By Holly Carpenter, BSN, RN

At work, have you felt short of breath or nauseous from inhaling fumes from cleaners/sterilants/disinfectants?

Do you and your patients want access to fresh, organic foods? Would you like to recycle batteries, OR blue wrap, sterile saline bottles, paper, cardboard, aluminum, plastic, or glass? If you answered in the affirmative, you would be an excellent candidate to join or start a Nursing Green Team (NGT).

An NGT is a group of two or more nurses actively engaged in any type of sustainable healthcare activity. Ideally, an NGT has a written plan with goals and objectives duly documented, has organized meetings, and is recognized and supported by the facility’s administration. Here’s how to get started.

Decide on an issue to address. With so many choices, choosing an environmental health activity can be daunting. Evaluate what is already being done environmental health–wise at your facility. Often the best way to start is small, within a single unit. A telemetry unit might begin a battery-recycling program. OR nurses may recycle blue wrap and saline bottles. The NICU team may phase out DEHP from medical devices. Points to ponder are: What kind of potentially recyclable items does your facility generate in large quantities? Are there recycling facilities nearby that offer free pickup? Is your facility already interested in enacting a facility-wide policy such as “No smoking”? Follow the adage of picking the low-hanging fruit first! However, ensure that your goal is feasible. For example, make sure that a recycler is available for intended collected recyclables and that a market exists for the recyclables.

Identify interested nurses. Willing, engaged, and informed team members are key. A unifying cause can be a rallying point. For instance, staff nurses exposed to toxic floor stripper fumes may be easily attracted to advocating for greener, less toxic cleaners. The team should include nurse managers, nurse educators, the occupational health nurse, and the infection control nurse. Nurses with an overall interest in environmental issues should also be included. Ensure all nurses are invited and made to feel welcome. Posters in elevators, the cafeteria, and nurses’ break rooms are a great way to recruit. Consider recruiting at facility events, such as health fairs, with an information-filled booth. No nurse is an island, so although it is a nursing green team, for long-term sustainability, representatives from other disciplines should also be involved. Staff from housekeeping, environmental services, purchasing, and administration can be excellent additions to an NGT, as well as any other interested staff.

Be creative. Think outside the box. Ask manufacturers to reduce packaging. Find out if single-use devices can be reprocessed and used again. Determine new ways to decrease energy and water consumption. Encourage green cleaning. Ask for dairy products free of synthetic hormones at the cafeteria. Establish a farmer’s market on campus grounds. Assist your facility in joining Practice Greenhealth, a nonprofit organization encouraging environmental excellence in health care.

Think long term. Ensure the policies and procedures that the NGT enacts are put into writing so that the movement outlives any one person or group. Consider input into purchasing policies and future budgets.

Make it official. Top-level commitment is essential. Formal recognition of the NGT is needed for program initiatives to have any “teeth.” Engage upper management with such information as potential financial savings, awards, recognition, and/or waste reduction. Your facility’s chief nursing officer will be instrumental in obtaining top-level buy-in. Bettie Kettell, Practice GreenHealth Nurse Coordinator, recommends naming your group, developing goals, creating a mission statement, advertising the group in employer newsletters, and hosting regular events during the year.

Overcome obstacles. Lack of support from management, anticipated high cost of the proposed program, and possibly large time commitments are common worries. Some teams experience push-back for change of any kind. Having a clear, well-written plan, evidence of potential financial savings, and/or concise data to show waste reduction should help. A simple business case outlining the economics of your program would also be effective.

With so many issues and so much work to be accomplished, you may feel overwhelmed. However, each NGT can have a positive, sustainable impact on health care. Your patients and the environment are counting on you.

For more information on NGTs, go to www.wsna.org/washingtonnurse/Story.aspx?id=117, www.utexas.edu/nursing/greenteam/index.html, or www.h2e-online.org/docs/h2egreenteams32106.pdf.

Holly Carpenter is a senior staff specialist in ANA’s Center for Occupational and Environmental Health.