We're in the midst of an environmental crisis: The world population
is exploding, food resources are diminishing, the ecosystem is breaking down,
and air and water are becoming increasingly polluted. The earth needs to check
into the ICU because it's in serious need of intensive care. Without our help,
the earth faces a bleak future, but if we all do our part we can help the earth
survive. Nurses, in particular, can have a positive impact on one serious problem—medical waste. Hollie Shaner, president of the Nightingale Institute for Health and the Environment, believes it's essential that nurses have a thorough understanding of environmental factors and conditions to be truly effective in their work. Are you a nurse who wants to do something about the problem of medical waste? If so, get ready, get set…get green!
Watching your waste
Seven Easy Tips to Help Save the Earth
While working to improve the handling of waste on the job, you also can be environmentally conscious in your everyday life. Here are seven things you can do to help save the planet:
Support water conservation efforts.
Use washable plates and utensils for your meals and snacks.
Use your own coffee mug at work or on the road instead of disposable cups.
Reuse paper that has been used only on one side.
Walk or carpool whenever possible.
Eliminate mercury thermometers from your home.
Share magazines and newspapers with friends.
According to the American Journal of Nursing (April 2001), U.S. hospitals annually
generate an astonishing 4 billion pounds of garbage. We're talking all types
of waste: solid, infectious (red bag), and hazardous. Landfills are filling up,
and incineration can leak toxic chemicals into the environment. The enormous
quantity of medical waste is an ongoing problem but as a nurse, you can take
certain on-the-job actions to be part of the solution. The first step: Educate
yourself. Learn the types of goods purchased by the hospital, how they're used,
and what's discarded. Then you can reduce hazards by following the environmental
3 R's: Reduce, Reuse, Recycle.
The first culprit: mercury
Elemental mercury—found in fever thermometers, blood pressure cuffs, fluorescent
light bulbs, and batteries—is
a reproductive toxin and a potent neurotoxin that can affect the brain and central
nervous system. Pregnant women and small children are at especially great risk.
How does this element get into our environment? If contaminated waste ends up
in a hazardous
waste incinerator, emissions may spill into the environment. If mercury products
are disposed of in landfills, toxins may leach into the water supply.
And accidents can be lethal. According to Michael Bender, director of the Mercury Policy Project, "Each thermometer contains about one gram of mercury, which is enough to contaminate a 20-acre lake."
The U.S. government (which typically moves like a
tortoise when it comes to instituting environmental reform) has taken a timely
and positive stand
against mercury waste. In
June 1998, the
Environmental Protection Agency and the American Hospital Association jointly
agreed to eliminate
as much mercury waste as possible from hospitals by 2005. And on August 5,
2002, the U.S. Senate passed S.351, a bill to phase out mercury thermometers
and improve management of existing surplus.
How to handle a mercury accident
How many times a shift do you take a patient's temperature or BP? From thermometers
to sphygmomanometers, hospitals are rife with mercury-containing equipment.
Because mercury is such a danger to we humans as well as the environment, the
American Hospital Association and the Environmental Protection Agency have
signed a
Memorandum
of Understanding to eliminate mercury-containing waste from hospital waste
streams by 2005.
Until then, what happens if, for example, you break
a mercury thermometer? Small spills
that
are cleaned up immediately are unlikely to cause serious health problems.
Take the following steps for safe clean-up:
Follow any guidelines your facility has for toxic or biological
material spills.
Do not use a broom or vacuum cleaner to clean up the spill.
Ventilate the room thoroughly.
If the spill is on a hard surface, wear gloves and use stiff paper to push the mercury beads together. Next, use an eyedropper to suction the beads; then drop them in a wide-mouth container with a lid.
Use sticky tape to gather any remaining beads.
Place all the items you used to gather the mercury beads in a plastic bag.
If the spill occurs on a carpet, cut out the contaminated section and place in a plastic bag. Seal securely.
If your shoes or clothing have come in contact with mercury, don’t walk around. Seal the contaminated items in a plastic bag.
Wash your hands thoroughly, and shower as soon as you’re able.
Culprit No. 2: PVCs
You know those disposable plastics used in your hospital? Those IV bags, tubing, oxygen tents, and mattress covers? Approximately 25 percent of these products are made of a plastic called polyvinyl chloride (PVC). These modern-day conveniences—intrinsic to a nurse's working life—can be lethal. The use, production, and disposal of PVCs produce two toxins. The first, dioxin, is a group of chemicals that are by-products of the incineration and production of plastics. The second, DEHP (d-ethylhexyl-phthalate), which makes PVC soft and flexible, is a developmental and reproductive toxin that can lead to birth defects.
There are many alternatives to PVC products, but in order
to say "no" to PVC, nurses must know how to choose a healthier solution. The
good news is that on September 9, 2002, the U.S. Food and Drug Administration
recommended that manufacturers label all medical devices that are made with
DEHP, and asked them to consider replacing DEHP with alternative materials.
Now the
bad
news: It's only a recommendation, not a requirement. Until it becomes mandatory,
it's up to the individual hospitals, as the purchasers, to make healthy choices.
Six steps to environmental health
Caring for the environment is a natural extension of caring for your patients. The following six steps offer you a way to help nurse our planet back to health.
1. Form a "green team"
A "green team" is a group of organizational healthcare workers who examine environmental issues, including waste management. Their mission may be to discover what happens to the facility's wastes, and where and how the waste is treated. The green team also may study the waste segregation programs to determine if they're functioning properly. With such knowledge, the team can find progressive disposal solutions.
2. Steer your hospital to Environmentally Preferable Purchasing (EPP)
Under an EPP program, your hospital purchases products that have a less-damaging
environmental impact. If no EPP program exists, you could serve on a product
selection committee and contribute to purchasing decisions. Don't feel alone—there's
plenty of assistance
and information available. You might want to start with the EPA's "EPP Update,"
which can be accessed online at http://www.epa.gov/opptintr/epp/pubs/update6.pdf.
3. Raise your mercury consciousness
Investigate public relations giveaways in your hospital to see if they distribute first-aid kits with mercury thermometers. Check out the gift shop. Are mercury thermometers sold there? If so, it's time to update these services.
4. Become a waste management enforcer
Be diligent in your efforts to ensure that waste is being separated properly. Educate other nurses and housekeeping staff about proper segregation. Encourage everyone to be involved in recycling efforts.
5. Order an ANA Nurses Pollution Prevention Kit
This kit will supply you with dozens of tools, including guides, articles, and
videos, to help you make a difference in your community. You can order an ANA
Nurses Pollution Prevention Kit by calling (800) 637-0323.
6. Learn to reuse
Nurses working in private homes may come upon health-related apparatus, like hot-water bottles, wheelchairs, or crutches, that the patient no longer needs. Instead of disposing of these items, send them to hospitals or loan closets for distribution to the needy. If you're part of an EPP, select reusable materials for linens, diapers, gowns, or scrubs. It's cost-efficient, environmentally friendly, and reduces disposable medical waste.
Cleaning up the environment often seems like a daunting task,
but together, we can make a difference. Remember the words of Margaret Mead: "Never
doubt that a small group of thoughtful, committed citizens can change the world.
Indeed, it is the only thing that ever has."
