title: Towards environmentally responsible nursing: a critical interpretive synthesis.
abstract: OBJECTIVE
  To provide a synthesis of studies on the environmental issues in nursing.
  
  
  BACKGROUND
  Interest in the environmental issues affecting health sciences has been increasing in recent decades. Health care is one of the largest publicly provided services and it share of the environmental burden is high. Nurses play an important role in environmental health issues as they are the largest group of healthcare staff and are most directly connected to the use of energy and materials. Despite this, previous studies on nurses' roles in environmental issues have been presented in a relatively fragmented way.
  
  
  METHODS
  Systematic literature searches of peer-reviewed papers published between 2002-2012 were carried out using the CINAHL, Science Direct and PubMed electronic databases.
  
  
  METHODS
  Critical interpretive synthesis was then undertaken to provide a comprehensive overview of the topic.
  
  
  RESULTS
  Eleven studies were included. Based on our synthesis, environmentally responsible nursing can be identified in relation to the: (1) theoretical framework; (2) background arguments; (3) role of responsible stakeholders; and (4) targets of environmental management. A fifth element: (5) tools for practical environmental responsibility, was also presented.
  
  
  CONCLUSIONS
  Awareness of environmental issues is starting to encourage nursing services to seek sustainable practices. Nurses themselves are naturally in a key position to promote and develop environmentally responsible nursing. Environmentally responsible nursing helps to promote healthy environmental practices. It also reduces undesirable practices that can burden the environment and have a negative impact on health.
authors.affiliation: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Mari
authors.initials: M
authors.lastname: Kangasniemi
authors.forename: Hanna
authors.initials: H
authors.lastname: Kallio
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Pietilä
mesh_terms: D006272:Health Facility Environment; D009736:Nursing Process
keywords: critical interpretive synthesis; ecology; environmental health; environmentally; global warming; greening; health care; hospital; nursing