Letter to the Editor
Towards Nursing leadership in environmental care
Hacia el liderazgo de Enfermería en el cuidado del medio ambiente
Sergio García-Vicentea,b,
, Vicente Gea-Caballeroc, Agustín Llopis-Gonzáleza,d,e
Corresponding author
a Unidad de Salud Pública, Higiene y Salud Ambiental, Departamento de Medicina Preventiva y Salud Pública, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
b Dirección gerencia, Hospital Imed Valencia, Burjassot, Spain
c Escuela Universitaria de Enfermería La Fe (Centro Adscrito Universitat de València), Valencia, Spain
d CIBER – Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
e Centro Superior de Investigación en Salud Pública (CSISP-FISABIO), Valencia, Spain
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Our healthcare activity continues to improve life expectancy and quality, but to do so, paradoxically, the health sector generates a remarkably high amount of dangerous (radioactive, toxic, infectious, pharmaceutical) waste, consumes a great deal of energy and natural resources, and is responsible for a very high percentage of CO<span class="elsevierStyleInf">2</span> emissions (up to 25% of the emissions from the entire public sector in England<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>). In order to improve this situation the health sector, in line with increasing awareness and social concern, has implemented various initiatives designed to address the negative environmental impact of its activity. These initiatives are based on the premises of their greatest exponent, the WHO, in order to create environments and systems that promote health.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In light of the above, reflection, concern and ecological action are fundamental in our daily professional lives and must be consolidated and incorporated in all our activities and, given our activity sector, health care and protection, must be considered prerequisites. There are very significant and specific nursing activities which can serve as benchmarks beyond those highlighted by organisations such as the WHO. The position taken by the International Council of Nurses (<a href="http://www.icn.ch/es/publications/position-statements/">http://www.icn.ch/es/publications/position-statements/</a>) on the environment, clinical waste and climate change is key, based on “Environmentally responsible nursing”. The examples of the Royal College of Nursing- United Kingdom (<a href="http://goo.gl/tgruHq">http://goo.gl/tgruHq</a>) and their benchmark for better waste management, the initiatives of the Alliance of Nurses for Healthy Environments (ANHE: <a href="http://www.envirn.org/">http://www.envirn.org</a>) and the “Principles of Environmental Health for Nursing Practice” of the American Nurses Association (ANA: <a href="http://goo.gl/YFMmcH">http://goo.gl/YFMmcH</a>) in force since 2007, provide interesting proposals that we should at least be aware of.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Environmental improvement is very broadly achievable through nursing activity and awareness-raising. The leading role of nurses in this area is clear and more than necessary. The theoretical, ethical and practical principles of environmental sustainability<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> must be incorporated starting at undergraduate level, with ongoing training at postgraduate level, and even creating higher levels of specialisation (see <a href="http://www.pehsu.org/">http://www.pehsu.org</a>), seeking to raise ecological awareness to encourage responsibility towards the environment and its care, and provide a benchmark for citizens and other health care and non-health care professionals. Examples of practical, nurse-led projects to reduce the environmental footprint of health care include training “green teams” in health care centres, creating clinical waste reduction programmes, taking specific action in areas such as ICU, Emergency and Maternity departments and haemodialysis, and implementing partnerships with teachers towards a culture of health.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Communicating with the public to implement strategies to reduce carbon emissions and training health care centres and the community to better address the impact on health of climate change are further examples.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We do not have to be visionaries, take risks, follow models: we must maintain the continuous improvement in excellent yet sustainable care. We must continue to innovate from an “environmental” perspective that inspires and raises awareness, cooperating with every agent involved in health care: the public, politicians, managers, health care practitioners and providers. Social and ethical responsibility<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> in minimising the environmental impact of nursing and health care work and innovating through safer, more sustainable and efficient holistic practice<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> are essential elements while developing leadership by implementing strategies to disseminate care for the environment. This underpins a new nursing achievement that gives a professional image to the public above and beyond the “art of caring”.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Vicente S, Gea-Caballero V, Llopis-González A. Hacia el liderazgo de enfermería en el cuidado del medio ambiente. Enferm Clin. 2017;27:206–207.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available in: <span class="elsevierStyleInterRef" id="intr0035" href="http://www.sduhealth.org.uk/documents/publications/1237308334_qylG_saving_carbon,_improving_health_nhs_carbon_reducti.pdf">www.sduhealth.org.uk/documents/publications/1237308334_qylG_saving_carbon,_improving_health_nhs_carbon_reducti.pdf</span> [accessed 31.03.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NHS carbon reduction strategy for England" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Saving carbon, improving health" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "January 2009" "editorial" => "Sustainable Development Unit. 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Vezeau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/HNP.0b013e3181a110fe" "Revista" => array:6 [ "tituloSerie" => "Holist Nurs Pract" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "101" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19258852" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24451479/0000002700000003/v2_201706121007/S2445147916300200/v2_201706121007/en/main.assets" "Apartado" => array:4 [ "identificador" => "66560" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24451479/0000002700000003/v2_201706121007/S2445147916300200/v2_201706121007/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445147916300200?idApp=UINPBA00004N" ]
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