Climate crisis and change management in nursing: A personal journey

After I moved from Canada to Australia in 2014, I started working as a community nurse. It took me a little while to adapt to the lifestyle of the lone nurse, travelling from home to home, and driving thousands of kilometres  per month. After a while, I noticed I could easily save fuel when using consistent fuel-saving driving behaviours. Being an asthma educator, I was well aware that air pollution is a major trigger for asthma flare-ups (Pollock, Shi & Gimbel 2017). Saving fuel for me was more than just cost, it became a professional responsibility towards my patients’ well-being.

I started spending time researching driving behaviours and fuel consumption. I took many hours, with the help of my project management office, to write a pilot project. My plan was to trial a mix of training sessions, technology implementation, and culture change actions to encourage fuel saving with nurses. Having solid backing from key managers and acting in a culture of open-mindedness helped me receive adequate resources to develop this project. I presented the initiative to the executive committee board and received good support and enthusiasm. Although this project did not get financial approval for implementation, the experience gained was worth my efforts.

In my research, I discovered an emerging community in the US, focused on nursing and climate change: the nursing climate challenge. This community’s sole purpose is to allow nurses to become educators specialised in the health impacts of the climate crisis. Of course, one does not become a nurse educator without credentials. I decided to take a course from eHarvard at edX.org on the health impacts of the climate crisis. This course helped me adapt the presentations with interesting Australian context and facts. Furthermore, it gave me the confidence to become a matter expert in front of my peers. Unfortunately, after my second education session, I was suddenly asked to stop further presentations in the workplace. Lesson learned: never underestimate the political impacts of your actions in your workplace! I was told the timing was not adequate to my change initiative. The political context was not favourable. For change to occur, it is imperative to understand your context and find key stakeholders at higher management levels who will support both you and the change you are bringing. I would also advise seeking their guidance on the scope and pace of your change initiative to maximise its success.

I have now changed the way I tackle the climate crisis as a nurse. I discovered nursing informatics and saw the opportunity to make health care more efficient and sustainable through the rapid implementation of new information technologies. Today, I work as a customer experience manager in nursing informatics while studying health service management. I conduct activist projects to sensibilise nurses to nursing informatics and change management. In informatics, there is money, resources, interest, and political agenda for growth. Information technologies are making nursing and health care more sustainable, efficient and safe.

Godbole & Lamb’s (2018) Making Healthcare Green is a great resource on this matter. Telehealth saves car travel and fuel-burning; electronic health records eventually translates to time-saving for clinicians, managers and executives; artificial intelligence starts providing outcomes in terms of early deterioration warnings, disability, mortality and length of stay reduction. Extra patient hours means more materials, energy, worker’s time and waste which ultimately results in more costs, pollution and carbon dioxide production. While recycling plastics and saving water use in the hospital are key parts of a more sustainable system, efficiency improvements are likely to make a much bigger impact in terms of CO2 reduction in the long term.

Healthcare CO2 production accounts for 7% of all emissions in Australia (Malik, Lenzen, McAlister & McGain 2018). As health care professionals, we have the ethical duty to be informed on the health impacts of the climate crisis, inform our patients and advocate for healthy environments (ICN 2012). Therefore we also have the responsibility to reduce this impact in our personal, professional and social lives. Whatever the topic, small or large, directly linked with green health care or not, if you work towards better efficiency, better management, better design or better health experiences, your innovative ideas will be helping to make health care greener.

As climate change continues and accelerates, Australian health risks will similarly accelerate, and disproportionately affect Australia’s most vulnerable and disadvantaged. The Climate and Health Community of Interest (COI) serves to inform and prepare nurses to ameliorate the health harm through capacity and skills building. You can learn more and join the COI on the ACN website.