Last Christmas, while doing the obligatory holiday shopping, something caught my eye it was not the ad for the sale at Macys but the one on the bus stop urging harried New Yorkers to use a cloth bag for Christmas shopping. No doubt inspired by the recent Nobel Peace Prize awarded to Al Gore for his work on the environment, and by the election year ahead, environmental issues have reached fever pitch. New York and elsewhere are going green. Americans are becoming more aware of or alarmed by, the overriding environmental issue of the times: global warming. The earth is febrile and its inhabitants are already suffering its consequences. The U.N. Intergovernmental Panel on Climate Change is predicting catastrophic results in weather changes, sea levels, and food production.
According to the website of Health Care Without Harm (www.noharm.org), a web-based organization campaigning for environmentally responsible health care, hospitals generate more than two million tons of waste each year. This conspicuous wasting is displayed at every patients bedside and throughout all aspects of the healthcare system. Start with the breakfast tray. Every day, tons of unopened packages of food are thrown in the trash. According to pioneer and foremost garbologists (garbology is the science of refuse and trash studies) William Rathye and Robert Lilienfeld, out of 160 million tons of waste that enters the American landfill each year, 20% is food-related. The list goes on and on.
I am not an environmental scholar by any means. Im an average nurse whose education and experience is in arterial blood gases and warming blankets not in greenhouse gases and global warming. My stake in the subject is personal and practical. I grew up poor in a poor country. Since we did not have much, we wasted little or not at all and enjoyed a low-consumption lifestyle both at home and at work, so I know it can be done.
So how is the average nurse going to help in resuscitating the environment? A search on the ANA website under position statements on social causes yields nothing on environmental issues, whereas under environmental issues, a series of articles on the subject will come up. Although the government is still a long way from a comprehensive response to the challenge of saving the environment (could a JCAHO mandate be near?), here are some practical tips for nurses:According to Health Care Without Harm, hospitals generate more than two million tons of waste each year.
Take only what you need. Avoid hoarding supplies at the bedside. They will most likely end up in the trash when the patient is moved or discharged. Among the supplies I often found in patients bedside cabinets not in use or not needed were: 4X4 gauze, alcohol swabs, angiocaths, and extra basins/bedpans.
Declutter the bedside by not stockpiling nonessential supplies. Clutter is not only a fire hazard but also makes work disorganized. Dispose of expired items.
Reduce food waste by asking patients which items they wont be using before serving their meal trays and restore them appropriately.
Return reusable items such as unopened and unexpired sterile equipment.
Print out patient information like lab results only when absolutely necessary.
Stock and order only essential supplies. Do a stock inventory and assess unit supply and demand.
Turn off machines and lights when not in use.
Use paper bags instead of plastic bags for medicine delivery.
Send personal equipment articles (bedpans, urinals etc.) and medication with the patient he or she is moved to another unit.
Devise a system in which leftover meds are not wasted but can reused. For example, if the pharmacy stock of a certain drug is 10mg and you only need 5mg now, but you know that the patient will need a similar amount for the next dose, reuse the leftover, with due consideration for infection control issues and drug potency. (Be sure to check with hospital policy before implementing this procedure.)
Consider having a return-to-pharmacy box.
Strictly follow local recycling regulations. Listing of recyclable items is beyond the scope of this article. Please log on to www.epa.gov/msw/recycle.htm, or for New York, log on to: www.nyc.gov/recycle.
How about a Time-Out for recycling? Think of how we go through the checklist when a doctor is about to insert a central line (did he/she handwash? etc.). How about asking a similar question while doing after-care what do we recycle? This mental exercise will also make us dispose of biohazards appropriately.
Set up an Environment committee that will collaborate with management to make sure that the hospital operation supports a sustainable environment, purchases environmental-friendly products, adheres to local recycling rules, avoids food waste, or better still, serves organic patient nourishments (fair-trade and hormone-free).
There are 2.7 million nurses in America; imagine if each one of us returned just one alcohol swab back to the shelf on each shift. Or if all of us switched off a light that is not in use? What a difference that would make! By acting locally (at the bedside) and thinking globally, well be saving the environment while saving lives.