Skip to Main Content

Transition Culture - an evolving exploration into the head, heart and hands of energy descent

Sarah Timmins: the Low Carbon Nurse

Sarah Timmins is a qualified adult nurse who is now doing a postgraduate qualification to become a health visitor.  She recently started the blog 'UK Nurse Against Climate Change' which she describes as "my own private journey into a year, and hopefully much longer, of trying to raise awareness of climate change and its devastating effects on human health".  "I’m passionate about what I do, I love nursing and I want to do something which will make a difference", she writes.  So how's it going, and what's it like being a nurse within the NHS trying to raise awareness about climate change. 

On your blog you wrote about how ‘The Lancet’ and the UCL Institute for Global Health Commission called climate change "the biggest global health of the 21st century". You wrote "that’s a big statement, why should we get involved as nurses?" That’s my first question: why should nurses get involved with climate change?

We’re here to protect the public’s health. Especially nurses who are more involved in the public health field, but all nurses as well even if you’re working in a care home or in a paediatric unit, you are still there to protect health rather than just treat illness. The government’s got a big drive on preventing ill health as well as treating the symptoms of all the illnesses and actually if there’s something so big as they’re suggesting it’s going to affect every person on the planet, it really should be a health issue we take on board and try to do something about.

What form has that taken so far? What have you been doing so far?

The main thing I’ve been doing is trying to raise awareness really. It’s surprising how little it’s actually talked about. I think the more people talk about things, the more normalised it becomes then people start to take action, so raising awareness online or just through having conversations with people. Also, health visitors in particular have four principles that we work by. A few of them are searching for health needs and influencing policy that affects health. I’ve been trying to get involved with that through getting involved in the Divestment campaign which I feel personally would send out a very positive message.

What kind of reception have those conversations and you raising that issue had within the work context?

Some positive. A lot of people don’t know much about it, so when I bring up the impact it’s going to have on people’s health, not just 200 years into the future but what’s happening now and in the near future, people seem to be quite surprised, but they do get on board with it. People have responded to different degrees.

Some people have said they’d like to get more involved and others have just said “oh, I didn’t realise that”. It’s good that they’ve then gone home and they might then process that and when they watch the news start thinking about things in a different way. It’s good to get people a bit more positive about it.

In your daily experience as a nurse, where do you see the biggest carbon generating aspects of modern healthcare?

Pharmaceutical use and wastage in medicine in this country is a huge problem. If you’re using carbon to produce these drugs and then not using them that is a horrific problem that needs addressing. But also the main thing that I’ve come across is the use of cars. The transport, especially that community nurses use. It’s such a conundrum because we have to use our cars to drive around to people’s houses and there are times when I will see nurses who will drive two streets away and I think "you could walk!" It’s such a little thing but a policy addressing that issue I think will go a long way to making a difference.

What’s your vision of what a low carbon NHS would look like?

I’ve seen a lot of positive things. I’ve been looking at what a lot of different hospitals around the country are doing and I know that some of them have implemented policies with their building regulations which is really good, automatically shutting off their lights, responding to when people walk into the room, that sort of thing so they’re not left on all night.

Also they’ve introduced green spaces and allotments for healthcare workers within the hospital environment as well. More healthcare workers utilising cycling and walking, active transport would be really key I think. You can’t try and encourage people or patients to do things if you’re not willing to do them yourself.

I was really surprised to see The Lancet coming out so strongly about climate change and the need to really shift how we do stuff, and the role that healthcare has to play in that.

They have been really positive in making such a strong statement. I would be really keen to see the nursing community be as strong with their position on climate change and low carbon environments as well. The medical community seem to be all guns blazing at the moment with it, and it would be nice to get the nursing press on board as well.

Do you have any sense of how you might try and bring that about?

We’ve been talking to a couple of organisations about creating a global network of nurses on climate change, trying to get more nurses involved in it, not just in the UK but globally. There are a couple of organisations in the US and Australia who are a lot more involved with this, and I’m keen to get UK nurses mobilised.

A good place to start is always Universities. Students are ever so enthusiastic, so it would be really good to get it into the curriculum of public health nursing as a standard practice so that all nurses learn about sustainability and about the health effects of climate change, because it is such an important issue.

Actually something I’ve been thinking about would be putting in on Trust inductions, trying to get NHS Trusts to really put their position forward – this is the sort of thing that’s really important to us, and it’s as important as your fire training and your health and safety training. This is our sustainability policy and we think it’s important. Every healthcare worker should get training on it when they go into a job. It’s a pipe dream but I’ll certainly try.

You’ve just started doing a blog, how are you finding it and what are your hopes for that?

I’d like to keep going with it and explore different themes and get more deeply involved with it. I’m hoping to reach more people, more nurses, other healthcare workers and maybe get them involved too. It would be nice to reach more people really.


As a health visitor, how do you notice, if at all, in the UK setting the impact of climate change on the people who you visit and the people you’re looking after?

I work in quite an urban environment so the obvious thing is the air pollution. I seem to have a lot of young patients who have a lot of allergies, pollen allergies and asthma and I know that the pollen season’s getting longer and it’s been suggested that this is linked to climate change. There are lots of hospital admissions every year from asthma attacks and respiratory disease. It would be ignorant to bypass that and think there’s nothing we can do about it. There’s plenty we can do. There are cities around the world who implement low emissions zones to try and combat air pollution and it’s really important to notice that really.

I hope that more people realise a little bit more about the impacts it might have on people’s health, go away, read a bit more, have more conversations and let’s try and change something. 



James McLaren's picture

A bigger philosophical question

Sarah's comment:

the main thing that I’ve come across is the use of cars. The transport, especially that community nurses use. It’s such a conundrum because we have to use our cars to drive around to people’s houses and there are times when I will see nurses who will drive two streets away and I think "you could walk!"

I could easily see the nurse in question responding "yes, but I then have to drive four miles up the road to the next person, and I can't spare five minutes to walk back", or "I have to lug an oxygen cylinder with me for this visit".

These are not excuses: but they are the symptom of something much bigger. The whole thrust of modern society is to do the same with less resources. I know nothing of Sarah's situation, but I do know that my sister was a community nurse and the pressure she was under to manage a case load was enormous. The key driver in such cases is efficiencyso you invest in software to schedule your route so you do the least amount of driving while fitting in the largest number of visits, just as you'd do if you were delivering parcels.

But the key thing with human care ought to be effectiveness - how well are patients looked after? We've seen all the stories about the highly efficient hospitals where patients waited in vain for water or bedpans or care. We've equally heard the stories of the community nurses run off their feet and unable to provide the necessary support inside a 15-minute slot, constrained by the need to move on because otherwise some patients would get no care at all.

Low-carbon nursing would require more and better paid staff, and it would cost us big-time. I happen to think that it would be a price well worth paying (and there are plenty of things I reckon that could be cut to make it work) - but it would require a groundswell of opinion that says we cannot go on the way we are going. It is political - but it's not party political, because all the main political parties won't lift a finger to make it happen (UKIP least of all).

Oh, and by the way, if it's all right with you I'll stick to single-use non-recyclable needles. The AIDS pandemic got into the USSR because needles were reused and no-one thought to check the steriliser was working properly...

redandblack_uk's picture

I absolutely agree

Hi James,

I agree with everything you have written. It is a symptom of a much bigger problem. There needs to be time taken (and resources given) to addressing the issue and unfortunately the political implications are great. There are however changes which some nurses could implement if they were honest, depending on individual situations. In most cases our health visitors (although I cant speak for other teams you understand) have very little equiment and indeed only go to perhaps two visits before returning to the office. We as a team cover a small geographical area and many of these visits could be done without the use of the car. This being said, I completely agree that the use of heavy equiment, a string of appointments all across town, or a wider geographical area would make this very difficult indeed. It would take pressure from a majority group to fight the issue which is not as I understand it anywhere near realisation. This is one of the reasons I am starting to raise the issue with fellow nurses. Its a long way off change but there always needs to be a first step.

Kindest regards,

Sarah Timmins

Tony Buck's picture


Sorry but the editor in me wonders about this sentence in your statement from the Lancet, I think there is something missing: the biggest global health of the 21st century 

Also, I think before you look at pollution as causes of illness you must first look at diet, that is, mostly foods from plants for the best nutrition, which many have abandoned due to consuming mainly coorporate edible substances, not food. 


redandblack_uk's picture

Hi Tony, Yes I believe the

Hi Tony,

Yes I believe the word 'threat' is missing. Although I'm sure you are aware of this.

You make a valid point about food. As a training health visitor it is part of my job to encourage nutritious foods to improve my families' health and wellbeing. And as a vegetarian I am on board with the plant based diets comment. But while it is valid to look at food quality, might we not address more than one issue at a time? I don't think anyone would argue that food quality should be a health priority. But there is more than one priority. I think many in the health field would agree that climate change is one of those priorities. And if global warming reaches such proportions in the future as is predicted by some scientists then crop yields may become comprimised. Something to think about.

Kindest regards,

Sarah Timmins