The link between sustainability, climate change, and positive health outcomes makes this an important topic for educators to introduce into the curriculum. The current pilot study utilized blogging as an instructional strategy. Two groups (N=91) have completed the learning module. Preliminary results will be reported at the conference.
The need to include sustainability in nursing education is well documented (Goodman, 2010, Richardson et al., 2017, McDermott-Levy, Jackman-Murphy, Leffers & Jordan, 2019). The link between sustainability, climate change, and positive health outcomes makes this an important topic for educators to introduce into the curriculum.
The concept of sustainability in nursing involves multiple elements. According to Anaker and Elf (2014) the defining attributes are; ecology, the environment, the future, globalism, holism, and maintenance. The authors define the antecedents that occur prior to sustainability and they include, climate change, environmental awareness, confidence in the future, responsibility and willingness to change. From their concept analysis, there were some suggested consequences of sustainability in nursing education. Sustainability should be included in nursing programs with a focus on the areas of ecology, environment, and sustainable development.
Strategies to incorporate sustainability in the curriculum have been discussed in the literature. In a review of the literature Lopez-Medina, et al. (2019) identified types of activities which can be used to help students understand the concept of environmental health. The use of case studies or scenarios was found to be useful in working with multidisciplinary groups and could include role play, simulations, group discussion and debates. The use of social media was also found to be an effective way of engaging students in discussion on environmental health and health issues in nursing. Grose and Richardson (2015) delivered an evidence-based sustainability teaching scenario to student nurses in a clinical session to determine if this type of teaching tool was relevant and meaningful to nursing practice. The majority of the participants found the materials provided in the session helpful. The authors concluded that the skill sessions are a realistic way of informing and motivating learners to consider current and best practices. The use of Twitter as a tool for discussion about sustainability was explored by Richardson, Grose, Nelmes, Parra, and Linares (2016). A one hour Twitter session was hosted by @WeNurses. A thematic analysis of the Twitter discussion revealed several themes related to sustainable use of healthcare resources and the need to reduce waste. The authors concluded that the use of social media is an effective way to engage students in a discussion. Alvarez-Neito et al. (2017) tested and evaluated digital educational materials on environmental sustainability and health in the context of university nursing education in European countries. Materials were adapted from the NurSusToolkit Sustainability Literacy and Competency framework. The overall outcome was positive with students, professionals, and technical experts finding the materials to be of very good quality. Garrity, Jones, VanderZwan, de la Rocha, and Epstein (2014) conducted an integrative review of blogging as a pedagogical tool in nursing education. Three themes were explored; learning occurs through dialogue and collaboration, learning involves challenging opportunities that stimulate learner engagement, and learning is a social process. Analysis indicated that blogging has the potential to enhance knowledge acquisition, provide stimulating learning opportunities, and recognize the social aspects of learning. The authors concluded that further research is needed to fully understand the development, implementation, and evaluation of blogging on student knowledge acquisition in nursing education.
In January 2019 the topic of sustainability was introduced in a senior level course in the online RN-to-BSN program at a Midwest Public University. Faculty designed a blog project that would allow students to explore sustainability topics and share their knowledge and experiences with each other. Pre-Module and Post-Module Surveys adapted from Richardson’s Sustainability Attitudes in Nursing (SANS-2) were completed by each student before beginning their blog and after completion of the assignment. Blogs were submitted in four separate posts. In the first blog post, students focused on the top medical waste issues in the United States today. They also discussed current national and local regulations and policies regarding medical waste. In the second blog the focus turned to their own practice environments and each student conducted an assessment of multiple issues such as the overall environment, single use equipment, the environmental health policies in their institution, cleaning products used in the facility, and management of pharmaceutical waste. In blog post three students were asked to discuss whether or not their practice environment has a green team, what the focus of the team was, and any successes they had experienced. If there was not a green team in their practice environment then students described how one could be started and what the nurses’ role would be. Finally, in blog post four the focus turned to The American Nurses Association (ANA) Scope and Standards of Practice (2015) Standard 17 which addresses competencies that call the registered nurse to practice in an environmentally safe and health manner. Student blog posts addressed the competencies of assessing the environment to identify risk factors, reduction of environmental health risks to self, colleagues, and health care consumers, advocating for the safe, judicious, and appropriate use and disposal of products in health care, participation in developing strategies to promote healthy communities and practice environments. Provision six of The ANA Code of Ethics (2015) addresses the need for nurses to look at their workplace in a more personal way and discuss how the provision relates to their responsibility for the healthcare environment.
Two groups of students (N = 91) have completed the sustainability in nursing module thus far. Students completed Pre and Post Module Surveys measuring their knowledge and attitudes towards the topic. Analysis is underway and results will be available to report at the conference. In addition to the quantitative data analysis, a qualitative analysis of student blogs is being completed to explore themes in student learning. Faculty experiences using the online blogging platform in Blackboard with also be shared.
Anecdotally, students complete a course evaluation at the end of each semester. To the question which aspects of the course were most valuable? Students responded
“I really enjoyed the blog project I felt as though it was a different learning tool while being still very informative”
“I found the blog assignment valuable”
“I felt the sustainability blog was very enlightening”
“The sustainability in nursing blog project”
“The project in relation to Sustainability”
“Sustainability in nursing profession”
A second question addresses: how can the instructor improve teaching this course? Student responses indicated some dissatisfaction with the blog format. Comments included:
“It would be interesting to provide a clearer cut path for the blog section of this course. I found navigating this assignment to be confusing”
“I did not like the set up for the Blog project. Using the Blog tab in blackboard was not easy to navigate. I like the overall project and found it very interesting and fun, just did not like doing it as a blog”
“Increase the amount of time student spend on designing their blog or give option of picture on blog”
References
Alvarez-Nieto, C., Richardson, J., Parra-Anguita, G., Linares-Abad, M., Huss, N., Grande-Gascón, M. L., … López-Medina, I. M. (2018). Developing digital educational materials for nursing and sustainability: The results of an observational study. Nurse Education Today, 60, 139–146. https://doi-org.libproxy.umflint.edu/10.1016/j.nedt.2017.10.008
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Nursesbooks.org
American Nurses Association (2015) Scope and Standards of Practice (3rd ed). Silver Spring, MD: Nursesbooks.org
Anåker, A., & Elf, M. (2014). Sustainability in nursing: a concept analysis. Scandinavian Journal of Caring Sciences, 28(2), 381–389. https://doi-org.libproxy.umflint.edu/10.1111/scs.12121
Garrity, M. K., Jones, K., VanderZwan, K. J., de, l. R., & Epstein, I. (2014). Integrative review of blogging: Implications for nursing education. Journal of Nursing Education, 53(7), 395-401. doi:http://dx.doi.org.libproxy.umflint.edu/10.3928/01484834-20140620-01
Goodman, B. (2011). The need for a ‘sustainability curriculum’ in nurse education. Nurse Education Today, 31(8), 733–737. https://doi org.libproxy.umflint.edu/10.1016/j.nedt.2010.12.010
Leffers, J. Smith, C., Huffling, K., McDermott-Levy, R. & Sattler, B. (Eds.) (2016) Environmental Health in Nursing, Alliance of Nurses for Healthy Environments. www.enviRN.org
Lopez-Medina, I. M., Álvarez-Nieto, C., Grose, J., Elsbernd, A., Huss, N., Huynen, M., & Richardson, J. (2019). Competencies on environmental health and pedagogical approaches in the nursing curriculum: A systematic review of the literature. Nurse Education in Practice, 37, 1-8.
McDermott-Levy, R., Jackman-Murphy, K., Leffers, J., & Jordan, L. (2019). Integrating climate change into nursing curricula. Nurse Educator, 44(1), 43-47.
Richardson, J., Heidenreich, T., Álvarez-Nieto, C., Fasseur, F., Grose, J., Huss, N., … Schweizer, A. (2016). Including sustainability issues in nurse education: A comparative study of first year student nurses’ attitudes in four European countries. Nurse Education Today, 37, 15–20. https://doi-org.libproxy.umflint.edu/10.1016/j.nedt.2015.11.005
Richardson J, Grose J, Nelmes P, Parra G, Linares M. (2016) Tweet if you want to be sustainable: a thematic analysis of a Twitter chat to discuss sustainability in nurse education. Journal of Advanced Nursing. 72(5):1086-1096. doi:10.1111/jan.12900.