The sustainable foundation year 1 doctor
Ciara Drummond is responsible for promoting environmentally friendly healthcare practice in her trust
Ciara Drummond is the foundation year one (FY1) sustainability fellow for the Severn Deanery. She is responsible for promoting sustainable healthcare practices to her colleagues and to widen interest in the field. She is only the second person to hold the role, which is an honorary position that she does in addition to her everyday job of being an FY1.
What drew you to the role of sustainability fellow?
I think that as a medical student, I had a general interest about sustainability and climate change, not necessarily related to healthcare. Then I started to think about it more in my clinical years, especially in situations where you walk on to a hospital ward and it’s boiling hot, the radiators are on, and the windows are all open; or when you see people using a lot of single use appliances—on one of my attachments everyone used single use laryngoscopes. There are a lot of resources going into that type of practice. Then I started looking into it more, and found that there is a wealth of information out there, and a lot of people interested in this field. It was great when I became the sustainability fellow because the job gives me the chance to find out more about sustainability and to do something about it as well.
What kind of projects are you involved in as part of the role?
Part of the reason I became interested in applying for the role is because there are a few things that annoy me in hospitals with regard to sustainability. Especially things like clinical waste—sometimes you see people come away from cannulating a patient and throwing everything in the sharps bin, which, from the trust’s point of view, is enormously expensive to dispose of, and, from a sustainability point of view, that’s all incinerated and produces emissions that are unnecessary. One of the projects I got involved in was to try and explore why people chuck everything into the sharps or clinical waste bins. One of my last jobs as an FY1 was in the emergency department, and there I monitored how many bags of each type of waste were being produced, and how many sharps bins were being used over a six week period. I tried different interventions—one of which was speaking to people about it to see if that improved our waste disposal practices.
Did you find that people were receptive to that?
People were very receptive. Initially I was worried because patients in the emergency department tend to be very sick, and [I thought] healthcare staff would think that they had more important things to worry about, but they knew they shouldn’t be doing things like throwing everything away in the sharps bin. If people take a moment to think about what they are doing, and there are more signs up to prompt that thought process, then they do a bit better. Also, if you move a bin to avoid the 10 metre walk to it, you find that people are more willing to use it.
Do you find lack of awareness about sustainable healthcare a problem?
Yes. I think everyone is aware of climate change, and the vast majority of people I’ve spoken to do believe that it is happening, and is driven primarily by human activity, but not that many people have translated that into the implications for health, or the actions that we can take in the healthcare industry to do something about it.
What role do you think medical students can have in promoting sustainable healthcare?
They can have a big role, and I think it can be under-recognised, especially by medical students. The first thing I would say would be to find out more about it—there are great resources out there. There is an organisation called Healthy Planet that is an offshoot of Medsin, and a charity called MedAct, which is a similar organisation for practising doctors. The Sustainable Development Unit for the NHS has some interesting information, as does the Centre for Sustainable Healthcare. After they’ve found out a bit more and found out what particular areas interest them, students could look at the areas that could be improved in their own hospitals—because that’s what got me interested. And in your everyday life, you can try and be a bit more sustainable. Finally, I think the most important thing is that we need to talk about the issue. Quite often people think that the issue is big, scary, and frankly depressing, so people aren’t having discussions about it. A lot of people might be feeling the same way as we are—we just need to engage with each other.
Do you raise the issue of climate change with your patients?
I have to admit that I haven’t so far. When I was in the emergency department doing a project, sometimes I’d be looking in the bins and moving them around and the patients would ask me what I was doing and why. The people that I did speak to about it were shocked about how much carbon dioxide the NHS produces. I’ll definitely be aiming to have more dialogue with my patients, I think. Patients are much more open to discussing things than we think; it’s just about giving them the opportunity.
Why do you think that doctors are so important in the climate change movement?
Two reasons. Firstly, I think that it is clear that climate change is going to have a huge impact on our health, and it is our task as doctors to deal with that and help our patients through it. The other thing is that we’re respected as a profession—and if we stand up and say we need to change, people might be more willing to listen to us than they are to others. We have a key role in raising the importance of addressing climate change.
I hadn’t realised the importance of climate change until I started finding out a bit more, so I’d encourage everyone, whatever your views about climate change and its importance, to explore it a bit more. In our professional lifetime—when we’re the consultants directing the NHS this is going to be a huge issue. We need to be more clued up about it than we are at the moment.Katherine Bettany, editor, Student BMJ
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2014;22:g2896