Environmental Health: Do No Harm
Water is life. It is the briny broth of our origins, the pounding circulatory system of the world. We stake our civilization on the coasts and mighty rivers. Our deepest dread is living too little-or too much. - Barbara Kingsolver
Today is the 40th anniversary of international Earth Day, and NAQ is in the midst of an issue devoted to Environmental Health: Do No Harm. On the first Earth Day, April 22, 1970, one US Senator, Gaylord Nelson, from my home state of Wisconsin, and a core of young organizers began a national teach-in on the environment and the "green" movement. Since then, Congress has passed 28 major initiatives that became the foundation of the nation's environmental laws, including the Clean Air Act, the Clean Water Act, the Endangered Species Act, the Safe Drinking Water Act, the Occupational Health and Safety Act, the Toxic Substances Control Act, and amendments strengthening the National Environmental Policy Act.
March 23 to 25, 2008, I was privileged to be included in a Fulbright Academy of Science and Technology think tank: Human Health and Environmental Challenges in the Middle-East in Doha, Qatar, sponsored by the Qatar Foundation. Approximately 80 international experts focused on the environmental issues affecting the health of all people, especially the children. During those very intense, thought-provoking days, an idea to devote an NAQ issue to this topic was discussed with Dr Barbara Sattler, who presented the curricula integration of environmental health into basic and advanced nursing education at the University of Maryland, which hosts the only graduate program for nurses that focuses explicitly on environment. Barbara Sattler, DrPH, RN, FAAN, Professor, University of Maryland School of Nursing, is the director of Environmental Health Education Center and has been working in the field of occupational and environmental health for almost 30 years.
She has served on Institute of Medicine committees on environmental health information and on the Maryland State Environmental Justice Commission and is currently serving on the Children's Health Protection Policy Advisory Committee to the US EPA. Dr Sattler has been the principal investigator on NIH (NIEHS) and EPA Research projects and the center she directs has been responsible for community outreach under an EPA Hazardous Substance Research Center grant working with communities that are struggling with contaminated waste sites, and she currently directs a model state program for engaging hospitals in sustainable and environmentally healthy practices. Dr Sattler helped to found the Alliance of Nurses for Healthy Environments, a national consortium of individual nurses and nursing organizations, which is addressing education, practice, research, and policy/advocacy issues associated with environmental health, and the National Environmental Health and Nursing Knowledge Network.
Anna Gilmore-Hall, RN, CAE, is the executive director of Practice Green Health, the nation's leading membership and networking organization for institutions in the healthcare community that have made a commitment to sustainable, eco-friendly practices. Members include hospitals, healthcare systems, businesses, and other stakeholders engaged in the "greening" of healthcare to improve the health of patients, staff, and the environment. She previously held the position of executive director of Health Care without Harm, a global coalition of more than 440 groups in 55 countries working to transform the healthcare industry, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to people and the environment. Membership includes hospitals and healthcare systems, medical and nursing professionals, community groups, labor organizations, and environmental and religious organizations. Before joining the HCWH staff, she was the director of occupational and environmental health at the American Nurses Association, a leader in linking occupational health with environmental health. At the American Nurses Association, she was responsible for developing and implementing environmental policy issues, along with occupational health and safety policy. She and Barbara are nursing luminaries, who have consistently worked and advocated environmental health sustainability, and NAQ is privileged to have them as coeditors for this unique issue.
Are we ready before it is too late to protect the environment we live and work in? The key question worldwide is whether we can create the balance between protection of the environment and sustained development. A Cambridge study released in January 2008, Lancet, links type 2 diabetes to environmental pollution factors. Where are we with emission controls, smoking, high infant mortality rates, and other child safety measure, including seat belt controls? Is our water safe to drink everywhere and palatable? Recently I was in a Midwest city, where the water had so many chemicals that I could not drink it. Some areas of our country have water scarcity issues, and the future does not look good for the next generations. Are nurse leaders in primary health doing their job as environmental sustainability advocates? Nurses working in all settings can impact health outcomes by making the connection between the health of the environment and the health of people. It is only with a healthy environment that we can truly have healthy people.
It is time to reexamine the role and increase the numbers of school health nurses. As leaders in the most trusted profession in the world, we have the ability to launch stop smoking campaigns and show black lungs to our youth and our own nurses so all can see the damage being done, graphically and for real. I lost my father, who was a lifetime smoker, to lung cancer at a young age and my daughter to cancer of the esophagus at age 47. She did smoke socially and had gastric reflex disease, sometimes considered stress-related. Are we allowing stressful work environments or nurturing our workforce in a positive way, to reduce stress and enable a less stressful workplace? Nursing administrative leadership is a major influencing factor to impact effective leadership in the community, the work setting, and healthcare systems in creating and maintaining sustainable healthy environments. We need partnerships with nursing education and practice settings to encourage environmental health research programs with evidence-based practice outcomes.
Enough of the talk, let us show action in what we believe and want for our healthy environment. I know, as I think of my progeny (14 grandchildren and 3 great grandchildren), I may be seen as a distracter, or a protagonist, but I like being old. It has set me free-no money, but free. While I am here, I choose not to waste time or resources, nor will I lament about what could or should have been, but I will think about what could be. I have been very blessed to be able to visit the major coasts and rivers of this great world-the Amazon, the Nile, the Ganges, the Yangsee, and all of the United States. Most recently, I drove the entire West coast and realized how hard so many dedicated environmentalists have worked to preserve our beaches and coastal waterways.
Yes, I have my "bucket" list and as you get older, it is easier to think positively, as you have earned the right to be wrong. My list includes seeing our country, not as a professional nurse speaking and consulting, but to appreciate and visit our many environmentally protected national parks, in expectation that we will sustain and nurture the beauty of America, for generations far beyond my lifetime. This issue of NAQ has reawakened in me the urgent need for all nursing leaders to embrace environmental health and sustainability in every aspect of our lives.
I expand and live in the warm day like corn and melons.-Ralph Waldo Emerson.
Nursing Administration Quarterly
Barbara J. Brown, EdD, RN, CNAA, FNAP, FAAN
Editor-in-Chief