Nurses “Green” Their Unit

By Maye Thompson, RN, PhD

Member, ONA Board of Directors

Several nurses in the Doernbecher Children's Hospital Prenatal Intensive Care Unit (PICU) are working to “green” their unit. Mary Frances Pate, RN, DSN, a PICU clinical nurse specialist, says a simple problem got them started. A sales representative asked them if they wanted reusable or disposable oximetry probes. They discovered that used disposable probes (the sensor-wire-plug units) could be collected in a pre-addressed shipping box and sent back to the company for “remanufacturing.” The hospital gets credit for each returned probe. The potential to reuse probes started the team thinking about many other opportunities for recycling.

The team communicated their ideas to various staff members at their institution responsible for waste management. The team received an enthusiastic response. They also attended the Health Care Without Harm (HCWH) Pollution Prevention Roundtable, a quarterly meeting in the Portland area. Open to anyone interested, the roundtable serves as a clearinghouse and problem-solving network for people working on “greening” hospitals and other health care facilities.

The nurses worked with their unit-based nursing practice council to develop a green team pilot project that aimed “to be leaders in responsible health care practices that promote positive patient, staff, and environmental outcomes.” The team developed a work plan with multiple goals for their 16-bed unit, including education, interventions, evaluation, networking and consulting.

The program features monthly topics, for example, recycling, reuse, PVC, DEHP or mercury. Focusing on these topics, the team conducts monthly baseline audits by walking through the unit’s patient care and administrative areas, including offices, conference room and the nurses’ lounge. After the audit, the team presents a short inservice.

For the topic of recycling, the team showed the 10-minute video, “Why Should I Bother,” available from HCWH. Afterwards, the team answered questions and generated ideas. Based on the inservice, the team developed interventions, posted signs and posters and put information in their unit newsletter. Interventions have ranged from changing the location of the battery recycling bin from the back of the unit to the front desk where pager batteries are changed to working with the institution’s hazard waste manager, safety officer and recycling coordinator to find alternatives to mercury-containing equipment and disposables.

With about 100 nurses, attending physicians, residents, certified nursing assistants, respiratory therapists, administrators and housekeepers, the PICU presents a challenge in communication and coordination. For instance, when auditing the amount of nonhazardous waste in red bags, they realized they would need cooperation from nursing and housekeeping staff on all shifts to count the bags as they were emptied.

Related to communication, the green team found that small incentives, such as a coupon for a free cup of Starbuck’s coffee or an antiseptic soap-on-a-rope, helped motivate attendance at inservice presentations. The team also found that their audience was much more responsive when the term, environmentally “responsible,” was used rather than “friendly.” In addition, Jeanean Rauch, RN, BSN, says that nurses like seeing nurses presenting information on the videos. “They really perk up when the nurse is talking.”

Rauch also reports that while the majority of nurses are supportive of the “greening” some nurses have been reluctant to get involved. Rare comments, such as “We tried it before and it didn’t work” and “I don’t have time to think about where I toss trash” have been heard.

The green team is working hard to make recycling as easy as possible. They are ordering special bins, shelves and other items that will fit recycling into the unit space and routine.

Team members admit that the process has been more time-consuming and complicated than they originally thought it would be. But that hasn’t dampened their enthusiasm for trying to make a difference; they intend to keep plugging away as they have time and energy. “We are documenting all we can to serve as a model for other units trying to go green. I think the hospital will respond even more enthusiastically if we can show money saved,” concludes Pate.

Does your unit have a green team? Share your successes and your challenges! Please contact Maye Thompson at mayedoug@spiritone.com with your story. For more information about HCWH, the Pollution Prevention Roundtable or a consultation at your facility, contact Neha Patel at the Oregon Center for Environmental Health at 503.233.1510 or neha@oregon-health.org.