Box 1
General Environmental health competencies for Nurses

I. Basic knowledge and concepts

All nurses should understand the scientific principles and underpinnings of the relationship between individuals or populations, and the environment (including the work environment). This understanding includes the basic mechanisms and pathways of exposure to environmental health hazards, basic prevention and control strategies, the interdisciplinary nature of effective interventions, and the role of research.

II. Assessment and referral

All nurses should be able to successfully complete an environmental health history, recognize potential environmental hazards and sentinel illnesses, and make appropriate referrals for conditions with probable environmental etiologies. An essential component of this is the ability to access and provide information to patients and communities, and to locate referral sources.

III. Advocacy, ethics, and risk communication

All nurses should be able to demonstrate knowledge of the role of advocacy (case and class), ethics, and risk communication in patient care and community intervention with respect to the potential adverse effects of the environment on health.

IV. Legislation and regulation

All nurses should understand the policy framework and major pieces of legislation and regulations related to environmental health.

teams. For effective teamwork, the educational preparation of all health professionals—nurses, physicians, and allied health professionals—need to place a greater emphasis on skills needed for interprofessional collaboration, such as negotiation, critical thinking, and mutual problem solving. In addition, there must be opportunities for interdisciplinary interaction throughout professional education and clinical practice, and existing barriers to interdisciplinary practice must be removed.

Interventions in environmental health problems often require nurses and other health care professionals to assume the roles of advocate, activist, and policy planner on behalf of an individual patient or population of patients. Patient advocacy, bringing a patient's concerns to the attention of the physician within the health care setting, is familiar to most, if not all, nurses. However, advocacy that goes beyond the confines of the health care system is a new kind of activity for many nurses, who may feel ill equipped for translating research and practice issues into health policy terms.

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