Standard 18 of the ANA Nursing Scope & Standards of Practice 4th edition is titled "Environmental Health". It is crucial in promoting sustainability in nursing and aligning with sustainable practices in my practice. 

Below we can discuss how 10 of the 14 competencies linked to Standard 18 are relevant to sustainability and how they can be applied in our own practice:

1. Promotes evidence-based practices to create a psychologically and physically safe environment: Emphasizing evidence-based practices ensures that nursing interventions are effective, efficient, and sustainable. It reduces unnecessary procedures, minimizes waste generation, and optimizes resource utilization while providing the best possible care. For Instance, our CRRT, ECMO, IMPELLA, and IABP charting Is done both on paper and In the chart. It is redundant charting that wastes paper and does not contribute to efficient patient care.

2. Assesses the environment to identify and address the impact of social determinants of health on risk factors: Understanding and addressing the social determinants of health, such as socioeconomic status, education, and access to resources, is crucial for sustainability. By identifying and mitigating these risk factors, we create a more equitable and sustainable healthcare system.

3. Reduces environmental health risks to self, colleagues, healthcare consumers, and the world: Reducing environmental health risks is fundamental to sustainability. By implementing environmentally friendly practices, such as proper waste management, infection control, and pollution prevention, you contribute to a healthier environment for everyone involved, including patients, healthcare professionals, and the global community. As aforementioned on my page on green teams, one of the ways that we can promote sustainability Is through the use of labels for proper disposal. Currently, my ICU has one recycling bin that Is In the soiled utility room. This Is Ineffective because most waste Is dumped directly In the patient's room to avoid bringing contaminants Into the halls.

4. Integrates environmental health concepts in practice: Incorporating environmental health concepts into your nursing practice helps identify and address environmental factors that can impact health outcomes. By considering the environmental aspects of care, you can develop sustainable interventions that minimize harm to individuals and the ecosystem. I can evaluate the environmental impact of procedures, medications, and disposal methods to ensure that they align with sustainable practices and explore alternative approaches when necessary. Much like the previous competency, we can further analyze materials of nursing care that are consistently wasted despite not using them.

5. Communicates information about environmental health risks and exposure reduction strategies: Effective communication is vital in sustainability efforts. Educating patients, colleagues, and the community about environmental health risks and promoting strategies to reduce exposure empowers others to make informed decisions that positively impact their health and the environment. For example, I can communicate with colleagues from various disciplines to develop strategies that promote sustainable healthcare delivery, such as reducing medical procedures' environmental impact. If you have ever done a bedside procedure, even as simple as a central line Insertion, there Is often a substantial amount of waste that simply gets piled up and put In a red bag. Many materials from the kit are not even being used. We can analyze the waste and collaborate with device companies to create kits that utilize essential components only and reduce the consistently unused materials that are thrown away.

6. Advocates for the implementation of environmental health principles in communities in which they work and live: Advocating for environmental health principles contributes to sustainability by promoting policies and practices that protect the well-being of communities and the natural environment. By engaging in community outreach and education, we can influence positive changes and encourage sustainable behaviors.

7. Incorporates technologies to promote safe practice environments: Utilizing innovative technologies can enhance the safety and efficiency of healthcare practices. We can utilize electronic resources like Telehealth and virtual communication platforms to reduce travel-related carbon emissions and promote efficient care. For instance, In my hospital, we use EMRs, patient portals, EICU, and TelePsych to promote sustainable and efficient care for all patients. By embracing technologies that reduce waste, conserve resources, and improve patient outcomes, we contribute to sustainability.

8. Examines how the healthcare consumer's biography affects their biology, resultant health issues, and the ecosystem: Taking a holistic approach that considers the individual, their health, and the ecosystem is essential for sustainability. You can develop interventions that promote sustainable health practices by understanding the relationships between individuals, their environments, and health outcomes.

9. Advances environmental concerns and complaints through advocacy and appropriate reporting mechanisms: As a nurse, advocating for environmental concerns and reporting issues is crucial for sustainability. By actively participating in reporting mechanisms, you contribute to identifying and resolving environmental problems, leading to improved health outcomes and a more sustainable future.

10. Promotes sustainable global environmental health policies and conditions that focus on preventing hazards to people and the natural environment: Promoting sustainable global environmental health policies contributes to the prevention of hazards and protection of human and ecological well-being. By advocating for policies prioritizing sustainability and minimizing harm, we play a crucial role in creating a healthier and more sustainable world In healthcare.

(American Nurses Association, 2004)

Provision 6 of the ANA (American Nurses Association) Code of Ethics deals with the nurse's contribution to nursing's advancement through participation in professional organizations. While this provision may not directly deal with sustainability, it indirectly supports sustainability efforts within nursing practice. Reidel (2015), in a study published in "Healthcare", establishes that an "indispensable requirement of sustainability is to think long-term. The challenge is to sensitize people to the dimension of sustainable decisions and to draw attention to the long-term consequences of practices and decisions carried out today. For this sensitization to be effective, it is necessary to analyze, consider and weigh the potential consequences for health care delivery in nursing education and day-to-day practice and demand that decisions are oriented towards sustainability." Below, we will discuss how each section of Provision 6 relates to sustainability:

1. Section 6.1: "The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality healthcare."

Believe it or not, sustainability is closely aligned with safe and quality healthcare. By establishing an ethical environment, nurses can advocate for sustainable practices that prioritize environmental responsibility. This may include reducing waste, promoting energy-efficient operations, or advocating for the use of environmentally friendly products. Nurses can work collectively as a TEAM to improve their work settings, incorporating sustainable practices into care, and thus minimizing the environmental impact of the healthcare system. (Reidel, 2015) and (American Nurses Association, 2015).

2. Section 6.2: "The nurse contributes to the profession through support and involvement in the development of the profession's body of knowledge."

In terms of sustainability, nurses can contribute to the development of the profession's body of knowledge by actively engaging in research related to sustainable healthcare practices. This involvement can include participating in studies that explore the impact of healthcare operations on the environment, identifying strategies to reduce waste and promote resource conservation, or evaluating the effectiveness of sustainable interventions in improving patient outcomes. Through these contributions, nurses can help shape evidence-based practices that integrate sustainability principles into healthcare delivery. (Reidel, 2015) and (American Nurses Association, 2015).

3. Section 6.3: "The nurse collaborates with other healthcare professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities."

Sustainability intersects with social justice and health equity. Nurses have a responsibility to collaborate with other healthcare professionals and the public to address health disparities, which includes advocating for equitable access to sustainable healthcare practices. By actively engaging in interdisciplinary meetings, nurses can promote sustainable initiatives that address environmental justice, ensure equitable sharing of resources, and reduce disparities in both access to healthcare and patient outcomes. These efforts contribute to a more sustainable healthcare system that prioritizes both environmental and social well-being. (Reidel, 2015) and (American Nurses Association, 2015).