Greening Healthcare

Regarding this week's module on greening healthcare, I was astonished to learn that 36% of nurses reported exposures to anesthetic gases and exposures led to an increased risk of congenital anomalies by sevenfold. As a former circulatory nurse working in the operation room, the data does concern me, and it allows me to be more mindful of all the chemical exposures that can occur in the healthcare setting. Also, I will consider choosing DEHP-free products in the hospital to reduce patients' risk for PVC and phthalate exposure. Furthermore, I am more conscious about handling medical waste so it can be appropriately disposed of.

This article stated that the health care industry is a significant contributor to climate change, as "healthcare creates a tenth of U.S. greenhouse gas emissions." In a separate article, Harveston revealed that the health care industry produces at least 4 billion pounds of waste annually. As a result, hospitals can convert to clean energy to reduce their environmental impact, and healthcare professionals can collaborate with policymakers to raise awareness regarding health risks due to climate change.

UCSF's green team is known as the "UCSF Office of Sustainability," and there is a specific page on their website involving "Greening the Medical Center." In 2015, the institution was recognized and given the Practice Green Health Environmental Excellence Award. After some research, the UCSF Supply Chain Management are the ones that make purchasing decisions.

Climate Change + Energy and Health

(Tehran Times, 2017)

Climate Change

As Earth Day is approaching, it is essential to address the issue of climate change. Climate change can have various impacts on human health, which is why it is crucial for healthcare professionals, such as nurses, to reduce health risks influenced by climate change by educating and advocating for their communities, as well as future generations. I believe that nurses, such as myself, can become prepared to address the effects of climate change that are likely to be experienced in my community by applying evidence-based research related to climate change into our practices.

(CDC, 2014)

The nursing community can use our trusted voices about health to strengthen climate change policies and practices by participating in organizations, promoting the use of environmentally safer products, reducing the use of products harmful to the environment, encouraging sustainable food purchasing, and advocating for vulnerable communities. Moreover, nurses can educate patients, as well as friends and families to reduce the health effects of climate change. More importantly, nurses must take the initiative to apply the knowledge of climate change and adapt the practices into our own lives to bring more awareness to the people around us.


Energy and Health

While the production of energy has a significant impact on the environment, human health and the well-being of many communities, I would say I am pretty comfortable with transitioning to sustainable and healthier energy choices. Currently, my house has solar panels installed, which I think is a big step. However, I can understand that renewable energy might not be feasible for everyone considering the cost, which is why I am in favor of the United Nations' Sustainable Development Goals of "ensuring access to affordable, reliable, sustainable, and modern energy."

Regarding incentives, the City of San Francisco established the GoSolarSF Incentive that "provides a monetary incentive to help residents and businesses install solar panels." The goal of the program is to reduce electricity bills and the city's carbon footprint. Furthermore, low-come residents can participate in the program as well, where customers can "save up to 100% off the installed cost of a solar electric system."

Occupational Health + Waste

Occupational Health

Materials Safety Data Sheet (MSDS)

I chose sevoflurane as a product that I wanted to look up using the University of California, San Francisco's (UCSF) Safety Data Sheets Database provided in the UC Safety Resources. I thought the MSDS was an adequate tool for a worker to use and gain an understanding of the potential health risks. It also provided simple safety instructions on how workers can protect themselves from the product. I would not consider the MSDS to be adequate or appropriate for the general public that reads at or below the 6th-grade level, considering some of the medical terminologies. 

Below is a comparison of UCSF's MSDS and TOXNET's report on sevoflurane:

(UCSF)

(TOXNET)

I thought both provided sufficient information for medical workers to follow. However, TOXNET elaborated more on human health effects, as the source also incorporated case reports and peer-reviewed data. 

Occupational Health Safety Program

The World Health Organization (WHO) occupational health and safety program that I chose was needlestick injuries because, in the past, I have experienced a needlestick injury. The WHO stated that "of the 35 million health-care workers, 2 million experience percutaneous exposure to infectious diseases each year," according to a report in 2002. As an effort to reduce needlestick injuries, the WHO implemented projects to promote injection safety by providing a toolkit and guidelines. 

The Cal/OSHA safety program I chose was safe patient handling because I sustained musculoskeletal injuries from mobilizing patients. As a result of the injury, I had to be placed on modified duty for two months, and it was debilitating to feel limited in mobility. The hospitals want to do their part to help reduce musculoskeletal injuries amongst hospital staff by incorporating the Cal/OSHA safety program and providing mandatory in-services on safe patient handling twice a year. 

Waste

I believe that nurses can play a role in addressing food waste by educating patients on practices to reduce waste. It troubles me when I see patients order trays of food, yet they only consume a portion of it, and the rest goes in the garbage. When patients are not placed on specific diet restrictions, individual hospitals allow them to order an unlimited amount of food items. I think hospitals can help reduce food waste by regulating the quantity of food that patients are ordering. Besides, hospitals can also implement practices to reduce the packaging of food products. I know some coffee shops give customers discounts if the customers bring in their own reusable tumbler/coffee mug, which can undoubtedly decrease waste if you can imagine how many Starbucks cups are used every day. After watching the clip on food waste in the United States on Last Week Tonight with John Oliver, I was surprised that grocery stores and restaurants were more willing to throw away food that was still good for consumption rather than donating because it was more expensive to do the latter. There is so much food wasted when there are families facing food insecurity globally. 

Nurses can exert leadership in addressing pharmaceutical waste by following hospital guidelines on proper disposal practices. Nurses can also promote these practices by educating colleagues, and if there is ever any doubt, I think it is essential to consult with the pharmacist or research the materials safety data sheet. 

After watching Lauren Singer talk about her zero-waste lifestyle on TED Talk, I was inspired to make some changes to lead a more sustainable and minimal lifestyle for myself. I find it frustrating that there is so much unnecessary packaging of materials in the world we live in today. 

Kathryn from Going Zero Waste provided "101 Easy Eco Friendly, Zero Waste Tips" in her blog. Below are a few tips extracted from her site:

• Ask for no straw in your drink order when out.
• Don't leave your house without a full reusable water bottle.
• Ditch tissues for handkerchiefs.
• Pick up a lonely banana.
• Always say no thank you to free promotional items. They tend to be cheap and break easily.
• Get a library card to support your local sharing economy.
• Donate unused items in good condition to support the second-hand market.
• Think second-hand first when purchasing something.
• Try elderberry syrup if you feel a cold coming on instead of immediately reaching for a plastic pill bottle.
• Swap your plastic toothbrush for a bamboo toothbrush.
• Turn old sheets and towels into handkerchiefs, rags, napkins, and cloth produce bags.
• Build a zero waste kit and put in the trunk of your car or carry it with you when you'll be out so you'll always be prepared. It doesn't have to be large just a few items!
• Wash clothes when they are actually dirty, instead of after only one wear.
• Open a window to cool down your home or air it out.
• Try to avoid palm oil.
• Buy food without packaging or minimal packaging.
• Instead of buying something when you're having a bad day, do something. I.e. go on a walk, take a yoga class, meet up with a friend.
• Repurpose stale bread.
• Make dry shampoo to stretch between washes.

Regulations & Policies

According to an article on the San Francisco Chronicle site, Tesla Motors is being fined for violating "hazardous-waste and air-emissions standards" at the manufacturing site in Fremont. The Environmental Protection Agency (EPA) made a statement on Monday that the company is fined a total of $86,000 "in penalties and equipment costs as part of the settlement." The EPA, Department of Toxic Substances Control and the Bay Area Air Quality Management District were involved in the inspection of the manufacturing site in 2017. The settlement requires the company to make improvements, which includes training workers on proper waste management. I found the article to be ironic considering Tesla is advertised as a sustainable brand that produces "clean energy" and has "zero emission." However, this article sheds light on the environmental impact that is caused by manufacturing "environmentally-friendly" vehicles. 

Regarding the article, I can see how poor hazardous waste management and air emissions by Tesla Motors can be directly related to human health. For example, it can affect workers that come into contact with the waste, and it can also change the air quality of residents that live near the manufacturing site. 

I am not aware of all the local elected officials, but this link provides an entire list of names for the City and County of San Francisco.

I have not personally tracked any health policies through my professional nursing organization or nursing union; however, I can become more involved in promoting health policies by collaborating with nursing leaders and government organizations, attaining knowledge about health policy through my doctorate program, and take advantage of resources regarding policy making.