With the COP26 climate conference ongoing in Glasgow, the world’s gaze has again turned to the harrowing consequences of our westernised world in creating climate catastrophe. The much touted 1.5c predicted rise in global temperature by 2050 could displace millions, cause mass extinctions and great suffering, threatening the very survival of humans on planet earth. World leaders have gathered to be, in some ways, held accountable to their past pledges which did not materialise, but more to join in union and commit to tough choices which could reverse or prevent further worsening of the crisis. This summit is pivotal to the global effort, following the United States monumental decision to part from the Paris accord of 2019 and later re-joining under Joe Biden’s administration.
With climate change and climate action – there may not be an immediate cognitive link between global change and nursing. The effects can be subtle, yet persistent – for example, there are many patients in the United Kingdom with COPD (Chronic Obstructive Pulmonary Disease) and other lung conditions related to toxins, pollutants and chemical exposure, some as a direct effect of industrial processes and manufacturing. Some of the increased rates in children’s asthma rates is said to be because of emissions, pollutants and poor air quality due to diesel and petrol motor vehicles. Another example is extreme heat, famine, disease and widening of malarial disease ranges northwards from equatorial zones. As always, the effects of changes in climate on health in general become harder to detect with increasing longitude where it may not be related to death or catastrophic injury – but at the equator in zones like Africa or South America, the consequences of these changes are stark.
The biggest threat from these changes is mass displacement, poor health status and disease. This puts a large secondary pressure on health systems worldwide and causes increased years lost to disability or injury due to chronic disease. For the nursing sector, there are initiatives like Nurse’s Climate Challenge and the Climate, Health and Nursing Tool (CHANT) survey to learn, educate and understand perceptions around the issue, beliefs about its impact on services and open forums for discussion. For recommendations on how nurses can educate patients and promote healthy behaviours which build resilience against factors already present in the environment which provoke health risk, the Alliance of Nurses for Health Environments (ANHE) propose several actions;
With several public health issues, action is needed often before ‘five minutes to midnight’. Changes can be made early to improve patient health such as encouraging subsidence near green spaces, continuing exercise and diet, and improving other aspects of poor health which react poorly to climate pressure such as poor air quality or heat. For example, people with sub-optimal health status may react adversely to even slight increases in temperature or localised climatological changes, even within a summer. This can easily cause hospital admission not just in the elderly seen normally during heatwaves, but also to people with compromised cardiovascular systems, respiratory issues, and frailty.
A key link with this health guidance for nurses and patients is that nurses are often the first point of call for patients undergoing check-ups, regular screening and procedures, and thus have a space to become very influential over patient conversation and a good opportunity to counsel around health matters. For example, a patient with emphysema may not understand why their condition may have worsened in the last 30 years or so, and counselling that air quality linked, even in fraction to climatological change, will have had an impact. In this conversation, there is a door to be able to provide other lifestyle advice around sustainable products, avoiding actions which cause environmental harm, and overall a good opportunity to maximise other health outcomes.
The world will be watching with bated breath to see the outcome of the ongoing climate conference. Although the changes may affect everyone, health leaders may be the first to feel the brunt of vast climatological change in their services with health pressures from environmental change or crises related to climate such as flooding or extreme heat. In the interaction between nurses and patients, the opportunity to discuss health outcomes and lifestyle factors related to environmental change must not be passed up. It is these bottom-up changes in being proactive which make small differences, adding up to the sum of it’s parts.