[Music]
Welcome to this episode of NLN podcast Nursing EDge Unscripted Scholarship track. I am your host, Dr. Stephen Palazzo, a member of the editorial board for Nursing Education Perspectives. Nursing EDge Unscripted and our track entitled Scholarship celebrates the published work of select nurse educators from the NLN's official journal, Nursing Education Perspectives,
and the NLN Nursing EDge blog. The conversations embrace the author's unique perspectives on teaching-learning innovations and the implications for nursing program development and enhancement. This episode is on the inclusion of climate change content in nursing programs we will discuss the author's article nursing faculty's perceptions of climate change and sustainability.
The discussion will focus on the unique findings of the author who published the manuscript in this September-October's issue of Nursing Education Perspectives. Our speaker today is Dr. Roxanne Calabria, formerly professionally known as Amerson. She is a professor emeritus and former director of global health certificate program school of nursing Clemson University, Clemson, South Carolina. So welcome Dr. Calabria. It's wonderful to have
you here. Well thank you so much for inviting me and allowing me to share the findings from my research. It's quite an honor to do the podcast. Well, it's an honor to have you here and we really appreciate you taking some time out to update our listeners about this very important topic. So I want to start by just asking you to briefly describe the purpose and findings of your study
for our audience. So well I think I would like to start by just explaining briefly what spurred me to start this research in the first place. As a the primary lecturer for the global health program at Clemson School of Nursing, whenever I would bring up the topic of climate change to my nursing students they always seemed very surprised that I was talking about climate change in the nursing classes. So I began informally asking them, had they heard about climate change in
their other classes? And what I consistently heard is that no, they were not hearing about this. So then i expanded that conversation to colleagues and I found the same thing that colleagues were sort of scratching their head whenever I would say do you talk about climate change in your nursing classes? So from there I decided I really needed to
look at this from a research perspective. So the study itself looked at nursing faculty's perceptions of climate change and sustainability and I focused on the nursing faculty in the state of South Carolina in order to keep this study more manageable. I considered it really a pilot study. So out of 31 schools of nursing in the state we sent questionnaires out to all of those schools we had 21 schools that responded and approximately 122 responses to our online questionnaire.
The questionnaire actually used two tools. One was the New Ecological Paradigm Scale, which looks at environmental attitudes. The second scale was the Sustainability Attitudes in Nursing Scale, and of course that looked at sustainability attitudes and practices. And then we asked some demographics and we asked two important questions: did the faculty include content about climate change and did they include content about
sustainability? The really big findings from this were that 81 of faculty who responded did not include climate change content and 67 of faculty did not include anything about sustainability so this was I won't say that it was a surprise to me, right, but it certainly grabbed my attention at
this point. We also found in the study that there seemed to be a connection with political affiliation so faculty who were more conservative in their political views tended to score lower on these scales, meaning they were not...they did not have this strong of feelings about or attitudes about the environment as opposed to people who were more liberal they tended to score higher
on these scales. We also found that they were probably more likely to include the content in their nursing content and so this was interesting because I found that there were other researchers in the last decade or so who have looked at similar studies who found this connection as well so I don't think that this was an isolated incident related to the political affiliation.
Thank you. Well, considering political viewpoints as a barrier to content inclusion how would you suggest integrating this content into nursing curricula? So the first thing is that the new Essentials by the AACN has now made that part of their required curriculum. I'm glad you brought that
up. Yes. So, that has actually been added as an objective so that is competency 3.6b and it says the student will "understand the impact of climate change on environmental and population health," so I think that that sort of takes away that political barrier because now we know that it's required content so people can't really make a choice of will I include this or not. It's going to be required.
I suppose I can make a choice of how in-depth they want to be, right, because that of course the objective or the outcome is written fairly broadly so how specific one would be in introducing that information and where in the curriculum that would be introduced is another interesting Really it is. So first, nursing faculty need to become more educated, I believe, about what are the health impacts of climate
change. I think we're talking about the issues but we're just not making that link to climate change and so that's the first piece is that faculty themselves probably need to be more educated about it so that they can address this with their students. Then as far as where it belongs in the curriculum, it actually needs to be threaded throughout the curriculum. Every course should include some portion
of this content. So for example, in pediatrics or med-surg, we talk about asthma and allergies already, but what we need to do is make that link that as the climate is getting warmer we're seeing more allergy responses and so we're seeing an increased rate in asthma - there's that
link. So just helping students see the link. As far as in courses like leadership, helping students understand that they can be the leaders to bring this to our organizations so this can literally be weaved throughout the curriculum without adding a lot of additional content. It's just
a matter of making the link. That's an important point because I think one of the resistances you're going to get, not you personally, is that we already have so much curricular content, right, that curricular overload and a lot of sacred cows in our curriculum that are what goes for something else to come in that you're making a great point. It doesn't have to be something else has to come in that kind of brings more kind of luggage to the curriculum.
It could be something that's already we're kind of already in our curriculum but maybe like you said, not linked or articulated in such a way that makes those connections to some of these things
are related to the warming of the climate. So you touched on this a bit but any more specifics about what faculty and schools of nursing can do better to articulate this link between climate change and health related illnesses in the classroom, in a in any classroom that you're talking about in any of these type of courses, what's something specific that one could do to make that link?
Okay, so as I said I think that this content needs to be incorporated into every course and there are a number of resources that are available. The [Alliance] for Nurses for Healthy Environments has some terrific resources on their website for nursing faculty that actually help them understand where this content can be added throughout the curriculum plan. The association does have a tool, it is the CHANT
tool. It is c-h-a-n-t and any nurse can go and complete that tool online and so they are continuously gathering data about people's perceptions and different aspects related to climate change. So that is a resource that people can go and look at.
So that's one of the places that nursing faculty can go to find that and so may helping students just see that there is a link between the diseases that they're already learning about and how that relates to the change in climate and then also talking about sustainability so also faculty need to help students understand their role in sustainability practices on a
personal level. They can help students think about things such as recycling in their own home, energy reduction techniques that they can use at home or wherever and even things like decreasing the consumption of red meat. All of these things are things that we can do personally to reduce carbon footprint but then from an organizational action there are things that students as well as nurses can do.
Many organizations are now forming committees that focus on environmental preferred purchasing so what are the products that we're purchasing for use in our hospitals and clinics that are better for the environment. So maybe you think about chemicals and cleaning products and things like that and also looking at the built environment, modifications such as lighting sources. Do we have lighting that will automatically turn out or go off when people leave the room?
This is a huge waste of energy when we have lights that remain on in areas where no one is working. We can look at reusable textiles and reusable equipment. Do we really need everything to be disposable? Another thing that organizations can do is what is called a waste stream audit where we look at the waste that is produced, where is it produced, and then how does it how is it disposed of. And then telehealth visits are an option for people rather than coming in for visits.
Do more telehealth. And then of course establishing green teams. That is their sole purpose is to look at all of these issues throughout our organizations and determine how can we do a better job of making sure that we are sustainable in our practices? Those are a lot of great pointers and gives me a lot of ideas too, thinking about integrate those into different courses specifically related to the topic that you're teaching and how you can thread that through the
curriculum. So from this work, what has been your response of some of your colleagues that you've had this conversation with? Have you met resistance from colleagues and then also have you gotten some support from some colleagues and how to move this into the curriculum in a purposeful way?
So I've gotten both yes I have certainly gotten feedback from some faculty who are resistant because they already have a packed curriculum and the thought of adding something more is overwhelming, but I have found that when I actually start to talk to people and help them understand these links that I talked about earlier they are surprised and they're like, oh, I could add that and it would only take just a couple more minutes
to add that to my lecture. I remember early on in the research I had a faculty member tell me well it's a great idea I agree with it personally but I don't think that it will ever be added to the curricula until there is some mandate that requires it. And it was interesting that that was about the time that AACN sent out their draft and as soon as I got the draft I immediately went through the draft and looked for competencies that addressed climate change or sustainability.
At that point there was not anything in there. I immediately wrote an email to the committee who was working on that. Now, I can't take claim that it was my thought that got that added. I think there were other people who also emailed the committee, but you know, as nurses we stepped up, we met the challenge, and we said we need to add this. And they listened! It was added so for me that is extremely hopeful that we now have
a competency. It may not be perfect yet, but it's there and it is now viewed as essential content.
Well it seems like a great place for it would be also in your BSN final projects, your master's thesis, you know as a competency or you know that you see where the student is thinking about sustainability and climate change within the work that they're doing, right, where can they add that to the work they're doing at least thinking about it in the process of developing whatever leadership or project that they're developing that this is somehow in there.
I agree because if you look at the literature you will see that various nursing organizations have been calling for this for quite some time. It's not new, but this is, we're just now really starting to see the momentum to get this moving forward. It's interesting. I think what i really appreciated about the the work you did was this idea about, I mean which makes complete sense, this political viewpoint impacting what we teach
in the curriculum. Nursing is of course a huge profession that is a replication of our population and so as the population has become more I think divided and more divisive so is the nursing profession, right, about what's important topics and what isn't so important. I think we run into the same kind of difficulties on what's important for us to educate our students about when they leave
our programs. Nursing has always been very, well, controversial in a way as far as taking a lead on a lot of topics both social and political over the course of its history. This is another area we should be leading in and that's why obviously the ANA has it in the new Essentials that will be coming out and so this be interesting.
The new essentials will be interesting in itself, that's a whole other topic, but how this plays out, where do you take this work now, what are your recommendations going forward to someone who might want to pick up the baton from you and go forward with some of this work? Or if what you're going to
continue doing, where's our next steps here? So I think that the next step is really education and I think that probably from a research perspective we really need to be looking at do nursing faculty have the knowledge themself
to teach this? That would be my next step is to and there are some tools that can be used to to measure knowledge, but I think that that is one of the things that we probably need to know for sure do nursing faculty have that knowledge base themselves because I have a suspicion that many nurses are not comfortable with this content themselves and so that may make them more resistant to add it if they don't feel
comfortable with it themselves. So really just education and making sure that all faculty have the knowledge to present this content. I think that'd be very helpful because as we in the next few years start sitting down and working on the new Essentials and aligning our programs with these new Essentials we're going to have these conversations around these particular topics
for these competencies. Well, I really appreciate the time that you took out of your day to further elaborate on the work that you're doing that's very important work.
You're broadening our understanding of this work and how we can introduce this into our our classroom with other faculty, leaders in nursing, it's great to see that this conversation is happening at the upper levels of nursing and academia and that we're actually starting to realize some of these ideas now through some of our essentials or our competencies that will be required for programs.
So, again, really appreciate the time and I hope that everyone takes a look at this article that just came out in the September October issue of Nursing Education Perspectives. It's a great read and if you have any suggestions, ideas, or comments you certainly can reach out to Dr. Calabria and I'm sure she'd be happy to to speak with you further about this. Thank you again, really appreciate it. Thank you so much. [Music]