Nurses from a variety of practice settings can assist worried community residents and workers by bridging the gap between scientific information and public understanding of the environmental health risks. However, this will require nurses to view such roles as integral to nursing practice. The environmental health competencies for nurses in generalist practice presented in Box 3.4 were adapted by the committee from competencies set forth by the International Council of Nurses (Appendix A) and by Lipscomb, 1994a (Appendix C).


The practice of nursing has historically included a consideration of environmental factors that may affect the health of individuals, communities, and other populations. Attention to environmental factors is explicitly included in the scope of nursing practice as defined by the ANA (1994). Nevertheless, for the last half-century, the major focus of nursing

Box 3.4
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.

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