Nurses working

For 17 years and counting, Americans have rated nursing as the most trusted profession. In the most recent Gallup survey, 84 percent rated nurses’ ethics as “very high” or “high” – 17 percentage points higher than medical doctors, who ranked second.

Shanda Demorest wants to leverage nurses’ positive reputation in the fight against climate change. To that end, Demorest, a professor at the University of Minnesota School of Nursing, last May launched a project called the Nurses Climate Challenge.

Her aim: Recruit a global community of nurses to inform 5,000 health professionals about climate change before the end of 2019. As of mid-January, over 400 nurses on five continents have educated 4,616 people.

“There’s a space for nurses in the conversation,” she said. “We’re the largest faction of people providing care for patients, and we’re really trusted.”

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To organize the challenge, Demorest works with two organizations that focus on health and the environment, Health Care Without Harm and the Alliance of Nurses for Healthy Environments.

Organizers initially planned to ask nurses to promote energy-saving initiatives in their hospitals, said Jessica Wolff, the U.S. director of Health Care Without Harm’s Climate and Health program. But they soon realized that many nurses weren’t aware that climate change could harm their patients.

“First they had to understand – really understand – climate change and health impacts,” Wolff said.

How climate change could harm health

As a whole, Americans are relatively unaware of the health impacts of climate change. Sixty-one percent have given little or no thought to how global warming might affect people’s health, according to a 2015 study.*

But the impacts are well-known by researchers. And communities are already feeling the strain of health challenges related to extreme heat, longer and more severe allergy seasons, vector-borne illnesses, air pollution, and natural disasters.

In 2018 alone, deadly heat waves scorched North America, Europe, and Japan; hurricanes and flooding caused fatalities; and air pollution from a devastating wildfire season in California aggravated respiratory illnesses.

Researchers have seen increasing cases of allergies and vector-borne diseases. In 2018, researchers at Rutgers University reported that allergy seasons are beginning sooner and that year-round pollen counts have increased, and the CDC has reported that cases of disease from mosquito, tick, and flea bites tripled between 2004 and 2016.

Future impacts are expected to be even more harmful. A 2018 study published in PLOS Medicine found that if emissions of heat-trapping gases continue at present rates, heat waves in most areas of the U.S. are likely to kill four to five times as many people between 2030 and 2080 than occurred between 1971 and 2020. The National Climate Assessment projects increasing strain on mental health, particularly in the aftermath of natural disasters. And in a report prepared for the late-2018 COP24 climate conference in Poland, the World Health Organization reported that between 2030 and 2050, the global population can expect “a highly conservative estimate” of 250,000 more deaths a year as a result of climate change.

Though dire, the World Health Organization report also presents hopeful news. If nations meet climate targets set in Paris in 2015 limit warming to below 2°C, it projects one million lives would be saved from the reduction in air pollution alone by 2050. (Poor air quality currently accounts for about seven million deaths annually.) Saving those lives, the organization found, would provide economic savings of twice the value of the cost of the policies needed to achieve the targets. But meeting the Paris targets is by no means a certainty. “Doing so would require unprecedented changes,” said Jim Skea, co-chair of the IPCC working group III, in a summary of the latest IPCC special report published in October 2018.

Nurses get to work

Those dangers – and the potential for change – are the impetus behind the Nurses Climate Challenge. The challenge urges nurses to inform their colleagues about climate change. The challenge also lays the foundation for the health care community to reduce its greenhouse gas emissions.

Researchers have found that within the health-care sector, there is significant room to reduce greenhouse gas emissions. The sector accounted for 10 percent of national emissions in 2013, according to a 2016 study by researchers at Northeastern and Yale Universities. Of that contribution, the study found, 36 percent of emissions came from hospitals.

“Hospitals are like this microcosm of society,” said Wolff of Health Care Without Harm. “Everything you do at home, they’re doing in a hospital times a lot.”

Hospitals use energy to keep spaces clean and sterile, but also to do laundry, prepare food, and light rooms. As a result, Wolff said, they use about 2.5 times more energy per square foot than a typical commercial building.

A cornerstone of Wolff’s program is a council of 19 health care systems that represent 500 hospitals in 35 states and Washington, D.C. Council members experiment with ways to reduce energy use, implement clean-energy infrastructure, and become more resilient to climate change. Wolff and her colleagues use the lessons learned to build toolkits for other health care institutions.

But transforming institutions can be slow work. That’s where the Nurses Climate Challenge comes in.

“As the perils of climate change are becoming more and more urgent, it’s important for us to reach out and directly activate both the nurses and the physicians as well as continuing to support, push, and pull the institution,” Wolff said.

How one nurse can make a difference

In Bozeman, Montana, emergency room nurse Julia Ryder joined the challenge in hopes of making her hospital more energy-efficient. Ryder worked through the spring and summer of 2018 to create a sustainability plan for her hospital. When she submitted the plan to hospital leaders, their response was initially positive.

“The CEO of the hospital loved it, but it’s been stagnant,” she said.

Her efforts were also met with resistance from some colleagues who considered her work too political. Ryder was frustrated, but refused to give up. Using resources from the Nurse’s Climate Challenge, she gave a presentation at an educational lunch for her colleagues. Ryder shared research on how climate change will affect their area of Montana and the impacts climate change will have on community health. She says the response was reinvigorating.

“I gained the support of my manager and co-workers,” she said.

Now Ryder works about 50 hours a month – on her own time – to shift the culture in her hospital. She shares her resources with other nurses and educators. She campaigns to reduce waste in the emergency room. She rallied her colleagues to insist that the hospital establish a green team. And she sends e-mails with subjects like “Calling All Superheroes” with the goal of infusing hope into conversations around climate change.

Ryder is also beginning to communicate the risks of climate change to her patients. When a child came in with a bad asthma attack, Ryder explained to the patient’s father that his child’s asthma is likely to be aggravated by climate change as the air is more frequently polluted by wildfire smoke and allergens. She urged the father to keep an even closer eye on local air quality.

“We rely so heavily on our planet that when the planet becomes sick, so do we,” Ryder said.

*Editor’s note: The director of the Yale Program on Climate Change Communication, which publishes this site, was one of the authors of the 2015 study mentioned.

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