Climate change isn’t just destroying the planet—it’s expected to cause approximately 250,000 deaths per year between 2030 and 2050, according to the World Health Organization. On top of that, the healthcare sector is a major source of greenhouse gas emissions, generating up to 8.5 percent of such emissions in the United States alone, according to a 2021 article in the New England Journal of Medicine.
“Our code calls us to be stewards of our environment. And there was a gap for helping nurses engage in this work,” says Shanda Demorest, the project’s coordinator and associate director of climate engagement and education at Health Care Without Harm, Anchorage, Alaska, USA.
When project leaders first launched the Nurses Climate Challenge in 2018, they’d hoped to reach 5,000 health professionals. But after acing that goal within nine months, the team scaled its ambitions. The team continues to expand its vision—and its boundaries. Nurses Climate Challenge Europe was launched in 2021 with a goal of educating 3,500 health professionals by 2023—and it has already surpassed the number at 5,512 as of November. Now project leaders are looking to launch similar initiatives in Africa and Latin America.
Demorest explains how the team relies on accountability, user-first design and innovation to deliver real climate action.
Let’s start at the beginning: What was the original purpose of the project?
We built the Nurses Climate Challenge to put climate education resources into the hands of nurses. We wanted to elevate the profession and demonstrate that nurses are capable of being leaders in the climate arena—but this isn’t really a cohort that knew much about the climate crisis as it pertained to their profession. We established a train-the-trainer model, which empowers nurses to educate their colleagues about climate and health.
The Health Care Without Harm network has 1,400 hospitals that work with us to decrease their environmental footprint, yet nursing engagement has been inconsistent. Now as nurses at these hospitals register as climate champions, we connect them with the folks on the ground who are professionally responsible for sustainability and climate work within their health system. By focusing on the responsibility and the accountability being in the hands of those who are participating in the Nurses Climate Challenge network, we empower nurses to be the change—to be the ones shifting our profession's trajectory when it comes to climate.
It sounds like the goal was to avoid a program that was prescriptive. How did you make it people-centric?
We were really big into design thinking. We asked: What do nurses need? What do faculty need? How will it be used? To do that, we needed to collect feedback and incentivize participants to provide that feedback. We started at the end and worked backward to convene with the right stakeholders—not just nurses in hospitals but also those working in communities, schools and higher education. From there, we hosted our first two pilots—nurses began educating their colleagues in hospitals in 2018. Then we updated the materials and launched our website to the public. It was very iterative, and we worked closely with nursing leaders to develop focus groups that helped us design the program.
With the project launched, what steps did you take to sustain interest—and how are you tracking your efforts?
The next level of engagement was: Are you using Nurses Climate Challenge resources to educate colleagues and students in the way that the initiative is designed? And then we worked to make sure they actually participated in tracking the metrics, including providing the data for the individuals who were reached with this program. But to get nurses to do the follow-up piece with reporting metrics has been hard, and that impacts the accuracy. Nonetheless, we feel that the data we’ve collected shows that the program has been successful.
The pandemic obviously changed everything—how were you forced to adapt?
We definitely saw a down trend in practicing nurses engaging with the platform. But our presentations were open source, so faculty were finding these and using them in their classrooms, in their laboratories, in their clinical settings. That led us to transition our focus from in the hospital to nursing schools. We built the School of Nursing Commitment, an agreement of faculty within nursing schools to use these resources to teach their students about climate and health. And now that program has grown to 61 schools that have reached over 30,000 students in all types of programs across the United States.
How are you measuring the impact—and how has the data helped drive change?
We have an activity report that tracks engagement with the platform. Nurse participants submit data about their educational sessions—how many people they reached and when the event occurred, etc. Our whole goal was to keep it really simple and easy for reporting. And that really helped meet our original target of educating 50,000 health professionals and students. That happened in October 2022. We've helped educate a really significant cohort of nurses and nursing students who are spreading the word. In looking to next year, we want to transition from primarily an education platform to action-oriented decarbonization: Now nurses understand climate change more and are ready to make change.
How do you see this project transforming lives?
Nurses are suddenly empowered to be meaningful change agents for a healthy climate. This gives authority and credibility behind the resources and the network in general. When nurses engage with the Nurses Climate Challenge, they access resources for advocacy and education and practice approaching climate in a science-based way. We’re helping them become leaders in this arena. Nurses acting on climate change are demonstrating to health leadership that this is a priority and that decarbonizing our sector is imperative for human health.