involves communication with public health agencies and private industry, wherein inquiries by individual citizens sometimes meet with responses that fail to address their concerns.
Establishing the legitimacy of advocacy activities as elements of nursing practice will require concerted effort among educators and leaders in the nursing profession. Environmental health issues are highly intertwined with social and political policies; thus, in the area of environmental health, advocacy is needed at the policy level as well as on behalf of individual clients. Advocacy as one component of the nurse's role is essential if a stronger, more prevention-oriented model of nursing practice is to be established. A more in-depth discussion of the practice of advocacy by nurses is provided in Box 3.2 and Appendix F.
Environmental hazards and their health effects rarely lend themselves to simple solutions applied from a single discipline. Effective interventions for environmentally related illness require collaborative efforts from many disciplines due to the complex nature of environmental health issues, the rapidly advancing science base in environmental health, and the need for primary prevention strategies that often must involve professionals from fields other than nursing. Such collaboration includes ongoing dialogue and fluidity of roles and responsibilities.
Nurses are accustomed to working with members of other disciplines toward a shared goal, although it is often in a multidisciplinary manner, with members of each discipline performing their activities independently and with clear role delineation. Various nursing associations and other health professions advocate a more collaborative approach to health problems that is highly interactive and more likely to be termed interdisciplinary. This issue is important to consider in order to most effectively address environmental health issues.
The ANA's draft Nursing Social Policy Statement notes that nursing has an "external boundary" that interacts with other professions in response to changing societal needs and the advance of scientific knowledge. The boundaries are fluid rather than firmly defined, with members of various professions cooperating in the exchange of knowledge, techniques, and ideas on how to deliver quality health care. Collaborative practice, with some overlap of function, enables members of various disciplines to interact with a shared overall mission (ANA, 1994).
The National League for Nursing (NLN) has described several aspects of the complex nature of health care: technological advances that increase access to information, the need to educate professionals to recognize patterns and engage in innovative problem solving rather than simply