Dr. Butterfield is the Dean of Nursing at Washington State University, where she directs Bachelor's through PhD Education programs for the largest nursing school in the Northwest. She is a public health nurse with expertise in environmental health interventions, rural environmental health, and household environmental contamination.  She conducted the nation's first randomized controlled trial addressing environmental health interventions delivered by public health nurses. She has served as a Robert Wood Johnson Executive Nurse Fellow and currently Co-Chairs the Environmental Health Expert Panel for the American Academy of Nursing. Dr. Butterfield is the author of the seminal article "Thinking Upstream," published in Advances in Nursing Science. 

The Hollie Shaner-McRae Student Essay

contest winner is Nicole Makris!

Hollie is a BSN-MSN student at Emory University's Woodruff School of Nursing. Prior becomin a nurse, Nicole worked as a journalist in the San Francisco Bay Area reporting and writing for non-profits such as the Breast Cancer Fund.  She studied the health implications of water quality near a landfill in Brazil, and worked as a Teaching Assistant for Antioch College's Environmental Field Program, visiting fence-line communities and superfund sites to help students connect the dots of environmental health disparities.  Nicole looks forward to becoming a Family Nurse Practitioner. 

Congratulations to both of our well-deserving winners!  

Awards will be presented April 26, 2013 at CleanMed. 

Victoria Rice Bean excels in making her dreams a reality, and she recognizes that patience in conjunction with finely tuned nursing skills - articulate planning, interdisciplinary negotiation, and teamwork - have been integral to her success.  Victoria was working as an O.R. nurse in the University of Washington Medical Center's 23-room Surgery Department several years ago when she realized the medical center had ample room for improvement in its recycling program. Red biohazard bags were being used for disposal of regular garbage, sharps containers were a catchall for a large variety of non-sharp materials, and the high volume of waste was expensive to process.  

 Maintaining her values as a self-proclaimed "wife, mother, and vegetarian urban homesteader," Victoria was determined to systematically shift the culture around waste in her facility, simultaneously empowering other nurses to join her. She decided to organize and implement a recycling program and began by auditing the surgical center's waste stream. Victoria contacted local sustainability vendors, utilized tools and resources from Practice Greenhealth, Health Care Without Harm, and Medline, and relied on input from the University of Washington's Campus Recycling Office and Environmental Services Manager to organize her data. She then analyzed the results of her waste audit, using the data to illustrate a cost-ratio analysis of misused resources to management.

The UW surgical center now boasts a 90% reduction in red biohazard bag use and over 50% shift from landfill waste into recycling! Nine other departments initiated recycling programs and plans for house-wide recycling are now underway. Victoria's advice: 

"Don't take no for an answer! Keep searching for the best solution- it's out there. Believe in yourself because what you are doing is the right thing."

Seattle Green RN's, from left to right: Annie Bruck, Victoria Rice Bean, Karen Bowman, Mary Margaret Thomas, and Laurie Beall

The topic of climate change can be divisive as well as depressing; the complex problems created as our communities are battered with one extreme weather event after another are as numerous as the solutions we have yet to discover. People sit at many points along the climate change debate continuum, from those who question the science, to those who see the effects first-hand and are actively involved in reaching out to vulnerable community members during disasters.  But many of us sit somewhere in the middle, realizing there's a problem but not yet knowing how to wrap our arms around it.

The Turning the Tide conference this past March at St. Patrick Hospital in Missoula, Montana, set the stage for meaningful discourse on the issue.  The conference brought together medical and nursing experts in infectious disease, mental health, and public health to discuss the health impacts of climate change.  As one of the founders of the Green for Good program that started at St. Patrick's 6 years ago, Beth Schenk, RN, BSN, MHI, Sustainability Coordinator, has made it her job to stay in tune with both hospital staff and community members on the issue.  She says, 

"We wanted to address the health impacts of climate change because it is a serious issue for both clinicians and hospitals.  However, climate change is seen as controversial, even though it is well-grounded in science.  Hospitals don't want to invite unnecessary controversy.  We are here to serve everyone, no matter their beliefs or perceptions. Community members on the planning group suggested we use a less controversial phrase for the conference.  So we chose the concept of health on a changing planet." 

While medical and nursing presentations on the health effects of climate change are helpful in that they let healthcare professionals know what we're up against, we also need to involve our communities in the process of finding solutions. After a morning of diving deep into the health impacts, the second half of the conference set the stage to explore options for moving forward.  On one of the afternoon panels there sat a coal miner, an elderly community group member, a high school biology teacher, a university environmental studies student, and a nurse. In listening to the different perspectives of the community members on the panel, I was encouraged by the willingness of those present to find common ground with others who have different religious, political, and moral beliefs.  

"I come at climate change from different perspectives: that of a doctoral student, a nurse at a hospital, and as a citizen of the planet.  In Missoula, we have lots of healthcare groups and environmental groups, but there's not much talk about where those two meet.  This seemed like a good place for the hospital to step in," says Schenk.

When Donna Dalsing, an RN in the surgical services department at Phoenix Baptist Hospital in Phoenix, Arizona attended the annual CleanMed convention in 2012, she was inspired by the Gundersen Lutheran Health System booth where they explained how their team made shoulder bags consisting of blue wrap used in operating rooms across the country. While necessary, blue wrap is abundantly utilized and contributes largely to surgical waste at hospitals. The material is extremely sturdy and can withstand up to 25 pounds of medical instruments.

Dalsing came back to Phoenix motivated to test this concept. As the founder of the Phoenix Baptist Hospital Green Team, Dalsing is passionate about ways to eliminate waste and looks for recycling opportunities at any given moment. With approval from hospital administration, Dalsing and her team quickly worked together - using their own sewing machines - to develop a blue wrap shoulder bag in time for the Komen Phoenix Race for the Cure. The hospital distributed the bags to employees who registered to participate in the event. They were a huge hit. So huge, in fact employees who did not receive a bag wanted to know where they could find one.

Her current project is developing an old smoking area to a tranquil garden, a beautifully-designed outdoor space that will give employees a quiet place away from a clinical environment to enjoy.

Donna Dalsing has been a registered nurse for 41 years. She currently works at Phoenix Baptist Hospital where she has been in the surgical services unit for more than 20 years. Her nursing experience has been focused in perioperative care where she has been a staff nurse, clinical coordinator and educator.

The HCWH Nurses Workgroup represents a community of nurses who are dedicated to implementing environmentally responsible practices in their hospitals. For more information about Health Care Without Harm, visit www.noharm.org.