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Introduction
Talking about the environment is not new in Nursing. Florence Nightingale, in her environmental theory, emphasized the importance of clean air, water, and light for the care and maintenance of health. Likewise, Virginia Henderson, Faye Glenn Abdellah, Madeleine Leininger, Dorothea Orem, Nola Pender, and Jean Watson included in their theories the environment as an indispensable element in the care of people 1; however, the inquiry in Nursing about climate change is relatively novel, making necessary the research and intervention around the knowledge and behaviors related with this phenomenon and its consequences on health 2.
The responsibility of nurses (male and female) in global health promotion is declared in the 2021 ICN Code of Ethics for Nurses as one of the four principal elements in the frame of an ethical practice. The code promotes equity in health services and the protection of human rights, which implies advocating for politics and practices that protect and better the environment for all people, especially those in situations of vulnerability. Even if it does not address environmental protection, its focus on the promotion of health and equity and the defense of human rights implies an integral consideration of the physical and social environments where people live and their impact on health 3.
The South America 2022 Report, from The Lancet Countdown about health and climate change evidences the affectation of the region's population, due to the progressive increase of temperature, the decrease in precipitations, the glaciers' melting in the Andes, and the increase in the sea level the Atlantic and Pacific oceans, to which the Niño phenomenon and the vulnerability of populations due social and environmental determinants add 4.
The increase in temperature not only generates a greater risk of wildfires but also has direct impacts on human health, especially on cardiovascular, respiratory, kidney, and eye diseases; vectorial and zoonotic illnesses; pesticidal intoxication; food poisoning; hepatic dysfunction; diarrhea; and neurological and mother-child (premature birth, low birth weight, neonatal death, neonatal stress, and malaria placenta infection, among others) 5.
What can we do from Nursing?
Climate is a reality and the predictions around it suggest the scenario of a threat to human health and health systems, which makes it a concern and a challenge for Nursing, because as a discipline it may become a transformation agent to contribute to the relief of and adaptation to climate change 4. Nursing professionals cannot be unaware of this scenario, which is why it is necessary to design strategies that allow caring for human health from a perspective of equity and environmental justice 3.
The first step is to raise awareness about climate change and the need for sustainable nursing practices, at hospital and communitarian levels, advocating for governmental decisions where environmental responsibility and sustainability are considered 6, as well as their inclusion in the professional training curricula and their thematic cross-cutting in nursing consultations, in a way that the professional advocates for the social participation in environmental justice and that promotes healthy environments, through the education of people, families, and communities 7.
Worldwide, various professional associations have accepted the challenge of working around the relationship between climate and health. In Nursing's particular case, fifteen years ago the Alliance of Nurses for Healthy Environments (ANHE) was created, and two years ago the Latin-American chapter was opened, which has guided its work and research on Nursing, the environment, and climate change, as well as in education and law. Currently, it has healthcare professionals from hospitals in Chile and Mexico, as well as undergraduate and graduate students and teachers from fourteen Latin-American and Caribbean countries.
Little by little, ANHE Latin-America has gained spaces in international scenarios thanks to its support of different initiatives of other professional associations and Nursing students, schools and hospitals, as well as through the publication of the Climate Justice Agenda for Nursing: A Guide for Latin-America and its participation in the United Nations' Science Summit UNGA 78 and the UAE COP 28. Additionally, the ANHE has collaborated to strengthen the competencies and abilities of professionals through academic exchange from a cultural perspective, centered on the Global South environmental problems. These experiences started in 2023, and it is expected to continue annually to support Latin American nurses in the new global challenges.
All of this work is strengthened through the interaction with other professions and transdisciplinary research. In this way, the promotion of a healthy environment for people, families, and communities is aimed at, creating spaces for law as a strategy that combines social and individual actions, establishing a commitment and support of the environment from Nursing.
One concern from ANHE Latin-America has been the harmonization of theory with sustainable practices, based on Jean Watson, who states that Nursing implies self-realization within an energetic caritas contemporary framework (care to a deeper level, with love), inviting other considerations that make new and wider connections between the inner and the outer, in self-development, and between the human and the universe, beyond conventional separatist mentalities of the West -that is, the prevailing mentality that confronts humans against themselves, against the environment, the planet and the greatest universe that is our shared home 8. In this context, a care alphabetization is proposed where it is highlighted that the nursing professional is part of the environment and is within it, and as a consequence, must change his/her way of being, doing, and knowing in that same physical environment that surrounds him 9.
In the face of this challenge, a reflection on our being and our doing in nursing is required to go beyond the classical care centered on illness, this will allow for an advancing pragmatic opening to a discipline that can sustain humanity and life. The environmental crisis and climate change we are facing invite us to advocate and strengthen our participation in the development of health public politics aimed at the care of human beings and the environment, with a vision of equity and climate justice 10.
Conclusions
Addressing the challenges in the Nursing discipline for environmental care requires an ongoing commitment to education, interdisciplinary collaboration, and transformative leadership. Working together to overcome these challenges, nurses can play a crucial role in protecting the environment and promoting global health.
It then requires professionals to prepare to face this new panorama. We need to embrace the holistic perspective of the human being and become aware of the vulnerability of all species. At this time, the nursing profession needs to be able to generate strategic alliances and participate in decision-making aimed primarily at the well-being of individuals and communities.
