You Mean the World explores the past, present and future of nursing in the face of the climate crisis.
The climate emergency is a global health crisis, and nursing staff are on the frontline. They see its impact firsthand – from diseases linked to air pollution to the damaging effects of extreme heat.
The World Health Organization estimates that between 2030 and 2050, climate change will cause 250,000 additional deaths per year. Our health is inseparable from the health of the planet.
As the largest part of the health and care workforce, it is crucial that nursing becomes more sustainable. The NHS has committed to being carbon neutral by 2045 but there is a long way to go.
The position of trust nursing staff hold in their communities mean they can be essential voices in the fight against climate change.
This exhibition shows how talented nursing teams are working to achieve these climate goals – from green social prescribing to developing sustainable nursing tools, from raising public awareness to showing how small changes can make a big difference to our future.
The air we breathe
The climate emergency affects us all, but some are affected more than others. In the UK, it has a greater impact on the very young and elderly, and on more deprived urban communities.
Nursing staff have long been aware of the unequal impact of unhealthy environments. In 1859, Florence Nightingale observed the shocking 90% mortality rate of patients in London hospitals compared to much lower figures in country towns.
Since the industrial revolution, rising air pollution has had a devasting effect on the health of urban populations. In 1952, the ‘Great Smog’ of London caused up to 12,000 deaths when a cloud of thick smoke and sulphur dioxide descended on the capital for 5 days. The 'Great Smog' led to the Clean Air Act of 1956.
Today, air pollution contributes to approximately 36,000 deaths every year in the UK and around 7 million worldwide – and not just in cities. The World Health Organisation estimates that 99% of the global population are breathing unhealthy air.
Nursing staff are crucial in raising awareness of the impact of air pollution. They take a hands-on role in asthma care and respiratory and cardiovascular diseases linked to poor air quality.
Rethink, reuse, recycle
“We might say, it’s cheaper to use single use plastic than buy some metal gadget that we’ve got to clean … but nobody looks at the overall lifetime cost.”
Clare Nash, Head of Clinical Procurement at the Black Country Alliance
For much of history, healthcare tools were designed to be reusable. Made of metal or glass, they could be sterilized each time they were used. In 1879, the first steam steriliser – or autoclave – was invented. It was used by nursing staff throughout the twentieth century to sterilise everything from metal tools to rubber gloves.
In the 1970s, things changed. The availability of cheap disposable plastics and new concerns about preventing infection led to a surge in single-use healthcare equipment. In the early 2000s, new guidance encouraged the reuse of clinical tools where possible. However, today, hospital waste remains higher than ever.
By switching from single use to reusable equipment, hospitals can reduce their carbon footprint by up to 56%. Nurses like Clare Nash, who has developed a tool to help health care staff choose more sustainable clinical products, are spearheading this change.
PPE Refashioned
The United Nations estimates that 75% of the plastic generated by the pandemic – including PPE medical waste and packaging – will end up in landfill or the sea.
The PPE Refashioned project at the Nottingham School of Art and Design responded to the need to address this waste.
Launched by Professor Katherine Townsend at the height of COVID-19, the project aimed to design and manufacture a reusable PPE gown for health care workers.
The future of green care
Today, there is a growing understanding of how important the natural environment is to our mental and physical health. In England, it’s estimated that the NHS could save £2.1 billion a year in treatment costs if everyone had access to quality green space.
Image: NHS Forest
Nursing staff have long understood how fresh air and contact with nature can help their patients. Many of the earliest hospitals had large and well-tended gardens where patients (and staff) could spend time and recuperate. Nowadays, most UK hospitals have fewer dedicated outdoor spaces, if they have them at all.
The NHS Forest is one initiative tackling this problem by increasing green spaces in health care settings. Since 2009, they have planted over 10,000 trees at hundreds of sites across the UK to encourage patient and staff interaction with nature.
Small changes, big differences
The climate crisis is everyone’s business. It can affect our health, our work, our lives and the lives of our loved ones. The scale of this global issue and making a difference can seem daunting. Yet, this exhibition shows how small actions can have an impact as we start this journey.
The Royal College of Nursing passed an emergency resolution on climate change in 2019 and held its first national sustainability conference in 2022. We are now exploring the changes we can make within the organisation and beyond. This includes working directly with RCN members on a new sustainability strategy that will transform nursing practice and contribute to the net zero goals of health and social care.
Nursing staff make up almost 50% of the health and social care workforce and there are an estimated 29 million nurses worldwide. They have the power to help shape our future. Now is the time to use it!
This exhibition was curated by the RCN Library and Museum team, with support from the RCN Archive team, the RCN History of Nursing Forum and the RCN professional lead for sustainability, Rose Gallagher.
With thanks to the Thackray Museum of Medicine and the Hunterian Museum at the Royal College of Surgeons of England. Thanks too to the artist, Louise Ward Morris and to Professor Katherine Townsend and the Nottingham Trent School of Design. Thanks to our other lenders, and to everyone who has contributed a story, experience, photograph or object to the exhibition.