The Public Health Nursing Series is a 20-blog collection, written by William (Billy) Rosa, author of the recently released title, Nurses as Leaders: Evolutionary Visions of Leadership (June 2016), that sparks a dialogue about each and every nurse's role in advancing and creating the future of global health. With a focus on cultural considerations and the current status of healthcare in nations worldwide, nurses will learn how they are called to contribute to each of the United Nations' 17 Sustainable Development Goals, an international initiative that seeks to end poverty, protect the planet, and ensure prosperity for all over the next 15 years.This series makes the case that every nurse, regardless of title, position, or credential, is a public health leader.

Sustainable Development Goal #13 – Climate Change

In 2012, a film was released that showed the tip of the future devastation possible if the global community does not awaken to the evolving threats resultant of climate change. Jon Shenk’s The Island President, documents former President Mohamed Nasheed’s quest to protect his country, the Maldives, from annihilation. As the lowest lying country on the planet, the Maldives is dangerously impacted by the rise in sea level that is occurring at rapid rates secondary to global warming. The Maldives is an endangered civilization that is now advocating for the world to adopt more sustainable industry options and reduce greenhouse gas emissions for their survival. We are not responding quickly enough.

The Environmental Protection Agency (EPA) (2016) has been clear that because of human activities that emit greenhouse gases, such as carbon dioxide, into the atmosphere, global warming is occurring at an alarming rate.  Burning fossil fuels for energy, deforestation, poor industrial processes, and agricultural practices that emit high amounts of such gasses lead to the signs and symptoms of climate change worldwide: more intense heat waves, dangerous floods and droughts, melting of glaciers, increased warming and acidity of the oceans, rising sea level, and an elevation in the average global temperature. Environmentalism and prevention are two keystones of the nursing profession that directly relate to the planetary efforts being taken to secure a future of health and well-being for all.

Sustainable Development Goal (SDG) #13 asks international partners to “take urgent action to combat climate change and its impacts” by 2030 (United Nations Sustainable Development [UNSD], 2016). Some of the SDG #13 targets include:

  • Increase preparedness and resilience to climate-related hazards and natural disasters in all countries
  • Incorporate climate change measures into national policies, strategies, and planning
  • Improve education and awareness regarding climate change reduction, adaptation, and opportunities to reduce impact
  • Raise the capacity for climate change-related planning and management in the least developed countries and those island countries most threatened by the consequences of global warming

Global collaboration is mandatory since the atmospheric and environmental fallouts of the harmful practices mentioned above affect all human beings everywhere.

Florence Nightingale was a staunch environmentalist who developed a tenet known as the precautionary principle (Luck, 2016; Luck & Keegan, 2016). This principle implies that “if there is a suspicion about a harmful environment or exposure, even though all of the evidence is not in, remove the person from the situation or stop the use of suspected harmful exposures (Luck & Keegan, 2016, p. 561). In regards to climate change, since it is impossible to remove people from the global environmental situation, the answer is simple: we must stop the use of these detrimental contributors to our health.

Nightingale was what Forrester (2016) calls an exemplary leader: a future oriented and active change agent who sought improved future outcomes for nursing, healthcare, and society. She was not content with merely theorizing about mechanisms for improved health; she took intentional action to impact change. Public health nurses must constantly assess their abilities to demonstrate the traits associated with exemplary leadership, such as being trustworthy, credible, fearless, shrewd and politically aware (Forrester, 2016). Exemplary leadership is the beanstalk we need to climb to effectively face the giant that is climate change. By continuing to role model excellence and ethical values, enrolling communities in the creation of a shared vision, challenging the current norms and processes, empowering others to act wisely and deliberately, and demonstrating courage and hope (Kouzes & Posner, 2012), public health nurses can create powerful advocacy initiatives to improve climate change.

When it comes to the consequences mentioned previously, public health nurses must look beyond their country’s borders to what is happening worldwide, employing a global awareness and public health sensibility that we are all in this together (Goldsteen, Goldsteen, & Dwelle, 2015). The world can no longer afford to think of itself as a landscape of individual nations and governments living side by side. We are, indeed, interconnected. If the planetary population is to not only survive but thrive in the years to come, we must accept responsibility for how we contribute to these problems and what solutions we can implement in realistic ways. A first small step is to calculate your household carbon footprint ( and learn which of your daily activities can be adjusted to lower greenhouse gas emissions.

It starts and ends with each one of us!


Environmental Protection Agency (EPA). (2016). Climate change: Basic information. Retrieved from

Forrester, D.A. (2016). Exemplary nursing leadership. In D.A. Forrester (Ed.), Nursing’s greatest leaders: A history of activism (pp. 3-17). New York, NY: Springer.

Goldsteen, R.L., Goldsteen, K., & Dwelle, T.L. (2015). Public health: promise and prospects. In R.L. Goldsteen, K. Goldsteen, & T.L. Dwelle (Eds.), Introduction to public health: Promises and practices (2nd ed) (pp. 235-260). New York, NY: Springer.

Kouzes, J.M. & Posner, B.Z. (2012). The leadership challenge (5th ed.). San Francisco, CA:         Jossey-Bass.

Luck, S. (2016). Informed and impactful: Stewarding the environmental determinants of health    and well-being. In W. Rosa (Ed.), Nurses as leaders: Evolutionary visions of leadership (pp. 333-343). New York, NY: Springer.

Luck, S. & Keegan, L. (2016). Environmental health. In B.M. Dossey & L. Keegan (Eds.),           Holistic nursing: A handbook for practice (7th ed.) (pp. 557-587). Burlington, MA: Jones & Bartlett

United Nations Sustainable Development (UNSD). (2016). Goal 13: Take urgent action to combat climate change and its impacts. Retrieved from

More About the Author

William (Billy) Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC, is currently Visiting Faculty, University of Rwanda and ICU Clinical Educator, Rwanda Military Hospital, Human Resources for Health Program in partnership with the New York University Rory Meyers College of Nursing. He currently has over 65 publications for refereed and non-refereed journals, newspapers, magazines, and national platform blogs and his book, Nurses as Leaders: Evolutionary Visions of Leadership, was recently published by Springer Publishing in June 2016. Billy currently sits on the US Advisory Board for the Nightingale Initiative for Global Health, and most recently received the American Association of Critical-Care Nurses' 2015 National Circle of Excellence Award and the Association for Nursing Professional Development's 2015 National Change Agent/Team Member Award.

Quick Links

Part 1 -  Understanding the Nurse as a Public Health Leader

Part 17 - Sustainable Development Goals #’s 14 & 15 – Life Below Water & Life on Land