Healing the planet to heal patients: A Q&A with Dr. Alex Zielinski

Nursing

Healing the planet to heal patients: A Q&A with Dr. Alex Zielinski

One might reasonably wonder what clean air and anti-pollution campaigns have to do with nursing, but nurses who have treated patients for asthma attacks on smoggy days can see the connection clearly.

"We see health impacts, social impacts for people who cannot gather like they normally do, and productivity impacts for people who can't go to school or work," says Dr. Alexandra Zielinski.

Zielinski, a three-time Marquette graduate and a mentor/advisor specialist with Project BEYOND-2, has seen the impacts of air quality degradation as a caregiver at Ascension. Her Doctor of Nursing Practice project focused on environmental justice, the principle that laws and policies regarding the environment should be carried out equitably. She is an active member of Healthy Climate Wisconsin and the Alliance of Nurses for Healthy Environments.

How did you first come to appreciate the outdoors? What led to you making the connection between that passion and the practice of nursing?

I grew up around nature. It's an environment that made me feel safe; it reminds me of all the things we humans share on this Earth.

While attending Marquette, I learned a lot about the social determinants of health, holistic care and the value of systems thinking. I adore taking care of patients, and through doing that I got to thinking about the broader connections between the environment and their health.

If there is a day with bad air quality, what measures can people take to protect themselves?

There's a great organization in Milwaukee called the MKE Fresh Air Collective, and they have neighborhood-specific air quality index levels through their app. They have monitors all throughout the city and you can see what's happening in your ZIP code. Staying informed on that is important because air quality can vary from mile to mile.

In addition, one of the things you can do is wear a mask if you have to go outside, preferably an N95. Limit activity outdoors, especially physical activity. Inside, you want to make sure you have the air conditioner running and the windows closed. Another thing that can be helpful is wearing a mineral-based sunscreen because we know that air pollution impacts your skin health.

Let's say you go out for a walk on a day with bad air quality. Your throat starts to scratch or maybe even burn a little bit. What is happening in your body that's causing this reaction?

In a word: inflammation. Every organ we have inflames in response to stressors and air pollution is a stressor to our body, which causes it to generate a response to protect itself. That's why you get symptoms like coughing, sneezing, tickling of the throat and shortness of breath at times.

Which segments of society are most adversely impacted by poor air quality and general environmental degradation?

Unfortunately, the people who feel the most impact from climate issues are the most vulnerable in society. A lot of elderly patients, pregnant patients, children, people of color and people with respiratory issues are going to struggle the most to adapt to climate change. They're going to feel the worst of the effects from air pollution and they likely will not be able to adapt as well.

For example, people of greater means or economic security might be able to stay inside or turn on air conditioners to make their home a safe place, but those without air conditioning will not have that option available to them. There are protective measures to be taken, but they're not available to everyone.

What can those who care about poor air quality's impact on public health do to better the situation?

You should share your story, particularly with elected officials and organizations in your community. You should also educate family and friends on risk factors and things they can do to protect themselves. Finally, anything you can do to promote a healthier environment, even in your home, can make a big difference.

Why do you believe nurses should play a central role in this conversation?

So often, nurses don't believe they belong at every table, but when it comes to the environment, nurses should be able to advocate and give their opinion because they have this wide-angle lens on community health issues. People who struggle with climate change will end up being taken care of by a nurse, and the more we can do to be proactive instead of reactive when it comes to the issue, the better our communities will be.

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