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Reducing the Environmental Impacts of Healthcare and Nursing Practice

By Beth Schenk, PhD, MHI, RN – ANHE Practice Work Group Chair

Nurses are the largest professional group in a polluting industry. There are more nurses than any other health profession in the United States, over 3 million RNs. RNs make up 30-40% of most hospital staffs. Nurses are at present at almost every clinical interaction and at many clinical decision points. At the same time, healthcare is quite polluting, creating 10% of Greenhouse Gases in the nation. In addition, hospitals are often the biggest water user in a community, healthcare creates thousands of tons of waste per year, and uses an abundance of toxic chemicals.

Nurses, very present in this industry, have a professional performance standard that states “The Registered Nurse practices in an environmentally safe and healthy manner.”  Yet nurses, as significant contributors to a polluting industry, are polluting!

What can nurses do to reduce the environmental impacts of healthcare and nursing practice? Much can be done, through behaviors, purchasing decisions, care protocols, direct care, and patient and community education. Nurses, as the most trusted voice in America for many years running, are in pivotal positions to make changes.

Take energy. Nurses can encourage their practice sites to use safer energy sources. Renewable energy, such as hydro, wind and solar created less environmental damage than fossil fuel based sources such as coal or natural gas. Nurses can ask about the energy mix at their practice site, be it a hospital, clinic, university, business or otherwise. Then nurses can encourage the organization to decrease fossil fuel sources and increase renewable. Nurses can also impact energy use in their practice. Nurses can identify opportunities to save energy, such as: using a low energy plan for empty rooms (beds unplugged, TV off, lights off, blinds left to optimize room temperature): in purchasing decisions, by encouraging energy star rated equipment and by asking about energy use in production of and transportation of a product. Nurses can commit to commuting to work in a less energy intensive way. Walking a biking not only save energy but promote health, and public transportation and car-pooling can reduce energy use.

Consider resource use and waste production. Nurses can decrease waste in several ways.  Push to return to reusable products where possible. For instance washable isolation gowns can be used up to 75 times, saving waste and money (and increasing comfort). Many single-use devices can be reprocessed for repeated uses, including oximeter probes, compression sleeves, blood pressure cuffs and many more. Nurses can help keep waste safe by proper segregation, so that hazardous waste is treated properly, and landfill waste is not over-treated, which is an energy-intensive and expensive process.

One hospital in Montana, through waste reduction, reprocessing of single use devices and energy conservation, saves almost a million dollars each year in cost avoidance.  Nurses are significant contributors to these savings.

Toxic chemicals create another challenge, and nurses end up being exposed to workplace chemicals.  Ask your environmental services staff to use certified green cleaners. Ask your food and nutrition staff to provide organic foods, and meat without antibiotics or hormones. Consider the presence of chemicals in purchasing decisions, and avoid dangerous ones. Work to eliminate DEHP in clinical plastics such as IV and O2 tubings. Wear the proper protection when handling chemicals, including pharmaceuticals.

Lastly, consider how you can be engaged with this challenge. Nurses are terrific advocates with their elected officials and city leaders. Speak up! Nurses are influential teachers of patients, friends and family members.  Help share science based knowledge about how a healthy environment is crucial to human health. Let’s help clean up the environmental footprint of nursing!

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