ABSTRACT Recognition that the environment is a determinant of health is deeply rooted in the heritage of nursing. Environmental hazards and their effects on health rarely have simple solutions that can be managed by one discipline alone. Environmental health issues are complex in nature and the science is developing rapidly. Primary prevention strategies often involve the participation of professionals from fields other than nursing, and interdisciplinary, collaborative efforts are usually required. This article describes learning experiences about local environmental health issues, several of which were designed to initiate and foster collaboration between baccalaureate nursing students and graduate students in public health.
Key Words Community Health Nursing - Environmental Health Learning Strategies - Partnerships
Deeply rooted in the heritage of nursing is the recognition that the environment is a determinant health. From the very beginning of her work, Florence Nightingale made environment the central focus of her practice. In her Notes on Nursing, for example, she devoted more chapters to discussions of environmental issues and criteria than to any other aspects that she considered part of nursing. Nightingale wrote that nursing was more than administering medicines and applying poultices. Nursing "ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet" (1, p. 6).
Later, Lillian Wald and Mary Brewster, both trained nurses, established themselves in the Henry Street Settlement in New York City's Lower East Side to provide health care to the poor in that area. While residing in the settlement house, Wald and Brewster worked toward changing the physical environment and social conditions that would have a direct impact on the health of people (2).
Since the days of these pioneers in nursing, the concepts of health, person, nursing, and environment have been valued as fundamental to the profession (3,4). However, while nursing students learn about people through basic courses, such as general psychology and sociology, and study health and nursing from various vantage points along the lifespan continuum, they have few opportunities for the study of environmental issues. The environment is introduced as a supplement in only a few nursing courses. Nursing schools that teach community health nursing usually have some brief discussion of the environment and its impact on the health of humans (5,6).
Green appropriately points out that nursing students must have an environmental orientation to prepare them for practice in today's world. "Grappl[ing] with the practical implications of environmental health problems," she states (7, p. 235), requires nurses to think critically. Essential critical thinking skills such as observation, examination, and analysis of environmental issues are needed for the continuing education of practicing nurses. The nursing literature recommends a focus on environmental health issues in preference to implementing a separate environmental health component in the nursing curriculum.
The 1995 report from the Institute of Medicine's Committee on Enhancing Environmental Health Content in Nursing Practice presented several recommendations grouped under nursing practice, nursing education, and nursing research (8). The report stressed the "importance of increasing environmental health awareness and content for all nurses regardless of their particular field of practice or educational preparation" (p. 4).
The Decision to Partner Given the need by nurses for a basic knowledge of environmental health, community health nursing faculty at Loma Linda University (LLU) sought ways to strengthen the presentation of environmental health concepts in the nursing curriculum. It was apparent to the faculty that environmental hazards and their effects on health are complex in nature, and that the science of environmental health is developing rapidly. …