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Before COVID-19, staff working in a paediatric ICU (PICU) had a variety of initiatives aimed at improving sustainability, but understandably, efforts slowed during the pandemic.

 “As a clinical area, ICUs dispose of huge amounts of single use plastic. Obviously, during COVID, PPE use increased exponentially, creating even more single use plastic waste,” says Evie Blaiklock, who was then working as a staff nurse and PICU sustainability nursing lead at the Evelina London Children’s Hospital. “In lots of hospitals where recycling had been widely available, suddenly it didn’t exist anymore.” 

As the worst of the pandemic began to recede, Evie and her team were keen to get back on track. “There was a definite desire within our whole team to try to become more sustainable, with lots of people talking about it,” she recalls.

When we started there was no recycling 

To kickstart the process, a survey was created, asking all staff members for three things they found wasteful on the unit, and how they could be tackled. Top of the list was reintroducing recycling bins, followed by reducing unnecessary glove and apron use, and minimising drug waste.

Rather than try to tackle everything at once, the unit focuses on a different theme each month, the first of which was recycling, with bins reinstated, appropriate signage, and up-to-the- minute information on what can and can’t be recycled, with good practice pointers. 

Making it habitual

“The idea is that by focusing on one thing each month rather than everything, people can get to grips with it more easily, and make it part of their daily routine,” says Evie, who moved to Barts Health NHS Trust this summer to become a research nurse.

Domestic staff were asked to monitor how much recycling was happening – with some dramatic results. “When we started, there was no recycling,” explains Evie. “When the bins were reinstated, we generated five to six full bags of recycling per day, equivalent to 60KG of recycling.”

Extra information and better signage improved rates even further, with up to eight full bin bags of recycling being collected twice a day – equivalent to 192KG of recycling per day. “Staff have made a huge effort to reduce waste and as a team, I think we’ve made a difference,” says Evie.

While managing the pandemic may have temporarily halted progress, sustainability has always been high on the agenda for nursing staff, says Rose Gallagher, RCN Professional Lead for Infection Prevention and Control and Nursing Sustainability Lead. 

We're a huge part of the solution  

“The focus has never gone away,” she says. “More than ever, I have members coming to me raising concerns around climate change and asking how they can get involved. They want to be active in ways that are relevant to them and the roles they have.”

Key to success is making sure efforts are integrated into everyday practice, rather than adding extra work to already over-stretched and exhausted staff, she believes. Getting involved in creating positive changes can also support the workforce.

“It helps health care professionals think about something else, where they can make their own contribution towards the greater good,” says Rose.

Climate change can feel overwhelming, she agrees. “And that can be a barrier to staff considering how to get involved,” says Rose. “The question I’m often asked is what difference can I make? But if we add up all the small changes we can do as individuals, both personally and professionally, it can make a big difference.”

The focus should be specific and relevant to the nursing profession, says Rose. Although health care’s climate footprint is 4.4% of net emissions globally – making it one of the largest contributors of greenhouse gases – it means there are also opportunities to create significant change. “Not only are we part of the problem, we’re a huge part of the solution too,” she says. 

Sustainability graphic

Get involved

In January 2023 the RCN launched a new UK-wide education programme, which provides an introduction to sustainability and action on climate change from a nursing perspective. It’s been designed to equip participants with the knowledge and skills needed to plan, lead and deliver health care with the principles of sustainability. The next one starts in September 2023. Book a place on the RCN sustainability programme

Together with NHS England, on 11 October 2022 the RCN hosted the first online five nations nursing and midwifery sustainability conference. It focused on raising awareness of sustainability and discussing opportunities to reduce the impact of care provision on carbon emissions. The conference outcomes fed into a nursing contribution towards COP27. “We are determined to take the nursing voice forward to these large political gatherings, so it remains visible and tangible,” says Rose.  

How can you make a difference? 

  • Ask questions and consider how things could be done differently, advises Rose. “We can’t continue doing things in the same ways we’ve always done,” she says. “We have a real opportunity to work differently.”
  • Become more involved in procurement decisions. “As nurses, we use the most consumables, and of course we need dressings and PPE. But can we use it more judiciously or improve the products we use?” says Rose.  
  • Share innovations and learning with colleagues across all professions. “Be a critical thinker and discuss your observations and potential solutions with others, including the RCN,” says Rose. 
  • Involving students and those who are newly qualified is crucial, Rose says. “You are our future leaders and will be the ones supporting health care services to manage the impacts of climate change,” she says. 
  • Be glove aware. “Check out our range of professional resources about appropriate glove use,” Rose adds.
  • Develop your own local networks or join established ones, advises Rose. “Grow a support circle and learn from others’ ideas,” she says. “The RCN is currently working on ways to expand our sustainability networks.” 
  • Listening to all staff, and acting on what they say is most important, and is crucial in ensuring their engagement, says Evie. “You need to let people feel they’ve been heard and their views are valued,” she says. “If people don’t want to change something, they won’t.”
  • Recognise that getting more involved in sustainability is a good way of managing your own anxieties about the climate challenge. 

    Sustainability illustration

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