Elsevier

Nursing Outlook

Volume 69, Issue 5, September–October 2021, Pages 720-731
Nursing Outlook

From Florence to fossil fuels: Nursing has always been about environmental health

https://doi.org/10.1016/j.outlook.2021.06.007Get rights and content

Highlights

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    Highlights pivotal nursing contributions to environmental science throughout history, from Florence Nightingale, to science activists in the 60’s and 70’s, to changemakers today

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    Describes the programs of research of leading environmental nursing scientists and how their work has paved the way for future generations of researchers

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    Emphasizes that all nurses must incorporate environmental science and translation into their research and practice; this is especially critical today in the context of urgent threats like climate change, significant racial health disparities, and emerging pathogens like COVID-19.

Abstract

Background

Since its founding, professional nursing has applied an environmental lens to healing.

Methods

This CANS 2020 Keynote article describes the history of nursing environmental science and nurses important contributions to the US Environmental Justice Movement. Starting with Florence Nightingale's Notes on Nursing, which established Environmental Theory, the paper introduces key figures throughout nursing history who have studied and advocated for environmental health and justice.

Findings

The paper emphasizes that nursing has always been about environmental health and that, regardless of specialty or practice setting, all nurses are called to incorporate environmental science and translation into their research and practice.

Conclusion

This call to action is especially critical today in the context of urgent issues like climate change, environmental racism and racial health disparities, emerging infectious diseases like COVID-19, and chemical exposures in the home and workplace (among others).

Section snippets

A Legacy of Trailblazers

In many instances, everyday nurses have stepped into national or global leadership roles out of necessity, when environmental hazards have threatened the families and communities they have served. Such threats were particularly pronounced in the late 1800’s and early 1900’s when housing and labor protections were in their infancy. At that point, nurses primarily practiced in community and occupational settings and were often the only line of defense against the dangers of shoddy construction

Important Exceptions and Critical Moments: Nursing Activism in the 60’s and 70’s

While nursing mirrored the health system's overall move towards reactionary medicine, there have been important exceptions in the form of outspoken environmental nurse leaders and activists at critical junctures in the US environmental justice movement. The 1960s brought a powerful constellation of events with lasting ramifications for both our country and profession. Historic occasions, like the Vietnam War, large-scale protests for race and gender equity, and outcry surrounding occupational

A Renewed Call to Action

No time period has matched the 70’s in terms of prolific environmental action across healthcare research, practice, and policy. And, while there have been notable calls to action for nurses since then—the Institute of Medicine's 1995 report, Nursing, Health, and the Environment; Provision 8 of the American Nurses Association Code of Ethics (2001); ANA's 2007 Principles of Environmental Health for Nursing with Implementation Strategies, among others—most nurses do not see themselves as

Threats to Vulnerable Populations

Children are most vulnerable to environmental threats. Reasons for this vulnerability include:

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    Fetal exposures to chemicals, which can manifest in the form of early childhood illnesses

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    Children's proximity to environmental hazards (i.e. by crawling, playing on, or simply being closer to the floor)

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    Learning behaviors like playing in dirt, putting soiled objects in their mouths, exploring high-risk areas (like cleaning cabinets)

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    The fact that children younger than 5 take in proportionately more air,

Where to Start?

There is a vast array of issues that nurses seeking to enter this space may choose to study, but nursing environmental science is typically organized according to four main categories:

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    Physical hazards: Earthquakes, tornadoes, volcanoes, blizzards, landslides, and droughts; ongoing exposures such as radiation, heat, noise, and sunlight

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    Chemical: Synthetic chemicals, pesticides and plastics; heavy metals like lead, mercury

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    Biological hazards: Viruses, bacterial infections, malaria, and tuberculosis

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Future Priorities for Nursing Science

This paper has illustrated the breadth of nursing environmental science, with several important themes emerging across illustrations. First, much of nursing environmental health research deals with the work environment; and this is not a spurious finding: Humans spend at least a third of their lives at work, and the type of work one does can be extremely hazardous to health. In 2016 alone, the US Bureau of Labor Statistics reported 5,190 occupational deaths and more than 2.9 million

Author Contributions

Both authors, McCauley, L. and Hayes, R., meet the definition of authorship according to ICMJE guidelines: Authorship credit is based on (a) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting the article or revising it critically for important intellectual content; and (c) final approval of the version to be published.

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    Conflict of interest: The authors declare no conflict of interest.

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