The World Health Organization predicts that between 2030 and 2050, climate change will be responsible for approximately 250 000 additional deaths each year due to malnutrition, malaria, diarrhea, and heat stress.1 Nursing is well poised to assume a primary role in building a climate-resistant health system. Methods to reach this goal could include developing climate-informed health programs, participating in climate-centered policy and advocacy work, as well as enhancing the capacity of the nursing workforce to address climate change-related sequelae.2
The American Association of Colleges of Nursing (AACN) publication, The Essentials: Core Competencies for Professional Nursing Education,3 has outlined a reconceptualized approach to nursing education that requires a competency-based approach. Along with these changes, there are specific recommendations to include climate change, disaster planning, and system-level approaches to public health emergencies.3 In light of these events, the publication of Vandenberg's "Planetary Health: Preparing Nursing Students for the Future" arrives at a nearly perfect point in time. This article highlights the importance of a global perspective and the use of the Planetary Health Education framework as a model to incorporate climate change into nursing education programs. The framework includes 5 distinct domains, which can be incorporated into the redesign of our undergraduate and graduate plans of study.
As a family nurse practitioner (NP), primary care provider (PCP), and NP educator, my focus is preparing future NPs and PCPs to provide comprehensive, high-quality care to individuals across the life span and continuum of care. Many current advanced practice registered nurse students do not have a strong background in environmental health or the health risks associated with climate change and may not appreciate how this will impact their work as PCPs. A recent study of primary care clinicians revealed that while most providers believed asking patients about environmental exposures was important, nearly 60% did not routinely ask about exposures during patient health visits.4 When asked about barriers to addressing exposures, 57% of respondents reported limited knowledge and only 7% of clinicians reported having received training or education on how to address these topics with their patients.4
These findings highlight the gap in clinician knowledge about environmentally related health concerns including indoor and outdoor air pollution, food and water contamination, and exposure to toxic substances. The AACN and the National Organization for Nurse Practitioner Faculties have long called for transitioning NP education to the postbaccalaureate DNP, and the proposed curriculum template highlights multiple avenues in which to locate this content. Required course work in advanced physical assessment, pathophysiology, and pharmacology (3Ps) provides foundational knowledge on the impact of climate change on human health and well-being and can be further built upon in the clinical diagnosis and management courses. In addition, core courses in population health, epidemiology, health systems policy, as well as system thinking seminars provide additional opportunities to assess student acquisition of the knowledge skills and attitudes required to improve long-term patient outcomes.
Experts agree that climate change represents the single greatest threat to global health. Incorporating nursing professionals in the war on climate change is supported by a number of local, regional, and international organizations including the Alliance of Nurses for Healthy Environments, Pan American Health Organization, and International Council of Nurses, to name just a few. It is time for us to embrace this crisis and do what we do best-prepare our students for a future where their work will make a difference in the lives of individuals everywhere.
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