UMSN Alumna Empowers Nurses to Help Patients Affected by Extreme Heat
The new program, which helps patients stay “cool and healthy” in their own homes, is already showing success and potential for expansion.
“I was inspired during my community health nursing rotation,” says University of Michigan School of Nursing alumna Angela Wan (BSN, 2013). “We were matched with home-visit clients and followed up with them consistently throughout the semester. I wanted to find a way to do more because the home environment is such a big aspect of your sense of identity and well-being.”
Wan, now a graduate student at U-M’s School of Public Health (SPH) and School of Natural Resources and Environment (SNRE), found her interests in health and the environment connected with those of fellow SPH graduate student Valerie Tran (MUP, MPH 2015). “I was really interested in disparities in heat-related illness,” says Tran who was already involved in a research project evaluating heat vulnerability in several U.S. cities. “Residential settings, social vulnerabilities, and the environment all play into how susceptible you are to heat-related illness. So, then I thought I wanted to do something about this.”
Wan and Tran applied for and received a grant from Health Care Without Harm’s Climate Change and Health Contest for Nurses to launch Nurses for Cool and Healthy Homes (NCHH). The program trains nurses who conduct home care visits to include an assessment of clients’ homes. Infants, elderly, patients with chronic disease, minority groups, low-income residents, and people living in urban areas are some of the most vulnerable to extreme heat related illnesses.
“A lot of nurses are seeing the health impacts on a day-to-day basis, but they‘re not necessarily attributing them to climate change,” says Tran, who doesn’t want NCHH’s efforts to be tied up in the discussion about whether or not climate change is real. “We know extreme heat happens. Nurses are seeing clients in sweltering hot homes but they don’t have the resources or know what programs exist for their clients. As long as you’re addressing the extreme heat and making those connections, that’s what’s most important to us.”
“I think the health impacts of climate change have been an understated part of the climate change discussion,” says Wan. “With three million nurses in the country, to get them to understand that they have the ability to speak on climate change through a health lens without asking them to be experts on this topic is really powerful.”
For the NCHH program, Wan and Tran partnered with California’s Fresno County Department of Public Health, which serves more than 400 home-visit clients. “We anticipated the nurses would think this is just an extra piece of work in their very busy, packed home visit,” says Wan. “But, we had top-level leadership from the Fresno County Department of Public Health to say ‘This is what we are doing; we are being an innovative program to show that nurses can do more to use their clinical judgment in other ways that are valuable to our clients.’”The NCHH toolkit includes video training for the nurses, a home environmental assessment checklist, a heat-related illness fact sheet, client-oriented tips on how to stay cool, and resources for energy assistance programs. Since NCHH has been adopted into Fresno County Department of Public Health’s policies and practices, any time a new case is opened the nurse will conduct a home environmental assessment. The nurses will evaluate the client’s vulnerability to extreme heat, share passive cooling strategies and connect the residents with resources such as home energy improvements and utility assistance.
Wan and Tran are optimistic that more health departments and community agencies will be interested in NCHH. “There are geographic variations and population differences of course,” says Wan. “But, NCHH is a very low-cost program because the nurses are already going to these homes for other programs and they have an ongoing relationship with the residents.” Wan says she also sees potential for hospital management to support NCHH, because preventive measures can decrease emergency room visits and lower hospital operating costs from heat-related admissions.
“The entire healthcare industry has a lot to gain from understanding the environment that we live in, not just the physical surroundings but the resources we use to operate,” says Wan.
To contact Wan and Tran, email NCHHdirectors@umich.edu.
Watch Tran's TEDxUofM Talk, "Re-Imagining Your Potential."
In April 2015, UMSN Dean Kathleen Potempa, PhD, RN, FAAN, and a coalition of deans from 30 nursing, medical and public health schools committed to ensuring that the next generation of health professionals is trained to effectively address the health impacts of climate change. Read the commitment statement.
