Climate Change – Actions Community Nurses Can Take

In the second blog in this series, Angela Disney QN talks about some actions you could take to make your workplace greener and reduce your carbon footprint.

Advocate for climate action

Most of the non-clinical carbon footprint in healthcare comes from patient and staff travel, followed by energy use and procurement of services. Nurses need to take stewardship and lobby for:

• Reduction in unnecessary patient and staff travel
• Promotion of active travel (walking, cycling)
• Reduction in energy use by increased efficiency
• The Switch to renewable energy sources
• Procurement of sustainable goods and services.

As trusted professionals, nurses can also support the case for climate action by communicating the health impacts of climate change, the need for climate adaptation, and advocating for health to be at the centre of policymaking on climate change at local, regional and national levels.

At the local level, nurses could consider nominating a Clinical Champion within their team. This person could be charged with promoting the message, and reporting on the challenges, opportunities and progress regarding climate change and public health at clinical staff meetings.

Consider the carbon footprint of clinical practice

Good clinical practice can be both high quality and low carbon. Good clinical practice should focus on preventing ill health through measures including promoting healthy, sustainable diets, promoting active travel and environmentally friendly social prescribing for mental and physical health. Building healthier communities, taking action on fuel poverty, reducing polypharmacy, using green inhalers, and reducing waste can all make a difference. Prescribing accounts for over 60% of the average general practice’s carbon footprint. We should avoid or at least reduce unnecessary patient and staff travel and engage with the voluntary sector in promoting community awareness and education.

Use of disposable synthetic gloves during the pandemic increased considerably. The RCN, during annual glove awareness week asks nurses to think about using gloves and when they might not be required. Think of all the non-biodegradable waste generated by gloves, masks, aprons etc. A green Quality Improvement (QI) project could look at whether your workplace is being as efficient as possible.

Promote active travel

Walking or cycling to work reduces air pollution (which the Royal College of Physicians estimates is responsible for 40,000 premature UK deaths every year) and has huge benefits to our physical and mental health. Nurses should consider promoting active travel in community healthcare settings, lobby their employers to install cycle racks to help staff and patients travel by bike and consider obtaining e-bikes to enable staff to travel to home visits quickly. By demonstrating active environmentally friendly travel, community nurses can act as exemplars for patients. For those staff and patients worried about their safety on a bike, they could consider cycle proficiency training to build their confidence (this can be offered free by the local council). District Nurses in Dorset have been keen advocates of electric bikes in recent years – Hattie Taylor QN describes the benefits: https://www.dorsethealthcare.nhs.uk/about-us/news-events/press/dorsets-district-nurses-get-their-bikes

Green Social Prescribing and Quality Improvement (QI)

Consider how you can signpost to green social prescribing, which aims to signpost patients to social activities involving time spent in nature, such as gardening and guided walks, open gardens, planting trees, picking up litter and recycling. https://www.england.nhs.uk/personalisedcare/social-prescribing/green-social-prescribing/.

This year, the QNI, working with the National Garden Scheme has created a new joint programme to explore the benefits of gardens and health, the Elsie Wagg scholarships. For more information and to apply for the next funding round, see: https://qni.org.uk/explore-qni/nurse-led-projects/ngs-elsie-wagg-innovation-scholarship/

There are more useful ideas and links on the National Garden Scheme website: https://ngs.org.uk/green-therapy-is-gaining-momentum/

The Queen’s Green Canopy https://queensgreencanopy.org/ is a campaign to celebrate the late Queen’s Jubilee by planting trees – many GP practices and other health premises have space. The QNI has encouraged Queen’s Nurses to plant a tree for the Jubilee. Many other local and national opportunities exist, such as free trees for schools and communities (Woodland Trust – https://www.woodlandtrust.org.uk/plant-trees/schools-and-communities/) and the plant a tree for £5 initiative by the National Trust https://www.nationaltrust.org.uk/features/plant-a-tree.

You could also consider planting wildflowers that benefit pollinating insects in an unused space, something that more and more GP practices are embracing. Key things to remember are, from the gardening point of view, avoid the use of pesticides and only use peat-free compost. From the human perspective, some people may have allergies to some plants or insect bites so think about your site carefully and include clear signage.

Refer families who are in fuel poverty

A 2019 government report estimated that almost 11% of the UK population were living in fuel poverty and with the huge hike in fuel costs in 2022, this will soon affect far more people. Fuel poverty is linked to cardiovascular and respiratory diseases. Nurses in the community and primary care can support people experiencing fuel poverty to seek help where this is available, for example with insulation grants for homes, lowering fuel bills and reducing carbon emissions. Your employer should have more guidance about partnership working and when to refer people to other agencies.

Work at Primary Care Network (PCN) Level

By working with local PCNs, resources and energy can be pooled. Support can be rallied to encourage a green mindset across many general practices and other healthcare providers. Money invested at this level can be used more strategically to develop individual climate action QI projects. PCNs could support initiatives such as pocket gardening (creating small garden areas), e-bike schemes for patients with chronic diseases, recycling schemes, negotiating discounts for block renewable energy contracts, etc.

In the third and final blog in this series, we will look at what actions we can all take as individuals, at home as well as in the workplace.

Other Resources

The National Health Service is responding with increased urgency to the environmental agenda. For more information see: https://www.england.nhs.uk/greenernhs/

The Royal College of Nursing acknowledges and supports the need for action to reduce our carbon footprint: Search results | Royal College of Nursing (rcn.org.uk).

Some Twitter accounts to follow:

@GreenerNHS
@GreenerPractice
@SusHealthcare
@NHSForest
@UKHealthClimate

Other blogs in this series:

• Climate Change: a Public Health Crisis
• Individual Actions for a Greener Planet

Main photo courtesy of pexels, Marcus Piske