6), 1257–1268. https://doi.org/https://doi.org/10.1046/j.1365-2648.1998.00623.x DOI: https://doi.org/10.1046/j.1365-2648.1998.00623.x

Warde, P., Sörlin, S., & Robin, L. (2013). The Future of Nature : Documents of Global Change. Yale University Press.

Watts, N., Amann, M., Arnell, N., Ayeb-Karlsson, S., Beagley, J., Belesova, K., Boykoff, M., Byass, P., Cai, W., Campbell-Lendrum, D., Capstick, S., Chambers, J., Coleman, S., Dalin, C., Daly, M., Dasandi, N., Dasgupta, S., Davies, M., Di Napoli, C., & Dominguez-Salas, P. (2021). The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises. Lancet, 397(10269), 129–170. http://10.0.3.248/S0140-6736(20)32290-X DOI: https://doi.org/10.1016/S0140-6736(20)32290-X

Downloads

Published

2021-12-18

How to Cite

Law, J., Kalogirou, M. R., & Dahlke, S. (2021). Nurses as Boundary Actors in Sustainable Health Care: A Discussion Paper. Witness: The Canadian Journal of Critical Nursing Discourse, 3(2), 36–46. https://doi.org/10.25071/2291-5796.105