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The Paris Agreement adopted in 2015 is an international binding United Nations (UN) treaty that aims to unite the global community to halt ongoing climate change through governmental and multisectoral partnerships (United Nations, 2015). Its primary objective is to limit global warming to below 1.5°C above preindustrial levels (United Nations, 2015). Despite this commitment, the World is not on track to achieve these targets (United Nations Environment Program UNEP, 2023). In 2021, the Intergovernmental Panel on Climate Change (IPCC) reported climate change as a "code red for humanity" (Intergovernmental Panel on Climate Change IPCC, 2023; Romanello et al., 2021). It is now apparent that we need much more aggressive interventions than previously anticipated to adequately cut global greenhouse gas emissions and avoid worsening climate change scenarios (IPCC, 2023). The global impact of climate change on health and healthcare is becoming increasingly evident. The significant death toll from extreme heat during the 2024 Hajj pilgrimage and the impact of recent floods in Europe and wildfires in Canada illustrate the growing threat (McCloskey et al., 2024). Healthcare systems and professionals, including nurses, are and will continue to care for patients affected by extreme weather events like storms, flooding, cyclones, wildfires, and droughts, which are becoming more frequent and severe (Mosadeghrad et al., 2023). The science is clear—our planet is warming and it is due to human activity. We need action, not debate or denial, and nurses must lead this response to build planetary health. The urgency of this situation highlights the importance of the nursing profession's role in leading systems change and adapting to these challenges. Understanding systems thinking and complexity, along with envisioning the tangible realities of an unpredictable future and leading a hopeful response, are essential (Braithwaite et al., 2024). Hope is the belief in our collective ability to create a healthier, more equitable world for current and future generations. This commentary embraces hope by presenting two future scenarios. The first envisions a reality where emission targets are unmet, global warming continues, and limited mitigation and adaptation responses exist in healthcare settings. The second outlines a reality where emission targets are met, global warming is halted, and proactive measures are implemented. We challenge nurses to imagine a thriving future for humans and the planet. This commentary not only provides a glimpse into possible futures but also serves as a call to action, emphasizing the pivotal role of nurses in driving necessary for a positive and hopeful future. It is 2050. Coral Haven, once a serene retreat, now bears the scars of a changing world due to the failure to limit global warming to 1.5°C. Rising sea levels and relentless storms have transformed Coral Haven into a place of constant struggle. The Coral Haven Hospital stands resolute amidst chaos, a beacon of both hope but also of despair. Sarah is a registered nurse at the Coral Haven Hospital. She and her children, Lily, aged 12 years, and Ben, 8 years, face the harsh daily realities of a changing climate. Lily spends her days mostly indoors due to oppressive heat and poor air quality, and Ben's outdoor adventures are stifled by the threat of mosquito-borne diseases. They both long for the world that their mother remembers, where families could run and play and explore nature and where the ocean was a pristine, sparkling refuge on summer days. The family's lives are now a daily battle against the challenges of global warming and the impact that humans have had on the planet. As Sarah heads to work, another severe storm descends upon Coral Haven. Floodwaters turn the streets into dangerous torrents. The hospital, now an island in chaos, loses power, leaving it in an eerie half-light as the generators struggle to maintain essential power. Electronic medical records are inaccessible, and the morgue has no cooling. Silent incubators expose premature babies to chilling air. The pharmacy's powerless refrigeration units threaten life-saving medications. In the ICU, patients on ventilators face grave danger as backup generators fail. The emergency department is overwhelmed by storm injuries and is running low on medication supplies. The air conditioning failure has turned the hospital into a sweltering furnace. Patients with heart and respiratory issues deteriorate in the heat, as do pregnant women. The floodwaters have turned the hospital into a breeding ground for infection. Many hospital staff have been stranded due to the havoc caused by the storm and roads that are blocked with debris or submerged under water. The few staff who were able to make it into work are stretched beyond their limits. Sarah's struggle to maintain order amidst the disaster is desperate. Sarah worries about her children who are being cared for by their elderly grandmother at home. She hopes the damage to her house is not too bad but knows that it is unlikely they will still have power. It will probably be days before the storm surge settles and she is able to return home. The emotional toll is visible on everyone's faces, but Sarah's resolve remains strong. She fights not only for her patients but also for a future where healthcare systems are resilient and prepared for climate challenges. Sarah makes a silent vow to advocate for better infrastructure and policies prioritizing climate adaptation to ensure a safer future for her children and community. It is 2050. The coastal town of Coral Haven has adapted remarkably to the changing climate, becoming a model of resilience. Rising sea levels and extreme weather remain frequent challenges. However, achieving the Paris Agreement target of 1.5°C and becoming net zero by 2050 has limited the scale and impact of these events. The community's actions have fortified their town, with Coral Haven Hospital standing as a testament to these efforts—a beacon of hope and innovation. Sarah, one of the registered nurses at Coral Haven Hospital, epitomises compassion and dedication. Her life is a delicate balance between managing her demanding job and caring for her elderly mother and two young children, Lily and Ben. Like other community members, Sarah's family have benefited from the proactive climate measures that have been taken in Coran Haven. They enjoy the new community parks that are safe and vibrant due to extensive tree planting and cool zones. They are able to enjoy the natural environments surrounding the town and often swim at local beaches. Their lives are enriched by the community's commitment to a healthier planet. Sarah sees the storm warning on television before she leaves for work. While storms are frequent, advanced early warning systems and resilient infrastructure mitigate their impact. Driving to work, she feels reassured by stormwater management systems and reinforced buildings. As the storm begins, Coral Haven Hospital is prepared. Clean, cool air fills the hospital, and Sarah moves with a sense of purpose, knowing they are equipped to handle the storm. While working, Sarah's thoughts are on her family. Despite the storm, she knows they will be safe in their retrofitted, storm-resistant home. The power remains stable, supported by a renewable energy grid and robust backup systems. In the neonatal unit, incubators hum reassuringly, keeping premature babies warm and safe. The pharmacy's refrigeration units maintain life-saving medications at required temperatures. In the intensive care unit, patients on ventilators are secure, with backup generators ready but unnecessary due to the reliable power grid. The emergency department, busy but orderly, efficiently treats storm-related injuries, supported by well-stocked medical supplies. Sarah finds herself part of a coordinated effort to maintain order. Staff members, confident in their training and resources, respond to the situation with professionalism. The phones and internet remain operational, connecting them to outside support. The emotional toll is visible but manageable, and Sarah's resolve is bolstered by the community's efforts. She commits to continuing to act for a sustainable and resilient future, advocating for ongoing improvements and educating her community on both climate mitigation and adaptation. Nurses form the largest group of healthcare professionals (~60%) and are described as "the most trusted profession globally" (Lokmic-Tomkins et al., 2023). Given the expected increase in climate change impacts on human health and healthcare, current and future nurses must be able to respond effectively, engaging in advocacy, leadership, systems thinking, and adaptability to ensure effective action at local, national, and global levels (Ward et al., 2022). The two scenarios in this paper highlight the stark differences between a future where proactive measures are taken to limit emissions, and one where they are not. Scenario A shows the chaotic and vulnerable healthcare environment resulting from political inaction and inadequate preparation and failing to meet emission targets. Conversely, scenario B depicts a resilient healthcare system thriving due to meeting Paris Agreement targets and comprehensive climate efforts. These contrasting futures illustrate the critical role nurses must play in driving change and safeguarding community health. In light of the increasing urgency of climate change and its impact on health, nurses must take on roles in research, education, advocacy, policy development, practice adaptation, and health systems design. We advocate that it is essential for planetary health to be integrated into nursing education to prepare nurses for the challenges posed by an uncertain climate future (Martin et al., 2024). Education strategies must focus on building competencies in systems thinking and complexity, human–nature connection (Martin et al., 2020), disaster response (Flaubert et al., 2021), and sustainable practices in the personal and professional domains (Zelenski et al., 2023). We recommend the evidence-based guidelines such as the Planetary Health and Sustainable Healthcare Knowledge and Skills Framework developed by Levett-Jones et al. (2024) and the Planetary Health Education Framework (Guzmán et al., 2021) to guide curriculum development. Nursing research must prioritize the development of evidence-based interventions that support planetary health and promote healthcare and community resilience (Portela Dos Santos et al., 2023). Additionally, nurses must be willing to advocate for policies that limit fossil fuel use and that support climate adaptation, ensuring that healthcare systems are robust and responsive. Nurses are uniquely positioned to drive change and must implement updated standards of practice that address the health impacts of climate change. This involves shifting the traditional roles of nurses to include population health (Portela Dos Santos et al., 2023) and a planetary empathy lens (Ward et al., 2024), along with specific actions that support the interconnectedness of human and planetary health. By adopting a holistic approach to care, nurses can better address determinants of health and advocate for climate justice. A call to action for the nursing profession is imperative. Nurses must advocate for systemic changes that prioritize climate adaptation and resilience. Embodied leadership means leading by example, demonstrating sustainable practices, preparing healthcare services for climate impacts, and influencing peers and policymakers. This includes demanding healthcare policies that integrate adaptation and mitigation strategies, support for nurse-led research on innovative climate health solutions, and participate in public health campaigns that prioritize people's health over fossil fuel interests. Nurses' core remit must expand to protect and promote health in the Anthropocene. Through collective and individual actions, nurses can shift the healthcare landscape toward planetary health, ensuring better health outcomes for all. Nurses' role in the Anthropocene, where human-caused environmental damage impacts health globally, is more critical than ever. As climate change, biodiversity loss, and pollution continue to impact the human health and healthcare systems, nurses must provide clear leadership in advocating for policies that limit emissions and enhance resilience. The contrasting scenarios of Coral Haven illustrate the urgent need for significant proactive measures. By integrating planetary health into nursing education, research, advocacy, policy, and practice and raising our voices locally and globally, we can mitigate health impacts of climate change. Embodied leadership and a population health lens are essential for nurses to champion a future where healthcare systems are resilient, equitable, and responsive to the needs of all communities. The time to act is now, and nurses are uniquely positioned to lead this transformative journey toward a healthier planet. The authors report that no funding was received for this article. The authors declare no conflict of interest. Not applicable.
Ward et al. (Tue,) studied this question.