Nursing’s metaparadigm, climate change and planetary health

Abstract

This paper offers a theoretical discussion on why the nursing profession has had a delayed response to the issue of climate change. We suggest this delay may have been influenced by the early days of nursing's professionalization. Specifically, we examine nursing's professional mandate, the generally accepted metaparadigm, and the grand theorists’ conceptualizations of both the environment and the nurse–environment relationship. We conclude that these works may have encouraged nurses to conceptualize the environment, as well as their relationship with it, mainly in terms of the individual patient, and as such, nurses have not been encouraged to understand these concepts from a broader perspective. By not having the philosophical and theoretical foundations to understand the environment in relation to society, it is not surprising that nurses have had a delayed response to climate change and may not have viewed it as a professional concern. A planetary health perspective is suggested as a theoretical basis for nursing education, research and practice. Taking on a planetary health perspective could help nurses progress the profession and move healthcare systems towards supporting a climate‐resilient future.

Nurses’ perspectives on climate change, health and nursing practice

“…Nurses may have not yet fully accepted climate change as a professional issue, and there is potential for nurses to benefit from increasing educational content on climate change and nursing's role in addressing it. This is not because the profession has not started this work (Goodman, 2011; Kalogirou et al, 2020; Kurth, 2017; Leffers & Butterfield, 2018; Sayre et al, 2010), or that professional bodies do not support the adoption of this issue (American Nurses Association, 2008; Canadian Association of Nurses, 2008; International Council of Nurses, 2018). Findings demonstrate that a gap remains between climate change and the consciousness of every‐day nurses.…”

Rhizomatic Assemblages: Connecting Climate Change to Nursing Action

“…Dominant discourses are reinforced through institutional systems, such as laws, media, industry, and education, which gain power through disciplining practices that organize space, time, and everyday activities. For example, from the outset of a nurse's education, nurses are socialized/disciplined to base their practice from an individual health and biomedical orientation (Butterfield, 2017;1990;Chandler et al, 2016;Schim et al, 2007;Thorne et al, 1998 Wright et al, 2020;Kalogirou et al, 2020). While this structuring of nursing knowledge was foundational in nursing professionalization, it is also responsible for nursing's tentative engagement and presence in global issues as a unified profession, especially climate action.…”

“…Nurses have long considered the environment a central domain of nursing practice; however, this conceptualization of the environment is now myopic in today's world. Rather than centering the focus on the individual's surrounding environment, we must shift our focus to understanding how the environment, from a local to global scale, impacts society at large and vice versa (Kalogirou et al, 2020). To do so, we need to engage in systems thinking to recognize the complex interdependencies influencing our patients' health.…”

“…Despite continued warnings that climate change poses a significant threat to human health, the nursing profession has been slow in engaging with this health threat and has yet to reach its full potential in climate action (Kalogirou et al, 2020;Leffers & Butterfield, 2018). While many nurses are aware of climate change's impacts on public health, most nurses do not believe that their work can effectively contribute to mitigating climate change (Xiao et al, 2016).…”

Awakening to the climate emergency

“…Despite the footprints of this wider thinking, we have clung to the deep and abiding tradition of individualized or person‐centered care as fundamental to nursing's unique angle of vision and distinctive contribution to health (Kalogirou, Olson, et al, 2020). In some respects, we have been the ultimate humanists (McCaffrey, 2018), resisting policy changes that override the individual expression of need, standing up for the particularities of the patients in our care so that their circumstances feature in shaping the experiences we provide for them.…”