Introduction by Croakey: On the frontline of extreme weather events, nurses have a critical role to play in climate mitigation and adaptation.
However, nursing education is failing to prepare them for the challenges that lie ahead, according to Dr Aletha Ward, Adjunct Senior Lecturer at the University of Southern Queensland, and Distinguished Professor Tracy Levett-Jones, from the University of Technology Sydney.
Below, Ward and Levett-Jones argue the case for universities and nursing education to embed planetary health principles as well as education on climate health advocacy.
Aletha Ward and Tracy Levett-Jones write:
A new cohort of nursing students is stepping onto university campuses filled with optimism about a career caring for others. But the world they are entering is unlike any before.
The healthcare system awaiting them upon graduation is already struggling under the weight of the climate-driven health crises – heatwaves pushing hospitals beyond capacity, infectious diseases spreading into new regions, bushfire smoke exacerbating respiratory illnesses, and extreme weather events displacing communities and overwhelming emergency services.
Yet despite this reality, planetary health is still not a mandated part of their curriculum.
A curriculum stuck in the past
For years, scientists have warned us about the risks of exceeding 1.5°C from pre-industrial levels, but 2024 saw us sail past that threshold, both nationally and globally.
Projections now indicate we are heading towards a 3°C world by the end of the century – a future where climate impacts are no longer distant possibilities but everyday emergencies.
The consequences for human health are catastrophic.
Nurses will be on the frontlines of extreme weather events, climate-related disease outbreaks, and systemic health service failures. Nurses will be the ones responding to:
- Heatwaves causing surges in cardiovascular, renal, and respiratory emergencies
- The spread of infectious diseases such as dengue, malaria, and antimicrobial-resistant bacteria into new regions
- Mental health crises linked to climate anxiety, displacement, and the destruction of homes and livelihoods
- Water and food insecurity exacerbating chronic health conditions.
Despite this, Australia’s nursing accreditation standards remain largely silent on planetary health.
Leaders in climate mitigation
Nurses cannot accept the projected climate trajectory as inevitable. They have a critical role to play in preventing further warming and mitigating climate change’s worst effects.
Healthcare is one of the largest global carbon emitters, responsible for nearly five percent of total greenhouse gas emissions. If it were a country, the health sector would be the fifth-largest emitter in the world. Hospitals rely on fossil-fuel-dependent energy, produce enormous amounts of waste, and use medical products with high environmental footprints.
Nurses – who make up over half of the global health workforce – are at the heart of healthcare’s daily operations.
They are in a unique position to:
- Advocate for sustainable healthcare systems, from renewable energy use in hospitals to reducing single-use plastics in clinical settings
- Champion low-carbon models of care, such as telehealth, nurse practitioner models, and preventative health approaches, that reduce the burden on hospitals
- Lead waste reduction initiatives, including promoting reusables, and minimising pharmaceutical waste
- Educate patients and communities on sustainable health practices, such as promoting plant-based diets, reducing air pollution exposure, heatwave preparation, and advocating for active transport.
Nurses are already doing this work, often in addition to their usual roles. However, without formal foundational education on planetary health, these efforts will remain fragmented and under-resourced.
Failure to prepare the next generation
The World Health Organization (WHO) and the International Council of Nurses (ICN) have declared climate change a global health emergency. The Australian Government has acknowledged the need for climate mitigation and adaptation with its release of the National Health and Climate Strategy in 2023.
Yet, nursing education is failing to prepare students for climate adaptation and mitigation.
Few universities in Australia have designated subjects or have integrated planetary health throughout undergraduate nursing degrees.
Inclusion of planetary health is largely driven by passionate and knowledgeable nursing academics who often face significant challenges in embedding this content within already crowded curricula – challenges compounded by the absence of clear prioritisation of planetary health by the nursing regulatory authorities.
This is a fundamental failure of the nursing education system. Nurses are the largest healthcare workforce – and the most trusted professionals.
If nurses are not taught about planetary health, how can they advocate for climate resilient, low-carbon healthcare?
A moral and professional responsibility
Planetary health is not an abstract concept – it is the single biggest determinant of health for future generations. Ignoring its integration in nursing curricula is both a moral and professional failing.
Nursing education must catch up with the reality of climate change. This requires:
- Mandating planetary health as a core part of nursing education and embedding into every aspect of nursing education.
- Embedding planetary health principles into the Australian Nursing and Midwifery Accreditation Standards and Registered Nurse Standards for Practice.
- Educating nurses to be climate health advocates in their healthcare organisations, in their communities, and at the highest levels of government.
Immediate action required
Nursing has a proud history of leading public health movements, from First Nations health reforms to abortion rights. Now, we stand at another pivotal moment.
If we do not act now, today’s nursing students will graduate unprepared for the defining health crisis of their time.
We owe them better. More importantly, we owe our patients and communities better.
It is time for nursing education to step up!
About the authors
Dr Aletha Ward is Adjunct Senior Lecturer at the University of Southern Queensland. She is active in climate and health research and advocacy, including as:
- Adjunct Senior Research Fellow – Curtin University
- Adjunct Fellow – University of Technology Sydney
- Co-Founder and Ambassador – Climate Action Nurses
- Chair Climate and Health Faculty – Australian College of Nursing
- Non-Executive Director – Climate and Health Alliance
- Leadership team – Planetary Health Collaborative for Nurses and Midwives
- Climate and Health Representative – Australian Primary Health Care Nurses Association.
Professor Tracy Levett-Jones is a Distinguished Professor at the University of Technology Sydney. She is a world-leading nursing researcher who leads the Planetary Health Collaborative and Empathy Initiative research group. Tracy is ranked as one of the world’s top 1% of nursing scientists by Stanford University and was inducted into the Sigma Theta Tau International Honor Society of Nursing Nurse Researcher Hall of Fame in 2022.
Tracy’s program of research includes planetary health, empathy and patient safety. She has written ten books and over 250 journal publications. Tracy has been the recipient of multiple teaching and research awards and over seven million dollars of research funding. She continues to lead major research and education projects and her collaborations with organisations such as Diabetes Australia and the Prostate Cancer Foundation of Australia demonstrates her commitment to community engagement and industry partnerships.
See Croakey’s archive of articles on the climate emergency
