My experience as a student nurse has taught me many things, but mainly about the fragility of life. At times, this fragility has felt overwhelming: the rise and fall of a patient’s breath, the tremor of a hand reaching for reassurance, or the quiet courage of someone facing uncertainty. As time passes, I find myself sensing another kind of fragility that is difficult to ignore; the fragility of the world that sustains us, the ecosystems that quietly labour so that we may live.

When I think about climate action, I think about bees because our actions, like bees, carry consequences far beyond what we can see. A bee spends its entire life moving from flower to flower, performing a task that is so instinctive it may never recognise its own significance. Yet this small, tireless being is responsible for pollinating crops that feed billions of us. Its labour keeps us alive, even though it may never be aware of the magnitude of its impact. I sometimes wonder whether we have misunderstood what power really looks like when we focus on the grand or dramatic, immediate things around us, whilst forgetting that ecosystems and health systems are shaped by the accumulation of tiny, persistent acts.

In nursing, we are taught to see patients as a whole people, shaped by biological, psychological, and social factors. For me, that understanding naturally extends to the wider environment- the places people live, the air they breathe, the food systems they rely on, and the conditions that shape their health. These environmental determinants are known to be inseparable from human well-being (1). I feel increasingly unsettled by the changes in our climate. But that sense of danger also reminds me of the potential we still have. It does not feel fixed or final. Rather it feels like a warning; a message we need to heed. In many ways, the climate’s response to what is happening in the world mirrors our own lives. We recognise that what we put into our bodies shapes our wellbeing, and the planet is not much different. Its reactions are simply physical consequences of what it has been fed and forced to endure. Just as our bodies give us signals when something is wrong, the Earth is also urging us to listen, reflect, and change. The choices we make, including what we consume, what we value and what we ignore, shape the planet’s health just as much as our personal choices shape ours. It feels less like a coincidence and more like a reminder that when our priorities move away from what sustains life, both the body and the earth begin to show signs of distress. Just as our bodies can heal when we change what we feed them, that change for planet Earth is still possible too, but only if we choose it.

I want to ask you something- 

We water our plants, positioning them carefully depending on what they need. We read the instructions and we adjust, noticing when something is wrong, and we change what we are doing, because we understand, intuitively, that a living thing placed in the wrong conditions will not thrive. We do this for plants, and many of us do this, tenderly and instinctively, for the things we love.

Why do we not do it for our patients?

We know from substantial evidence that whole-food, plant-based diets are associated with lower rates of cardiovascular disease, diabetes, obesity, and cancers (2). These conditions fill our wards, consume NHS resources, and quietly diminish the quality of people’s lives. Yet in my experience, diet is almost never discussed. We discuss socioeconomic factors, document comorbidities, refer to physiotherapy, and optimise medications, rightfully doing all of this with genuine care, and we should. But it feels like we have somehow collectively agreed to work around the thing that might matter most, as though what a person puts into their body every single day is too intimate, too complicated, or simply not our place to address.

Many believe that comorbidities are a natural part of ageing, as though deterioration is inevitable rather than, in many cases, modifiable. Our attention goes to survival, to extending life, reducing mortality, but what about the quality of those years? About what it might mean to not just live longer but to feel well whilst doing so. I find myself questioning whether many of us accept things as they are, because imagining something better feels too uncertain.

We also know that food systems are among the most significant contributors to global greenhouse gas emissions (3), and hospital food procurement accounts for a meaningful share of the NHS carbon footprint (4). And even though the NHS has committed to net zero by 2040 (5), sustainability concerns are still mostly absent from conversations we have with patients (6), and food that is not necessarily conducive to health or sustainability agendas is still being served to patients. The diets we fail to discuss with patients is not a neutral act. Every plate is both a clinical and environmental decision, whether we treat it that way or not.

Bees do not choose their role in the ecosystem; they simply act consistently and without hesitation in the way they were made to act. But we do choose. In consultations, we decide what to say, what falls within our scope, and whether to ask questions that could change a person’s life. Planetary health and patient health are connected expressions of the same underlying reality, one that is visible in a single person and the other across the world we live in. The food that heals a patient is also often the food that costs the earth less to produce. The diet that reduces a person’s risk of chronic disease is also the one that reduces greenhouse gas emissions. These things move together, like the bee and the flower, in a relationship that is both so ancient and elegant that it should fill us with possibility.

Human health is the first place where the consequences of our environment appear. To heal people, we cannot ignore the world that shapes them.

We are part of nature. Our lungs mirror forests; our blood mirrors rivers; our gut microbiome mirrors soil. When ecosystems are depleted, we are depleted, and when we nourish them, we are nourished. If we let that understanding guide the way we speak with patients in the care we provide, including having honest conversations about food, health and the world that shapes both, we will not be stepping outside our role as nurses.

We will be returning to it.

References

1. Watts, N., Amann, M., Arnell, N., Ayeb-Karlsson, S., Belesova, K., Berry, H., Bouley, T., Boykoff, M., Byass, P., Cai, W., Campbell-Lendrum, D., Chambers, J., Daly, M., Dasandi, N., Davies, M., Depoux, A., Dominguez-Salas, P., Drummond, P., Ebi, K. L., & Ekins, P. (2018). The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. The Lancet, 392(10163), 2479–2514. https://doi.org/10.1016/s0140-6736(18)32594-7
2. Almuntashiri, S. A., Alsubaie, F. F., & Alotaybi, M. (2025). Plant-Based Diets and Their Role in Preventive Medicine: A Systematic Review of Evidence-Based Insights for Reducing Disease Risk. Cureus, 17(2). https://doi.org/10.7759/cureus.78629
3. FAO. (2024). Greenhouse gas emissions from agrifood systems. global, regional and country trends, 2000–2022. Statistics; FAO. https://www.fao.org/statistics/highlights-archive/highlights-detail/greenhouse-gas-emissions-from-agrifood-systems.-global–regional-and-country-trends–2000-2022/en
4. Mortimer, F., Isherwood, J., Wilkinson, A., & Vaux, E. (2018). Sustainability in quality improvement: redefining value. Future Healthcare Journal, 5(2), 88–93. https://doi.org/10.7861/futurehosp.5-2-88
5. NHS England. (2022). Delivering a “Net Zero” National Health Service. https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2022/07/B1728-delivering-a-net-zero-nhs-july-2022.pdf
6. Kuiter, S. G., Herrmann, A., Mertz, M., Quitmann, C., & Salloch, S. (2025). Should healthcare professionals include aspects of environmental sustainability in clinical decision-making? A systematic review of reasons. BMC Medical Ethics, 26(1). https://doi.org/10.1186/s12910-025-01230-4

Author

Lily May Godfrey

I am a final year adult nursing student who is passionate about improving healthcare through the lens of sustainability and planetary health. I strongly believe in promoting health and well-being by focusing on lifestyles that prevent ill health at its root. I am committed to advancing nursing leadership that recognises the influence environment, diet, and social context has on wellbeing, and to delivering care that supports both people and the world that sustains them. 

Declarations of Interest
None