The practice of nursing is guided by standards and definitions established by leaders of nursing in professional associations and to some extent by governmental agencies such as the Public Health Service's Bureau of Health Professions. Systematic frameworks for the practice of nursing also guide nurses in actual nursing performance. The most widely accepted framework for nursing practice currently in use is the nursing process of assessment, diagnosis, planning, intervention, and evaluation. A model to guide medical and nursing practice specific to environmental health concerns established by the California Public Health Foundation (CPHF, 1992) consists of three roles: investigator, educator, and advocate.
Awareness of the formal descriptions, definitions, and systems of nursing practice is useful for determining how environmental health concepts and related activities fit into nursing as it is currently practiced. A brief overview of the definitions and systems that guide nursing practice and their application to environmental health concerns is presented in the following section to demonstrate the "fit" between nursing practice and environmental health issues. The integration of environmental health concerns into nursing's scope of practice and the profession's philosophy of health and health care also illustrate nursing's historic and continued concern about environmental influences on human health.
The American Nurses Association (ANA) provides leadership in determining the goals, objectives, and professional practice of nursing. ANA defines nursing as " … a caring-based practice in which processes of diagnosis and treatment are applied to human experiences of health and illness" (ANA, 1994).
ANA describes three basic nursing activities that explicitly include issues related to the environment and health, a preventive approach to health, and concern for populations as well as individuals:
Restorative practices modify the impact of illness and disease.
Supportive practices are oriented toward modification of relationships or the environment to support health.
Promotive practices mobilize healthy patterns of living, foster personal and familial development, and support self-defined goals of individuals, families, and communities.