This week’s blog has been written by Ebenezer Akore Yeboah, a nurse and PhD candidate at Coventry University, UK, specialising in nursing, climate change, and sustainability. He is a member of the UK Florence Nightingale Foundation’s sustainability expert group.

Climate change is having a widespread impact on all forms of life, leading to shifts in weather patterns, increased disease burdens, and economic struggles across the globe¹. Global institutions such as the United Nations, World Health Organization, and World Bank are calling for measures to reduce these impacts and protect the planet for human survival². The healthcare sector has recognized the significant influence of climate change on public health and is actively pursuing sustainability initiatives to reduce its environmental impact³ while continuing to care for those affected. Nurses, given their trusted role in society⁴ and close relationships with vulnerable populations, are in a key position to drive climate action and promote sustainable healthcare practices. Green initiatives being undertaken by nurses include sustainability in quality improvement projects (SUSQI), teaching sustainability in universities and others such as Ebenezer Akore Yeboah undertaking scholarly research.

Ebenezer’s PhD research on nursing and climate change involved three phases: a systematic review, a multi-country mixed-methods online survey, and a qualitative study with NHS clinicians and healthcare leaders. The systematic review utilised the Joanna Briggs methodology for mixed-methods review and found 18 papers from nine countries across five continents. It was however noted that continents with higher climate vulnerability had few studies done there (i.e. one study was found in Africa, no studies in South America, and three in Asia) ^5,6. The review findings showed that a significant proportion of nurses were unaware of how their daily practices impact climate change.

Ebenezer’s multi-country mixed-methods online survey with over 500 respondents from 56 countries found that most nurses recognised the connection between their daily practices and their potential impact on climate change. The survey also found that minority of nurses were aware of the term ‘Net-Zero Healthcare’. However, nurses’ willingness to participate in climate actions was notably high and many respondents felt that nursing activism could help slow down the progress of climate change. Despite growing awareness of climate change, there is a critical need for effective communication surrounding the implementation of sustainability policies within healthcare organizations. Preliminary findings of qualitative interviews with 15 healthcare leaders and clinicians, underpinned by an appreciative inquiry approach revealed the significance of developing sustainability awareness among health professionals, and channelling society’s eco-anxiety into eco-actions.

The results of this research highlight key areas for sustainable healthcare and potential for nurses to champion and support sustainability efforts in health systems. Organizational leadership is imperative to empowering nurses to embed sustainability in their healthcare practices. The research calls on healthcare organisations to have established priorities for sustainability and carbon reduction, set out clear ambitions and targets for the workforce, devise ring-fenced roles to achieve the desired outcomes, support to implement short and longer term strategic plans ranging from 1-10 years and looking beyond to a future focused healthcare systems. Furthermore, the research recommends incorporating climate change and carbon literacy training into undergraduate nursing proficiencies and post qualifying skill sets. By fostering a culture of sustainability, nurses can play a crucial role in mitigating climate change and ensuring a healthier future.

In conclusion, nurses play a crucial role in advancing sustainable healthcare by integrating eco-friendly practices into patient care, advocating for green policies, and promoting climate change education. They can lead by example in reducing waste, conserving resources, and supporting energy-efficient systems within healthcare settings. Nurses also have the potential to drive change through leadership, policy advocacy, and quality improvement projects focused on sustainability. By collaborating with other professional groups and engaging with communities, nurses can ensure that sustainability is embedded in healthcare practices, ultimately contributing to a healthier planet and a more resilient healthcare system. The nursing profession has the potential to drive sustainability through academic integration, and research. To maximize impact, nurses must be involved in policy decisions, as their engagement is essential for success.

Thank you to my supervisory team and co-authors; Prof Rosie Kneafsey (Director of Studies), Prof Amanda A R Adegboye, Dr Laura Wilde, and Dr Om Kurmi.

Reference

1. Intergovernmental Panel on Climate Change. (2022). Climate change: A threat to human wellbeing and health of the planet. Taking action now can secure our future. IPCC Reports.
2. https://ihf-fih.org/news-insights/the role of global organizations in sustainable healthcare (YEL 2024) – IHF
3. WHO, ‘Climate change and Health’, 2018 : https://www.who.int/news-room/fact-sheets/detail/climate-changeand-health
4. https://www.ipsos.com/en-uk/trust-politicians-falls-sending-them-spiralling-back-bottom-ipsos-veracity-index
5. Asmall T, Abrams A, Röösli M, Cissé G, Carden K, Dalvie MAJSoTTE. The adverse health effects associated with drought in Africa. 2021;793:148500.
6. Yeboah, E. A., Adegboye, A. R. A., & Kneafsey, R. (2024). Nurses’ perceptions, attitudes, and perspectives in relation to climate change and sustainable healthcare practices: A systematic review. The Journal of Climate Change and Health, 16, 100290. https://doi.org/10.1016/j.joclim.2023.100290