Nursing, Care, and Climate Change Tips for Managing Heat Waves

Climate and health are closely inter­lin­ked. The effects of climate change directly influence human wellbe­ing. The German nurses associa­tion, the „Deutscher Berufs­ver­band für Pflege­be­rufe” (DBfK), is drawing atten­tion to this. Heat waves also pose problems for health­care and nursing facili­ties, as extreme heat puts people who are elderly or sick at parti­cu­lar risk. In 2003, around 70,000 people died in the course of the Europe-wide heat wave as a result of the climate.

At the same time, the DBfK explains, the health­care sector contri­bu­tes signi­fi­cantly to climate change. For example, its C02 emissi­ons are higher than those caused by aviation. The DBfK has recently published an infor­ma­tive brochure, under the title „Nursing and Dealing with Climate Change”(Pflege im Umgang mit dem Klima­wan­del), which includes exten­sive infor­ma­tion on how to manage extreme heat. There are also tips on what can and should be done in a nursing capacity during the heat. The brochure is available to download on the DBfK website.

Heat as a health risk

Extreme heat parti­cu­larly affects the follo­wing areas:

• Blood pressure and fluid balance
• Heart and circu­la­tory disea­ses
• Lung disea­ses and aller­gies
• Postope­ra­tive wound healing

Increased cardio­vas­cu­lar decom­pen­sa­tion, kidney failure due to dehydra­tion, or increased suscep­ti­bi­lity to stress are just three of many scena­rios that can arise from extreme heat. Further­more, mosqui­tos or ticks can lead to an increase in the number of conta­gious disea­ses, just as lung disease can be caused by breathing in nitro­gen oxide from indus­trial areas. Wound infec­tions also occur more frequently in warm months than during cold seasons. Side effects of medica­tion and medical devices can also worsen as a result of the tempe­ra­ture.

Symptoms for both a heart attack and a more harmless heatstroke include sweating fits, exhaus­tion, dizziness, fainting fits (initi­ally when getting up, or incre­asingly there­af­ter), nausea, or vomiting. In order to prevent these, you should drink plenty of water, not put strain on your circu­la­tion through alcohol or smoking, wear appro­priate clothing, and stay out of the sun to avoid overhea­ting. Groups that are parti­cu­larly vulnerable to risks associa­ted with loss of fluid include elderly people, people in need of care, but also newborn babies and young child­ren.

Preven­ta­tive measu­res against heat in nursing

Many nursing homes have already taken precau­ti­ons against heat waves in the past, for example in relation to the arran­ge­ment of the resident or patient’s room, protec­ting appli­ances from overhea­ting, altering the menu by offering speci­fic drinks, or storing medica­tion and medical devices.

There are also further precau­ti­ons that the relevant organi­sa­ti­ons can take in order to help facili­tate work at high tempe­ra­tures. Here is a short excerpt from the list (Brochure, p. 12f):

• Adhering to occupa­tio­nal safety regula­ti­ons and ensuring employees have suffi­ci­ent breaks.
• Provi­ding free drinks for everyone, light­weight work clothes and changes of clothes. Well-venti­la­ted changing rooms and shower facili­ties.
• Cooling rooms with venti­la­tors, modern air condi­tio­ning, shading, and insula­tion of the top floors.
• Clear code of practice regar­ding the struc­tu­ring of workloads to relieve staff. Training staff.

Further­more, it would be desira­ble for the organi­sa­tion to have a consis­tent approach to climate protec­tion. Through saving resour­ces, saving energy, sensi­ble waste manage­ment, and sustainable manage­ment, health­care facili­ties can help to reduce green­house gas emissi­ons.

Which tasks in care and nursing are parti­cu­larly important?

The follo­wing is a list of activi­ties through which nursing staff can help the residents of nursing homes find soluti­ons against the heat (Brochure, p. 13 – excerpt)

• Explana­tion of the dangers of climate change.
• Advising patients/residents regar­ding the correct behaviour and suffi­ci­ent intake of fluids during hot spells.
• Repla­cing bedding with lighter bed sheets.
• Airing out rooms in the morning, evening, and night.
• Using all means available to create a comfor­ta­ble room tempe­ra­ture (air condi­tio­ning, fans etc.).
• Refres­hing washes, bathing feet and arms.
• Provi­ding ice cubes, water ice, cold drinks, iced fruit soup, or fresh fruit.
• Turning off appli­ances after use.
• Drink breaks and changes of clothing to ensure your own safety.
• Adapting work routi­nes, nursing measu­res, and care services.
• If neces­sary, indivi­dual nursing measu­res, depen­ding on the situa­tion of the residents/patients.

The brochure is available to download on the website of the DBfK.