Environmental Health Advocacy and Nursing Practice

1. Environmental Health Advocacy and Nursing Practice Brenda M. Afzal, MS, RN U.S. Climate Policy Coordinator Health Care Without Harm

2. To advocate: to act in support of a particular person, group, or cause. Case Advocacy: On behalf of an individual Class Advocacy: On behalf of a group Policy in 25 words or less…. “At the end of the day, the formulation of [environmental health] public policy involves a process of making good decisions – for the public good.” Sherri Toriman Caledon Institute of Social Policy What is “advocacy” and “policy” and how are they relevant to nursing practice?

3. Why Nurses? • Environmental Health Advocacy is Fundamental to our Roots • We are “fix it” people. • We recognize the wisdom of heeding early warnings. • We care passionately about our patients and our communities. • We are trusted conveyors of health information to our patients, community members, AND policy makers. • There are a lot of us • And we get it……

4. We understand that our bodies are becoming alarming reflections of the toxic chemicals in our AIR… Brenda M. Afzal, RN, MS Google images

5. IN OUR FOOD…. Brenda M. Afzal, RN, MS

6. IN OUR WATER…. Brenda M. Afzal, RN, MS

7. Supporting Framework • Institute of Medicine Report: Nursing Health and the Environment • Timeline: Organizational Actions • APHA PHN Section’s EH Principles for Public Health Nurses • ANA Standard 16:  Environmental Health 

8. Current Opportunity for Action May 16, 2011 Dear Nursing Colleagues: It Is Time To Take ACTION! We are thrilled to announce that Senator Lautenberg has introduced the “Safe Chemicals Act of 2011.” This bill will improve the health of all Americans. We want nurses across the country to support this important legislation by asking you to: Contact your U.S. Senator and encourage them to consider becoming a co-sponsor of this bill. Nurses know that the chemicals in our environment are having an impact on our health and the health of those for whom we care.  We know that most consumers believe that if a product is in the market for sale that it has been tested and are safe. This is just not true.  Write your Senator and ask them to be a co-sponsor of this important legislation to improve the health of Americans. http://org2.democracyinaction.org/o/7183/p/dia/action/public/?action_KEY=6636

9. Opportunity for Action Tell EPA: Close Toxic Air Pollution Loophole from Coal-fired Power Plants The Environmental Protection Agency has proposed a rule that will significantly reduce emissions of mercury and other hazardous air pollutants from power plants. This cleanup action is long overdue!  A 'toxic loophole' has allowed many coal-burning power plants to operate without any federal limits on emissions of mercury, arsenic, dioxin, acid gases such as hydrogen chloride and other dangerous pollutants. The U.S. Environmental Protection Agency is currently accepting comments on new standards that will cleanup this toxic power plant air pollution.   We can and must act to make sure that the promise this rule proposes is kept. Please, send in your comments today! http://org2.democracyinaction.org/o/5140/p/dia/action/public/?action_KEY=6798

10. Thank you! Brenda Afzal, MS, RN Brendaafzal@gmail.com 410-465-6907

11. Presentation Appendices

12. Institute of Medicine Report: Nursing Health and the Environment • To prepare the profession for a broader range of advocacy activities, nursing curriculum and continuing education programs may come to include content on lobbying, use of media, mediation, expert testimony, community organizing, and the like. In the meantime, whether with institutional support or on their own, nurses who are stretching the definitional boundaries of advocacy practice will need to build skills that were likely not part of their basic nursing education.” (IOM, 1995)

13. Timeline: Organizational Actions 1986ICN: Nurses role in Safe Guarding the Environment 1991NASN: Environmental Impacts in Schools 1994AORN: Definition of Regulated medical Waste 1997ANA: Reduction of Health Care Production of Toxic Pollution 1999ICN: Reduce Environmental and Lifestyle Created Hazards 2001 NASN: Position Paper on Indoor Air Quality AWOHNN: Protecting the Health of Women and Children from Environmental Toxins 2002ICN: Universal Access to Water 2003 ACNM: Environmental Pollutants in Breast Milk ANA: Adopts the Precautionary Principle 2004 ANA: Resolution on Inappropriate Use of Antimicrobials in Agriculture 2005 APHA: Environmental Health Principles & Recommendations for PH Nursing AORN: Guidance Statement: Environmental Responsibility 2006 ANA Resolution, Nursing Practice, Chemical Exposure and Right to Know ANA: Board of Directors passes position statement on use of Thimerosal in Vaccines NSNA: Increased Awareness Regarding Minimizing Exposure to Medically Generated Toxins

14. Safe and sustainable environments are essential conditions for the public’s health Environmental health is integral to the role and responsibilities of all public health nurses. All public health nurses should possess environmental health knowledge and skills. Environmental health decisions should be grounded in sound science. The Precautionary Principle is a fundamental tenet for all environmental health endeavors. Environmental justice is a right of all populations. Public awareness and community involvement are essential in environmental health decision-making. Communities have a right to relevant and timely information for decisions on environmental health. Environmental health approaches should respect diverse values, beliefs, cultures, and circumstances. Collaboration is essential to effectively protecting the health of all people from environmental harm. Environmental health advocacy must be rooted in scientific integrity, honesty, respect for all persons, and social justice. Environmental health research addressing the effectiveness and public health impact of nursing interventions shouldbe conducted and disseminated. EH Principles for Public Health Nurses http://www.apha.org/membergroups/newsletters/sectionnewsletters/public_nur/winter06/2550.htm

15. ANA STANDARD 16.  ENVIRONMENTAL HEALTH  The registered nurse practices in an environmentally safe and healthy manner.  • Attain knowledge of environmental health concepts, such as implantation of environmental health strategies. • Promotes a practice environment that reduces environmental health risks of workers and healthcare consumers. • Assesses the practice environment for factors such as sound, odor, noise and light that negatively affect health. • Advocates for the judicious and appropriate use of products used in health care.  • Communicates environmental health risks and exposure reduction strategies to healthcare consumers, families, colleagues and communities. • Utilizes scientific evidence to determine if a product or treatment is a potential environmental threat. • Participates in strategies to promote healthy communities. Source: American Nurses Association (ANA). (2010). Nursing: Scope and Standards of Practice, Second Edition.  Silver Spring, MD: Nursebooks.org.

16. https://www.sph.umich.edu

17. Make a Difference in your Professional Association • Encourage your association to offer environmental health educational opportunities to the membership. • Create or contribute to an environmental health column for your association’s newsletter. • Create or participate in an Environmental Health Task Force entity within your association. • Initiate or support legislation that seeks to protect nurses, your patients, and communities from environmental toxins and hazards. • Collaborate with other professionals, policy makers, advocacy groups, and the public to promote local, state, national and international efforts that address environmental health concerns where you live, work and play.

18. Make a Difference in Public Policy • Join with your state professional association and specialty nursing association and work to advance environmental health public policy. • Build a relationship with your state and federal legislators so you can be their “go to nurse” when they have questions on environmental health issues. • Work on a campaign to elect a candidate that supports environmental health issues. • Be a part of your association’s grass roots action team to influence critical votes on environmental health issues. • Write opinion pieces or letters to the editor of your local paper to share your perspective about critical environmental concerns.

19. Make a Deference in Public Policy • Testify on an environmental health issue before your state legislature. • Contribute to political action committees (PACs), which raise funds for legislators to support worthy candidates for state and federal office who have demonstrated their support for environmental health issues. • Educate your legislators about important environmental health issues and encourage them to become environmental health advocates. • Seek a political appointment on the state or federal level for an opportunity to influence environmental policy. • Run for office.