Mental Health Impacts of Climate Change: Considerations for Nurse Practitioners

Climate change is the most critical public health crisis of the 21st century. Physical and medical sequelae of climate and weather-related events are well documented and may be addressed in clinical practice. Mental health impacts of climate change are increasingly addressed in the literature but remain underrecognized by clinicians. This report focuses on mental health impacts of climate change through the theoretical framework of Maslow’s Hierarchy of Needs. It offers a broad overview of mental health impacts, particularly for vulnerable populations, and introduces screening, assessment, and treatment considerations for the nurse practitioner.     

Caring for Vulnerable Populations: Role of Academic Nurse – Managed Health Centers in Educating Nurse Practitioners

Vulnerable populations, including the uninsured, immigrants, and working poor, are at greater risk of developing health problems. Historically, nurse practitioners (NPs) have cared for this growing population. Care of these vulnerable patients requires a specific set of skills for optimum effectiveness. This article identifies the unique educational needs of NP students working with vulnerable populations in resource-scarce settings and makes recommendations for augmenting NP education to increase students' sensitivity and skill, including the use of academic nurse–managed health centers. A case study shows the NP skill development necessary in caring for these populations.     

The Nurse Practitioners’ Role in Engaging Health Care Systems in Addressing Climate Change

A recent United Nations (UN) report concluded that the inability to curb fossil fuel emissions from burning coal, oil, and gas has resulted in a short window of time to prevent an abysmal future. The health care industry remains one of the largest contributors to climate change. NPs must not only recognize the clinical presentations resulting from climate change but must also contribute to the efforts presented by the UN report to create a health system that does not contribute to climate change. This article reviews potential ways to decrease the health care sector’s contribution to climate change.     

Integrating Climate Change in the Curriculum: Using Instructional Design Methods to Create an Educational Innovation for Nurse Practitioners in a Doctor of Nursing Practice Program

An applied epidemiology course for doctor of nursing practice students was revised to include a module on the impact of climate change on population health. The Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model of instructional design is a gold standard framework for creating course content and guided the module development. A nurse content expert discussed the environmental impacts of climate change on health using literature, actual clinical scenarios, and the application of epidemiologic data. Topics included safeguarding workers and vulnerable populations within the context of the coronavirus disease 2019 pandemic. Students posted reflections on their understanding of module content in response to structured prompts electronically in the learning management system for review by the faculty. Faculty evaluation of responses identified the need to further develop and integrate environmental epidemiology and climate change content more fully within the doctor of nursing practice curriculum.     

Film as a pedagogical tool for climate change and mental health nursing education

The relationship between climate change and worsening mental health is of increasing concern globally. Climate change is ubiquitous, yet marginalized populations bear a disproportionate burden of the physical and mental health impacts, while youth are more likely to report mental health concerns related to climate change than older generations. Mental health nurses will inevitably see these impacts play out in their practice, thus it is important to explore innovative tools for teaching about and responding to the emotional and psychological impacts of climate change. This perspective paper presents an educational project that utilized film and structured reflection to engage with the intersecting topics of planetary and mental health. The authors created a documentary film that presents the relationship between mental health and climate change as well as an accompanying reflective toolkit. Both the film and toolkit were integrated into an undergraduate course about the health impacts of climate change. This paper explores the relevance of climate change to mental health nursing education and practice, describes the process of creating and integrating the film and toolkit into a course and advances the position that film is an innovative way to engage individuals and communities (such as student or community groups) with the emotional and psychological concerns that arise in response to complex challenges of climate change. More research is needed to better understand the mental health impacts of climate change and to explore novel approaches to education and advocacy about this topic. We hope that sharing our project and experiences will inspire additional discussion and research related to these emerging issues that are of great relevance to mental health nursing.     

Educating Nurse Practitioners About Climate Change,Health, and Climate Justice

Climate change poses unprecedented threats to health, leading to higher rates of heat stress; cardiopulmonary illness; food-, water-, and vector-borne diseases; adverse pregnancy outcomes; poor mental health; and premature death. These impacts are inequitably distributed, with vulnerable populations bearing the greatest burdens. Nurse practitioners must be prepared to care for people affected by climate change and to advocate for policies to mitigate its harm. To date, efforts to integrate climate change and health concepts into health professions education are lacking. This article describes one nursing school’s experience incorporating these concepts into nurse practitioner curricula.     

Race to Beat the Heat: Climate Change Impacts Physical Activity

Climate change has led to increased frequency, intensity, and duration of extreme heat events with dire consequences for health. These are the deadliest of climate change impacts with preventable mortality from heat-related illnesses and increased threat to safe participation in physical activity and sports. Nurse practitioners can collaborate with community and professional sports health organizations to ensure evidence-based health and safety policies to reduce health-related risks. Adverse consequences on engagement in key health-promoting physical activity and sports may catalyze urgent action to address climate change.     

The Organizational Climate for Nurse Practitioners Working in Primary Health Care in New Zealand: A National Survey

Little is known about the working conditions of nurse practitioners (NPs) in primary health care in New Zealand. Data were collected using an online organizational climate questionnaire from NPs and managers who employed NPs. Nearly two-thirds of all primary health care NPs in the country (n = 136) responded together with a purposive sample of 58 managers. More than 90% of respondents from both groups identified that organizations created an environment where NPs could practice independently and autonomously with collegial support. Other results signaled opportunities for improvement in local and national health policy. This study adds to international evidence on creating positive practice environments for NPs.     

Climate Change: Effects on the Older Adult

The effects of climate change include floods, hurricanes, heat waves, and fires; these natural disasters can result in respiratory, cardiovascular, and psychological harm in older adults, who experience the highest morbidity and mortality during heat waves. Advanced practice registered nurses (APRNs) need education on preparing, assessing, and treating older adults for climate-change disasters, especially heat waves. This article will help APRNs understand the effects of climate-change events on the vulnerable older adults and advocates for the need to integrate health effects of climate change into curricula, practicums, policy, and research agendas.     

Climate Changes Children’s Health: Improving Clinical Practice to Address Changing Health Needs

Climate change is impacting children’s health in unprecedented ways. Although everyone is vulnerable to some health impacts associated with climate change, children are disproportionately affected because of their developing bodies. Climate changes that include extreme heat, flooding, rising sea levels, wildfires, and increasing carbon dioxide levels are associated with a wide range of health issues in children such as asthma, allergies, vector-borne diseases, neurodevelopmental issues, and depression. Nurse practitioners play a critical role in translating scientific findings into their clinical practices to promote and protect children’s health through interventions that include anticipatory guidance.     

Trends in mental health: implications for advanced practice nurses

PURPOSE: To examine current trends in mental health care for vulnerable populations and suggest how advanced practice nurses (APNs) can incorporate mental health care into primary care practice. DATA SOURCES: Original research and evidence-based clinical articles, government publications, and professional practice guidelines. CONCLUSIONS: Vulnerable populations, such as racial and ethnic minorities, adults with chronic mental illness, the elderly, the incarcerated, and those living in rural areas have long been ignored as recipients of quality, integrated health care services. There is a compelling need for APNs to participate in the integrated delivery of physical and mental health care to all Americans, especially to vulnerable populations. IMPLICATIONS FOR PRACTICE: Under the umbrella of advanced practice nursing, a variety of nurse practitioners (NPs) and clinical nurse specialists (CNSs) can offer a holistic approach to the provision of evidence-based health care in a wide variety of settings to an array of vulnerable and underserved people. By serving on provider panels, partnering with consumer groups, and advocating for the unmet health needs of vulnerable populations, APNs can have a positive impact on the health care delivery system.     

Nurse practitioners and physicians: a collaborative practice

The rapid evolution of health care delivery within the United States has created increased opportunities for nurse practitioners (NPs) to work in a variety of challenging advanced practice roles and to impact the quality of health care. The NP role was originally developed to meet a perceived shortage of primary care physicians, especially for underserved populations. Today, NPs work in various fields, such as geriatrics and women's and family health care, as well as in various systems such as private practice and health maintenance organizations. Effective collaboration with physician colleagues will promote improved communication, health care management, and positive health outcomes. Barriers to effective collaboration are reimbursement, territorialism, and role confusion on part of the health care team and the general public.     

Climate and Environmental Health: Education for Rural Communities

Rural populations experience underinvestment in communication and technology infrastructure that may contribute to an information gap about climate change and the relationship to health impacts in rural communities. This report describes how a student and nursing faculty member provided community education to 3 rural communities about how climate change impacts the health of rural communities through the local community newspaper serving the 3 communities. Climate and health-related topics in a weekly newspaper column in this project included extreme heat events, Lyme disease, air pollution, water quality, soil health, environmental justice, and the role of the nurse in planetary health.     

Faculty practice and health promotion in a community correctional facility

Faculty practice and health promotion are topics of interest to nursing faculty to prepare students and themselves for the future. Health promotion with vulnerable populations is a focus for the 21st century health care delivery system. Faculty practice emphasizing health promotion with a vulnerable population meets the needs of faculty as they strive to meet personal and professional goals. The development of a faculty practice serving a vulnerable population represented by clients in a community corrections facility will be described. Scope of practice, the development of a research focus, teaching approaches, and future initiatives are presented.     

Oral Health in People Who Use Methamphetamine

Oral health directly affects systemic health, yet a large proportion of the population has insufficient access to oral health care. People who use methamphetamine are at particularly high risk of having poor oral health due to a combination of pathophysiologic and socioeconomic factors. Nurse practitioners are well positioned to improve access to oral health care for this population through early screening, prompt referral, and targeted harm reduction strategies. The purpose of this article is to enhance nurse practitioner competency in providing oral-systemic health care to vulnerable populations. This article summarizes current knowledge regarding methamphetamine-associated dental decay and explores opportunities for health promotion and harm reduction in this vulnerable population.     

Climate Change and Population Health: Incorporating Stages of Nursing's Political Development

Climate change is the greatest public health threat of the 21^st century and is associated with environmental degradation and deleterious health consequences. In 2019, the Lancet Commission Report on Health and Climate Change: Ensuring that the Health of a Child Born Today Is Not Defined By a Changing Climate (Watts et al., 2019) examined the critical health issues that children will face in the era of climate change. Greenhouse gas emissions (GGEs) are responsible for an alarming increase in the warming of the planet, shifts in weather patterns, loss of arable land, and exacerbations of acute health issues, chronic health problems, and disaster-related health consequences. The purpose of this paper is to provide an overview of climate change and the associated deleterious health consequences in our climate-changing world. The paper will also examine the stages of political development to advance the 21^st century role of the nursing profession in climate and health advocacy and policy.     

The Identification and Management of Military Sexual Trauma in Veterans: Ask the Question!

Military sexual trauma (MST) is a serious and pervasive problem in the US military and results in the occurrence of physical, psychological, and psychosocial negative health consequences in female and male veterans. The prevalence of MST is increasing, and more veterans are seeking health care outside of the Veteran Affairs Medical Centers (VHA). Consequently, nurse practitioners as non-VHA health care providers may treat this population in the community. Insufficient knowledge precludes the ability to identify and manage MST. This article provides NPs with information for accurately identifying and managing military sexual trauma in the military and veteran population.     

Poverty and Adolescent Mental Health

PROBLEM:  Poverty and accelerations of inequality, manifested by the increasing difference between the richest and poorest populations, have significant effects on the mental health of vulnerable groups. Adolescents are vulnerable to the effects of poverty. As a time of change and transition for youth and their families, adolescence creates both challenges and opportunities to intervene in the effects of poverty.
PURPOSE:  The purpose of this article is to discuss the significance of poverty and its impact on adolescent mental health and mental health services.
SOURCES:  An interdisciplinary literature search was conducted on the topic of poverty and adolescent mental health.
CONCLUSIONS:  Results indicated that nurses need to remain active participants in the provision of mental health services to adolescents in poverty and increase their advocacy for the creation of policy changes that address mental health needs of this population.     

Discharge Planning in the Era of Climate Change

We are living in an era of climate change, which has a tremendous impact on the health of our patients. Therefore, radiological nurses should be aware of and address climate change–related problems that impact patient health, such as heat, air quality, drought, wildfires, increased precipitation, and extreme weather. This article highlights the concerns and consequences of climate change on patients discharged from interventional radiological and other outpatient settings. Recommendations for discharge planning are provided to support, protect, and promote the health of patients in radiological services.     

Heparin-induced Thrombocytopenia

Heparin products are commonly used in the hospitalized patient for prophylaxis or treatment of thromboembolic disease. One adverse effect of using heparin products with potential devastating consequences is heparin-induced thrombocytopenia (HIT). It is crucial the health care providers, including nurse practitioners (NPs), consider HIT in the differential diagnosis for this patient population when they present with thrombocytopenia. This article provides NPs with the latest evidence-based guidelines for diagnosing and managing the patient with HIT.