New Hampshire - March 2022

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Page 16 • New Hampshire Nursing News March, April, May 2022 Policy Proposal continued from page 14 Name: Ms. Joan C. Widmer Credentials: MS, MSBA, RN, CEN Phone Number: 603-620-1531 Email Address: joan.widmer@ana.org Second Contact Person (or Designee) Name: Dr. Judith A. Joy Credentials: PhD, RN Phone Number: 603-477-4895 Email Address: judyajoy1@gmail.com 1. Provide reason for submitting the proposal: Because the single biggest health threat facing humanity is climate change (WHO, 2021), the strategic goal of evolving of the practice of nursing to transform health and healthcare will not be possible without addressing this topic. As the leading nursing organization, ANA needs to take a strong leadership position in addressing the impacts of climate change on human and population health and help prepare nurses to engage patients in conversations about climate change and its health impacts. The top two listings under a Google search of the key words “ANA and climate change and health” are the 2008 HOD Position Statement on Climate Change and Health and a Letter from ANA President, Rebecca Patton (term 2006-2010). Our knowledge of climate change and health has expanded significantly in the ensuing 12 years, yet ANA has shared little new information with nurses. Is this the sort of message ANA wishes to send to nurses, especially younger nurses who are passionate about this issue? Section 2 of this document will identify the numerous reasons why this issue is of national relevance, not the least of which is that the World Health Organization has declared that climate change is now the single biggest health threat facing humanity. Further, climate change is increasing the number and severity of weather related disasters and nurses need to be better prepared to address the health impacts of these disasters. Possible Questions to Ask: • What role can and should nurses play in increasing the awareness of the impacts of climate change on health? • What are the best ways in which nurses can advocate for climate actions to reduce the impact of climate on human and population health? • What can individual nurses do to help reduce their personal impact on climate change? 2. Explain how the topic/issue is of national relevance. In Florence Nightingale's Environmental Theory, she identified five (5) environmental factors: fresh air, pure water, efficient drainage, cleanliness or sanitation, and light or direct sunlight. Her observations are still relevant in today’s world as evidenced by this quote “According to the Standard 18 of the Standards of Professional Nursing Practice found in Nursing: Scope and Standards of Practice, 4th Edition,” the registered nurses practices in an environmentally safe and healthy manner. “ (ANA, 2021) We have seen an approximate 1.0 °C rise in average global temperature to date, and if greenhouse gas emissions continue unabated, the average global temperature is on a trajectory to reach between 3-4 °C increase by the end of the century. (WHO, 2021 and Climate Interactive, n.d.) Last fall, in advance of the COP26 in Glasgow, editors from over 200 health journals, including the prestigious New England Journal of Medicine warned that a global temperature increase of “1.5° C above the pre-industrial average . . . risk(s) catastrophic harm to health that will be impossible to reverse.” (Dewan, 2021 and Atwoli, et al, 2021) Conversely, if efforts to keep the temperature rise below 1.5 °C are successful, significant public health gains will be realized, such as half the number people globally will experience water scarcity; similarly, instead of 37% of the world’s population being regularly exposed to severe heatwaves, this will be cut by more than half to 14%. (IPCC, 2019) As demonstrated by the CDC wheel below, the climate crisis impacts many areas of health care: Section 3 of this document will identify the reasons why this issue is important to the ANA, the nursing profession and the public. Most importantly, as nurses are considered the most trusted and ethical profession, nurses need to be messengers of the impacts of climate change on human and population health; and ANA needs to take a leadership position in being the voice of nurses. The purpose of the proposed dialogue forum is first and foremost to inform nurses of the relevance and importance of this issue. It will also help to identify the most important role which nurses can play, what actions we can take as a profession, to address this issue. (CDC, 2021) WE ARE HIRING COTTAGE HOSPITAL. WOODSVILLE . NEW HAMPSHIRE REGISTERED NURSES FULL-TIME, PART-TIME AND PER DIEM DAY AND NIGHT SHIFT - BENEFIT ELIGIBLE MED SURG/ICU SURGICAL SERVICES EMERGENCY DEPARTMENT GERIATRIC PSYCH SIGN-ON BONUSES OFFERED FOR SOME POSITIONS! WHY COTTAGE? FOR MORE THAN 115 YEARS, COTTAGE HOSPITAL HAS SERVED THE RESIDENTS OF THE UPPER CONNECTICUT VALLEY. TODAY, COTTAGE HOSPITAL IS A LEVEL IV TRAUMA CENTER AND MODERN 35-BED CRITICAL ACCESS HOSPITAL THAT HAS BEEN RECOGNIZED FOR PROVIDING EXEMPLARY CARE. OUR HOSPITAL OFFERS LOW-COST, HIGH-QUALITY HEALTHCARE DESIGNED FOR YOUR SCHEDULE. “WE’VE CREATED AN ATMOSPHERE WHERE EVERYONE STRIVES FOR EXCELLENCE.” THIS “CULTURE OF EXCELLENCE” IS EVIDENT IN THE HOSPITAL’S QUALITY CARE RESULTS! We are an equal opportunity employer APPLY TODAY! COTTAGEHOSPITAL.ORG/CAREERS
March, April, May 2022 New Hampshire Nursing News • Page 17 The climate crisis may impact health directly, or by acting as a “threat multiplier;” that is, taking a common, treatable health care condition and catapulting it into a health emergency. For example: • An elderly patient with COPD easily maintained on home oxygen presents to the ER because his home has lost power in an extreme weather event, or • A patient with renal insufficiency suddenly requires dialysis because of an extreme heat event. • The mentally ill homeless person whose medications lose their effectiveness in extreme heat, or • Individuals displaced from their homes because of flooding at the onset of the COVID-19 pandemic, prior to vaccines being readily available. The good news is that “climate solutions ARE health solutions,” since many of the actions addressing greenhouse gas emissions reductions also improve indoor and outdoor air quality, increase activity levels, and improved diet. For example: • Transitioning to clean, renewable energy sources improves outdoor air quality. • Electrification of our transportation system improves outdoor air quality. • Electrification of our building sector improves indoor air quality. • Eating less meat is better for cardiovascular health. • Active transport is also better for cardiovascular health. And, as beautifully stated by Kailey Kanaziz BSN, RN, currently enrolled at University of Michigan School of Nursing graduate program: "With the climate crisis being an incessant and dire threat to human health, influential organizations like the ANA can help by taking a health-centric approach to discussing and acting on the matter. Young nurses, like myself, seek out organizational membership to stay current, and we look to established leaders and organizations for guidance on what emerging topics we should be paying attention to that are impacting our patients and practices. While climate change is far from being a new circumstance, the limited extent to which it is discussed is not proportional to the vast burden it is imposing on our health and communities. It is my hope that the ANA can serve as both a role model and trusted resource for climate stewardship in the context of healthcare. By updating their climate statement and integrating climate change awareness into every facet of the organization, the ANA will send a clear message to young nurses that our profession is committed to staying current, aware, and adaptable." Fortunately, the Alliance of Nurses for Healthy Environments, the Medical Society Consortium on Climate and Health and other groups (see below) have many wellestablished resources to empower registered nurses to educate themselves, their patients, and their community. Locating all resources in an easy to use site on nursingworld.org will reduce the need to reinvent the wheel. • Alliance of Nurse for Healthy Environments and Health Care Without Harm’s Nurses Climate Challenge • Climate - Smart Health Care • Medical Society Consortium on Climate and Health • MiAir/MiHealth (and other similar state groups) 3. Describe the impact of this topic/issue on the association, profession and/or the public. According to the World Health Organization (WHO, 2021), “climate change is the single biggest health threat facing humanity.” In its summary report of the COP26 Conference 2021, WHO recounted the many extremes that have occurred in our climate with unprecedented frequency in recent years including those that directly and indirectly impact health: heat, wildfires (air quality) hurricanes, droughts, and floods. They conclude that “The climate crisis is upon us .... The consequences for our health are real and often devastating.” (WHO, 2021) Likewise, the Union of Concerned Scientists has declared that human sponsored changes in our climate have created “one of the most devastating problems that humanity has ever faced.” (Union of Concerned Scientists, 2021) In 2018 the International Council of Nurses issued a strongly worded climate health position statement in an update to their previous statement. Its leading sentence states that public health advances over the past five decades are at risk due to climate changes. (International Council of Nurses, 2018) The Canadian Nurses Association (CNA) updated their 2009 position on Climate Change and Health in 2017. They conclude state that nurses, across the practice, research, leadership, education and social policy spectrum, must play a part in “adaptation and mitigation” in response to global climate change. Just last year, a poll by an independent polling organization (Pew Research, 2021) states that two thirds of Americans feel there is a need for greater focus on climate issues. With this overwhelming expression of concern by internationally respected health care organizations, credentialed scientists, the public, and the foremost international nurse organization it is incumbent upon nurses in the United States to address climate in practice. The foundational documents of the American Nurses Association also cite the profession’s obligation to address climate change. The Code of Ethics for Nurses concludes with the ethical obligation for the profession of nursing, collectively though its professional organizations to address social justice issues through nursing and health policy. Specifically, 9.4 Social Justice in Nursing and Health Policy states: “Social justice extends beyond human health and well-being to the health and wellbeing of the natural world. Human life and health are profoundly affected by the state of the natural world that surrounds us. Consistent with Florence Nightingale’s historic concerns for environmental influences on health, and with the metaparadigm of nursing, the profession’s advocacy for social justice extends to eco-justice. Environmental degradation, aridification, earth resources exploitation, ecosystem destruction, waste and other environmental assaults disproportionately affect the health of the poor and ultimately affect the health of all humanity. Nursing must also advocate for policies, programs, and practice within the healthcare environment that maintain, sustain, and repair the natural world. As nursing seeks to promote and restore health, prevent illness and injury, and alleviate pain and suffering, it does so within the holistic context of healing the world.” The newly revised Nursing Scope and Standards of Practice, 4th Edition, refers specifically to the issue of environmental health, stating that the registered nurse practices in a manner that advances environmental safety and health. Among the competencies identified for all registered nurses are: • “Analyzes the impacts of social, political, and economic influences on the human health experience and global environment. • Advances environmental concerns and complaints through advocacy and appropriate reporting mechanisms. • Promotes sustainable global environmental health policies and conditions that focus on prevention of hazards to people and the natural environment.” Additional competencies for the graduate-level prepared registered nurse, including the advance practice registered nurse include: • “Designs research addressing the connections between the environment, its conditions, and health status. • Uses community assessment data and plans to develop policies, recommendations, and programs addressing threats as well as prevention of hazards to both the people and the natural environment.” Policy Proposal continued on page 18
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New Hampshire - March 2022

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