Advances in Nursing Science Vol. 29, No. 1, pp. 43–54 c 2006 Lippincott Williams & Wilkins, Inc.Environment, Ecosystems, and Ecological Behavior A Dialogue Toward Developing Nursing Ecological Theory Gary Laustsen, PhD, APRN,BC Current epistemological foundations of nursing theory incorporate minimal ecology theory. The purpose of this article is to present a nursing ecological theory with a goal to broaden current nursing perspectives by incorporating expanded concepts of global ecosystems, communities, and interrelationships derived from ecological sciences. A theory derivation process is utilized, and a nursing ecological model is proposed. Nurses face a challenge to translate global environment concern and ecological beliefs into professional activities. Elucidating a nursing ecological theory may guide our profession toward new directions in holistic care and will be good for the care of our patients, profession, and the Earth. Key words: environment, global ecology, nursing theory, theory derivation All of us must aspire to develop global ecologic skills if we are to endure.1(p291) E COLOGY may be defined as the study of the relationships of organisms to their environment and to one another.2 Humans, as with all living things, are ecological entities that interrelate with other organisms and with the environment. Human interactions with the environment encompass both personal and professional activities. Thus, it is proposed that nurses exhibit ecological interactions while performing their professional nursing activities. Current epistemological foundations of nursing theory incorporate minimal ecology theory. Does the current nursing domain of environment delimit nursing theory? Is nursing cognizant of the relationships between practice behaviors, ecosystem damage, and public health? Do ecological laws apply to healthcare systems? The purpose of this article is to address such questions and present a dialogue and process toward the development of a nursing ecological theory. This article will begin with a brief historical review and identification of relevant concepts. Theory derivation3 will be outlined and utilized as the knowledge development process. Application of this process will develop a nursing ecological model, preliminary concepts of a nursing ecological theory, and a few examples explicating ecological laws and nursing. Finally, the dialogue will offer some concluding remarks. BRIEF REVIEW AND CONCEPT IDENTIFICATION One of the great lessons of ecology is the interrelatedness of nature, and . . . for thinking of the ecosystem as the foundational unit.2(p11) From the Loretto Heights Department of Nursing, RHSHP, Regis University, Denver, Colo. Corresponding author: Gary Laustsen, PhD, APRN,BC, Loretto Heights Department of Nursing, RHSHP, Regis University, Mail Code G-8, 3333 Regis Blvd, Denver, CO 80221 (e-mail:
[email protected]). The writings of many theorists from Nightingale’s Notes on Nursing4 to Fawcett’s metaparadigm5 identify the concept of environment as a prominent domain within the nursing discipline’s theoretical foundations. However, the domain as conceived 43 44 ADVANCES IN NURSING SCIENCE/JANUARY–MARCH 2006 of biotic and abiotic interrelationships, or systems within the environment. Thus, the current concept of environment within nursing is vague, burdened with competing and transient definitions, and lacks a consistent epistemology by nursing professionals. To address this issue of conceptual chaos, I propose the term ecosystem as an alternative to the concept of environment for the nursing discipline. Originally suggested in 1935 by the biologist Tansley, ecosystem is described as “the whole system, including not only the organism-complex, but also the whole complex of physical factors.”2(p334) Within ecological science, the term ecosystem addresses the dynamic, interacting, and relational nature of organisms and their environment. The essential activities of nursing also address the dynamic relationships of clients interacting within environments. In this article, environment is defined as the conditions, circumstances, factors, or variables affecting the individual, family, or community. Such conditions may include physical factors, such as the climatic effects on a community’s citizens. Other nonphysical influences, such as economic and political forces, are also considered influential environmental aspects. Some nurse theorists have included the concept of interaction or relationship with the environment. However, these concepts in nursing theories typically present a linear, anthropocentric model in which the environment affects the client. The relationship and interaction of humans with the environment are generally not addressed in nursing theories. As Brewer states, “In the ecosystem, community and habitat are bound together by action and reaction, the reciprocal effects of physical environment on organism and organism on physical environment.”2(p334) Ecosystem is a broader concept that embraces the circularity of influence and causation, creating a web of interrelationships among and between the environment and all of the inhabiting organisms. However, because ecological literacy is absent from the theoretical foundations of nursing, ecosystem is a by nursing theorists has historically focused on a narrow perception of the environment. Chopoorian,6 a proponent of the reconceptualization of environmental concepts in nursing, stated that nursing’s “rigid, static concept [of the environment] does not inform the nursing paradigm in a substantive manner.”6(p41) Other nurse authors, for example, Kleffel7 and Stevens,8 have also suggested that nurses need to rethink and reconceptualize our environmental domain. Meleis has suggested that “several types of theories related to environment need to be developed.”9(p115) The term environment originates within the biological and ecological sciences and refers to the surroundings or conditions of an organism. Habitat is often used as a concept equivalent to environment. In Smith, environment is “the place where an organism lives and its surroundings, both living and nonliving.”10(p13) Thus, the biological concept of environment generally refers to physical entities. Tomey and Alligood,11 in their exploration of the work of nurse theorists, found that the concept of environment has been accorded a plethora of meanings. For example, Nightingale’s “house” obliquely referred to the environment as ventilation, warmth, light, diet, cleanliness, and noise.4(p6) Watson cited the “mental, physical, sociocultural, and spiritual environment.”12(p81) Rogers proposed the environmental field as an “irreducible, pandimensional energy field.”13(p31) Roy’s environment is “all the conditions, circumstances, and influences surrounding and affecting persons or groups.”14(p22) Neuman defined environment as “all the internal and external factors that surround or interact with man/client,”15(p2) and Parse cited the humanuniverse diad that “interchange energy to create what is in the world.”16(p27) Chopoorian defined environment as “social, economic, and political structures; . . . as human, social relations;. . .as everyday life.”6(p47) A critical review of these definitions identifies a consistent view of the environment as an entity or object and rarely alludes to the significance Environment, Ecosystems, and Ecological Behavior generally unknown concept in the discipline’s epistemology. The definition of ecosystem may be extended to the dynamic interactions and interrelationships of humans and the healthcare system. Such a human health ecosystem would be characterized by actions, reactions, and coactions between the healthcare providers (eg, nurses and doctors), the healthcare client, affiliates (eg, the client’s family), and the healthcare environment. A model for the proposed human health ecosystem will be presented later. The purpose of this article, as previously stated, is to present a dialogue toward developing nursing ecological theory. That is, I will suggest a framework that incorporates the ecological relationships of healthcare participants and recipients into the healthcare ecosystem. A theory derivation process as proposed by Walker and Avant3 will be employed as the method for developing and informing a nursing ecological paradigm. I propose that developing a nursing ecological theory will promote a reconceptualization of the environmental domain and support the inclusion of the expanded concept of ecosystem. Nursing theorists have historically and consistently included the concept of environment within the domain of nursing’s professional discipline. Nurses have not only focused traditionally on discrete environmental levels such as a hospital room or the community, but they also participate in an interconnected and dynamic relationship with both local and global ecosystems. Thus, we need to expand nursing’s worldview and our understanding of ecological relationships related to the activities of the profession. Professional activities and behaviors of nurses are intertwined with the Earth’s ecological systems. The activities of nurses produce effects on the local and global ecosystems, just as the environmental components of ecosystems interact with human populations. The activities or behaviors of organisms are an important aspect of ecological study. General ecological behavior (of humans) can 45 be viewed as the “actions [that] contribute towards environmental preservation and/or conservation.”17(p153) Proenvironmental attitude, concern, or consciousness, and ecofriendly or “green” behaviors are concepts congruent with general ecological behavior. Many nurses exhibit general ecological behavior in their concern for the environment and seek ways to minimize their personal impact on the Earth’s ecosystems. Some nurses, concerned about the effects their professional behaviors produce on ecosystems, have developed actions to ameliorate environmental degradation. To address these activities, I propose to identify this phenomenon as nursing ecological behavior. Nursing ecological behavior may be defined as the behaviors nurses enact while performing their professional duties that contribute toward environmental preservation or conservation or both. As previously noted, nursing theories demonstrate a consistent recognition of the domain of environment within most theoretical models. However, the concept of ecosystem, implying functional relationships of organisms within environments, was not specifically identified in the nursing theories reviewed. In addition, while the phenomenon of nursing ecological behavior is believed to exist, I find a conspicuous lack of theoretical underpinnings to understand or relate this concept to nursing theoretical models. Therefore, with the development of a nursing ecological theory, I will seek to illuminate nursing ecological behavior in relation to the healthcare ecosystem. Using the theory development process, I will explore current ecologic theory and suggest a method for applying ecological concepts and models to develop an analogous nursing ecological theory. KNOWLEDGE DEVELOPMENT PROCESS Theory derivation is the knowledge development process used in this article to promote an evolution toward a nursing ecological theory. Theory derivation is the “process of using analogy to obtain explanations or predictions about a phenomenon in one 46 ADVANCES IN NURSING SCIENCE/JANUARY–MARCH 2006 of concept redefinition offers an opportunity for creative thinking in the development of the new theory. Although the steps outlined above have been presented in a sequential order, theory derivation may not necessarily proceed in such a linear fashion. The process may more likely be iterative, with steps being repeated nonsequentially and in an itinerant order. PROCESS APPLICATION “Theory derivation is particularly useful where no data are available or where new insights are needed to inspire research and testing.”3(p172) Intuitively, I believe that the phenomenon of ecological behavior exists among nurses. However, this concept is poorly understood, and minimal nursing research has been applied to elucidate the meaning of nursing ecological behavior. Of relevant concern to understanding ecological behavior is the lack of an ecological theoretical perspective in the nursing discipline. The following theory derivation steps offer a suggested development toward a nursing ecological theory. Literature review The initial step in the theory derivation process is for the theorist to become familiar with the state of the science within his or her own field of interest. This step may be accomplished through a literature review, nursing practice review, and professional resource review. A literature review is relatively easy to conduct, using key word searches within the healthcare databases such as the Cumulative Index of Nursing and Allied Health Literature (CINAHL) or MEDLINE. Key words such as ecology, environment, ecosystems, theory, and nursing may be used to identify nursing literature references relevant to the phenomenon of nursing ecological theory. A literature search using key words (singly and in combinations), such as ecology, environment, knowledge, concern, awareness, theory, nurses, and nursing, was conducted in the CINAHL, the Education Resources field from the explanations or predictions in another field.”3(p171) Theory derivation is an exercise in analogy that attempts to borrow theoretical concepts from one field of study to develop a theoretical grounding in a second field of study. An ability to “see analogous dimensions of phenomenon in two distinct fields” 3(p171) is prerequisite for the theoretician. The application of theory derivation to the development of ecological theory within the nursing discipline incorporates certain basic steps. As proposed by Walker and Avant,3 the first step is to examine the literature within the theory-deficient field related to the phenomenon of interest. Thus, the nursing literature would be thoroughly examined for writings related to ecological theory. If a theoretical foundation for the topic of interest is unrealized, the next step is to read widely in fields expected to offer a suitable theoretical background. When developing the phenomenon of nursing ecological theory, readings within the literature of biology and ecology would offer the theoretician probable sources for the explication of general ecological theory. Once the theoretical base is discovered and explored, a “parent theory” is identified from which a theoretical offspring within the new discipline is conceived. A parent theory should be chosen to promote new and insightful explanations about the phenomenon of interest in the theorist’s field.3 It is not feasible or necessary to use the entire theoretical structure and concepts from one field to the other. The theorist’s next step is to identify the content or structure from the parent theory that supports the analogous development of theory within his or her own field. As Walker and Avant stated, “the theorist is free to choose what best fits the needs of the situation.”3(p174) The final step represents the most challenging part of the theory derivation process: concept redevelopment. Concepts and statements from the parent theory are modified from their original field to provide meaningful concepts for the theorist’s field. The task Environment, Ecosystems, and Ecological Behavior Information Center, Health and Psychosocial Instruments, and MEDLINE databases. In reviewing the healthcare literature on ecological theory and behavior, no research studies or discussions critically examining these topics in nursing were found. However, disciplines such as environmental science and education, environmental biology, conservation biology, and ecology were found to have many studies addressing this topic. The literature search produced no citations specific to nursing ecological theory or behavior. As Shaner remarked, “Unfortunately, environmental education is not a standard part of the curriculum for physicians, nurses and other health professionals.”18(p3) However, many authors19–36 have suggested professional activities that imply developing ecological behaviors of nurses. Broad categories, identified by these authors, that reflect these activities include waste reduction, energy conservation, “green” product use, and recycling. Yet, these suggested nursing ecological behaviors are promoted without a guiding framework or theoretical foundation. Some nurse scholars have, however, suggested paradigms and concepts congruent with developing an ecological theory base for nursing. Kleffel suggested an ecofeminist perspective for nursing: “looking for an environmental viewpoint within a feminist framework.”7(p13) Her salient points were that ecofeminism is antinaturist, antisexist, and antiracist, has contextual ethics, is pluralistic and inclusive, is not objective or unbiased, and reconceives what it means to be human.7 Ecofeminism also sees the connections between the domination of women and the domination of nature.37 The ecocentric perspective, a paradigm subsequently proposed by Kleffel,38 progressed beyond her previous ecofeminism framework. To foster a new model in nursing that promotes an understanding of ecosystems, she suggested a transition to the ecocentric perspective based on Miller’s39 work. The underlying assumptions about ecocentric theory can be summarized as follows. • 47 The nature of human beings: Humans remain one among many other species and are interdependently involved in the global ecosystem. • Social causation: Human affairs are influenced not only by social and cultural factors but also by intricate linkages of cause, effect, and feedback in the web of nature . . . human actions can have unintended consequences. • Human society: Humans live in and are dependent on a finite biophysical environment. • Constraints on human behavior: Ecological laws will always provide the primary context for human and other animal life. • End goals: Unity, stability, diversity, self-sustaining systems, democratic social systems, self-sustaining resource systems, sustainable development.39(paraphrased from Table 1.3) Kleffel suggested that nursing scholars are shifting to the ecocentric perspective because of a developing global community. This paradigm is “grounded in the cosmos, and the environment is considered whole, living, and interconnected.”38(p1) The ecocentric perspective draws its theoretical roots from diverse traditions such as eastern philosophies, contemporary western thought, Deep Ecology theory, and traditional Native American ideas. Sarter40 suggested that nursing theorists such as Rogers, Neuman, Watson, and Parse are considered contemporary proponents of ecocentric nursing theory because of shared, common holistic themes. According to Sarter, these themes include “process, evolution of consciousness, selftranscendence, open systems, harmony, relativity of space and time, pattern, and holism.”38(p4) Adopting the ecocentric viewpoint has “exhilarating potential for transforming nursing scholarship and practice beyond its traditional boundaries.”38(p5) Kleffel’s ecocentric paradigm provides a relevant perspective, but lacks the developed concepts and relational statements to consider it a nursing ecological 48 ADVANCES IN NURSING SCIENCE/JANUARY–MARCH 2006 this topic within the biological sciences: the parent discipline for ecology. To investigate this topic within the ecological literature, it was more germane to select scientific materials of a general nature rather than of a specific nature. Textbooks in general ecology or environmental science were scanned as appropriate media to begin the search for generic ecological theory. Although a systematic search may yield the desired material, utilizing imagination, creativity, or intuition may lead to serendipitous discoveries.3 To accomplish this step, I reviewed and read library resources within the generic content area of general biology and ecology. Web-based courses in ecology were also searched for theoretical concepts and models that could offer analogies for the development of nursing ecological theory. A final activity was to solicit input from a university colleague who has educational and professional experience within the fields of ecology and medicine. The result of this search was the decision to use concepts from 2 specific resources in the derivation of a nursing ecological theory: The Science of Ecology2 and The Closing Circle: Nature, Man, and Technology.43 Parent theory selection In the search outlined above, a parent theory was successfully identified for use in the derivation of a nursing ecological theory. Choosing a parent theory is not necessarily based on convenience or because it is the most widely used in the parent field. A parent theory should “offer a new and insightful way of explaining or predicting a phenomenon in the theorist’s field of interest.”3(p173) It is not necessary to adopt the entire parent theory, and only relevant concepts or models may be brought over to the new field. Brewer’s The Science of Ecology2 and Commoner’s The Closing Circle: Nature, Man, and Technology43 provide relevant theoretical models and concepts amenable to the needs of deriving a nursing ecological theory. The selection of these resources leads to the next phase of theory development. theory. In addition, her ecocentric paradigm relies on the use of nonacademic and less empirically based writings and does not incorporate theoretical elements from the ecological sciences. Holistic nursing is another theoretical perspective relevant to nursing ecological theory and was originally derived from Levine’s41 4 conservation principles. In his work, environment is “where we are constantly and actively involved” and “the person and his relationship to the environment is what counts.”11(p197) Holistic nursing practice and natural systems theory have promoted the “interconnectedness of natural structures in the universe.”42(p7) The Holistic nursing perspective recognizes that the well-being of the planet’s ecosystem is a determinant of the well-being of humans. The concepts and proponents of holistic nursing have blossomed into a welldeveloped framework for the practice of nursing. Books and journals have expanded the concepts of holistic nursing into a recognized subculture of the nursing profession. Holistic nursing, as a theoretical paradigm, offers a substantial contribution to the foundations and exploration of nursing ecological behavior. However, similar to Kleffel’s ecocentric paradigm, holistic nursing is a developing theory with minimal influences from the ecological sciences. Originally, I suggested that the literature review should also include a nursing practice review and discussions with professional nurses involved in nursing ecological behavior. However, the identification and professional expression of this concept is currently undeveloped. Therefore, the attempt to review this phenomenon in nursing practice or through discussion with other nursing professional resources is not a tenable option at this time. Exploration of relevant fields After exploring the current state of the science in nursing, the next step was to look for suitable concepts or theories from other disciplines. As the phenomenon of concern is ecological theory and behavior, I explored Environment, Ecosystems, and Ecological Behavior Relevant parent theory content The fourth step in theory derivation as suggested by Walker and Avant3 is the identification of content, concepts, or structure that will be borrowed from the parent theory. As previously mentioned, the parent theory does not have to be used in its entirety, and the theorist has the freedom to choose the portions of the parent theory suitable for transference to the new theory development process. Conceptual models, theoretical structure, and/or theoretical statements may individually or in combination provide the needed substance for new theory derivation. Barry Commoner in the classic treatise The Closing Circle: Nature, Man, and Technology proposed a distillation of classic ecological theory into “four laws of ecology.” He described ecology as “the science of planetary housekeeping”43(p32) and his informal laws of ecology were organized from generalizations of the scientific knowledge and principles. His 4 laws are as follows: The First Law of Ecology: Everything is connected to everything else. . . The Second Law of Ecology: Everything must go somewhere. . . The Third Law of Ecology: Nature knows best. . . The Fourth Law of Ecology: There is no such thing as a free lunch.43(pp33–45) 49 Figure 1. Proposed nursing ecological model. New theory development: A nursing ecological model “The hardest part of theory derivation, but also the most fun”3(p174) is the task of creating a new theory within the theorist’s field of interest using the concepts, models, and structure borrowed from the parent theory. The goal of this step is to modify and adapt material from the parent theory into a meaningful, organized, and relevant metamorphosed theory. I concede that the following is only a preliminary attempt at constructing a nursing ecological theory. Nursing ecological model A proposed Nursing Ecological Model is presented in Figure 1. The model identifies 3 major components (large circles) of a community that interact with the healthcare environment, as well as having coactions among each component. The unifying structure for these components is the human health ecosystem. In this model, the healthcare client, the healthcare providers, and affiliates (eg, family These 4 “laws” are the basic statements chosen to derive and inform foundational concepts for a nursing ecological theory. Although couched in the vernacular of lay language, the 4 laws are supported by principles espoused in the scientific writings of ecology. For example, his fourth law is supported by the principle that “both the environment and the amount of energy fixation in any given ecosystem are limited.”10(p7) His 4 laws of ecology were chosen to guide the developing nursing ecological theory because they convey the relevant principles of ecology in a succinct and inclusive format. 50 ADVANCES IN NURSING SCIENCE/JANUARY–MARCH 2006 cides to “trial”the new hand-washing soap (reaction). The use of the new antiseptic soap significantly reduces the occurrence (coaction with healthcare providers) of nosocomial infections acquired by patients (healthcare client) within the hospital. Hospital rates of morbidity and mortality due to iatrogenic infections are reduced (reaction with patients). Patients are discharged from the hospital with lower costs and improved health. The integrity (coaction) of patients and their family (affiliate) is maintained, and further use (action) of the hospital by the family is assured because of the provision of a safe healing environment. The example has been simplified for demonstration purposes, and other aspects, such as costs of the new soap and the effect of soap on the local environment, would have to be considered. Applications of this model to other arenas of nursing such as public health nursing, or advanced practice nursing are possible, but are beyond the current scope of this article. Ecological laws and nursing Commoner’s43 4 laws of ecology may be analogously used to develop a nursing ecological theory and support the nursing ecological model. The first law, “Everything is connected to everything else,” reflects the elaborate network of interconnections and the progression of cyclical events that exist in ecosystems.44 This principle may be applied to the human health ecosystem. For example, environmental air pollution created by burning hospital wastes in an incinerator releases dioxin.45 Dioxin, a known carcinogen, may lead to the development of cancers within the local population.46 The population afflicted with dioxin-related cancer then seeks care within the same polluting hospital. An important concept within the principle of interconnectedness is the circularity of ecosystems.44 Typically, causation is viewed as being linear, in that the burning of hospital waste results in cancer-causing pollution. However, in ecological theory, causation is circular, in that there is no beginning or end in members) have coactions between each other. These 3 components and their relational coactions comprise the community. Additional components, such as workplaces or physical geography, could also be included within the community, but are excluded at this time to maintain a more parsimonious model. The community’s individual components are acting on and reacting to the healthcare environment. The healthcare environment is the physical entity that coordinates and provides health-related services in its interactions with the community. This may be a local hospital, a long-term care facility, or a state health department. The community components and healthcare environment together make up the human health ecosystem. The lines enclosing the community and the human health ecosystem are interrupted indicating that these are not rigid boundaries, but allow for interchange and integration with other communities or other ecosystems. It is also possible for multiple communities to interact with one healthcare environment, as might occur if a single large hospital was assessable to a variety of local and regionally discrete communities. The 3 components of the community identified in Figure 1 represent a few of the relevant “inhabitants” in the human health ecosystem. Additional components can also have significant interactions with the healthcare environment but have not been currently included in this preliminary, simplistic model. Some of these important components might include political stakeholders, legal and governmental agencies, economic influences (eg, insurance and reimbursement agents), cultural and social forces, and suppliers of healthcare equipment and peripheral services. Just as in biological ecosystems, the difficulty of identifying and evaluating all relevant components is a complex and ongoing task. The following scenario illustrates an example using the nursing ecological model. A nurse (healthcare provider) suggests a new antiseptic soap (action) to the hospital (healthcare environment). The hospital de- Environment, Ecosystems, and Ecological Behavior the chain of causation. Using our hypothetical example from above, treating an increasing number of local patients with cancer requires the hiring of more nursing staff and the building of more patient rooms. Funds that could have been invested in new technologies for safer, nonpolluting disposal of hospital wastes are now diverted toward hospital and staff expansion. The current method of waste incineration and the release of carcinogenic dioxin are thus continued. The recognition of the concept of interconnectedness is important. However, to be of value within the human health ecosystem, identification and elucidation of the meanings of these connections present significant challenges to researchers within the relevant sciences. The emerging concept of nursing ecology is beyond the traditional scope of nursing practice and requires intradisciplinary and interdisciplinary communication. Thus, there is a need for developing nurse scientists with training in environmental sciences, especially in areas that influence nursing practice.47,48 The second law of ecology,43 “Everything must go somewhere,”is partially derived from a basic tenet in physics that matter is not only transformable but also indestructible. As applied to the science of ecology, this concept emphasizes that in nature there is no such thing as waste. For example, the expired carbon dioxide and excreted wastes of animals are used by plants for growth, which subsequently expel oxygen for consumption by the animals. A problem made apparent by this principle is that substances created by humans but previously unknown in nature, such as plastics, do not have the requisite organisms to transform the materials into a useful biological product. Thus, humans create substances that do not fit into the natural cycle of producers and consumers. Nursing ecological theory can incorporate this law within the human health ecosystem. When dealing with physical items, nurses should always ask, “Where does it come from and where does it go?” To illustrate this concept, we can look at a battery, a common item used in many patient care devices. Where did 51 it come from? One of the key elements in the functioning of batteries is mercury. Mercury mining may be responsible for significant environmental pollution on a local level that may affect human populations. After the battery is used and discarded, where does it go? If the healthcare worker inappropriately discards a battery, the incineration of the battery or degradation at the landfill releases mercury into the local environment. Eventually, the mercury will enter water systems via rainfall or landfill leaching, where it is absorbed and bioaccumulated by fish. Pregnant women may transmit the neurologically toxic mercury to the fetus. Lactating women eating mercury-ladened fish will concentrate the mercury into their breast milk. A mother nursing her baby can pass on a potentially toxic dose to it. The bioaccumulation of mercury resulting in human health problems is a real and disconcerting example of Commoner’s first and second laws of ecology and illuminates a need for promoting a nursing ecological theoretical framework within the human health ecosystem. The route that a substance, such as mercury, travels through the ecosystems may be called its ecological path. Understanding the concept of ecological paths in which “nothing goes away” and “everything has to go somewhere” is important if nursing is to study and adopt nursing ecological behaviors into its professional paradigm. The essential theme of Commoner’s third law is that natural systems develop over a long period of time and evolve survival relationships. This concept challenges the anthropocentric view of the universe commonly held within the human ontology. Some nursing scholars have also challenged this prevailing view and proposed antianthropocentric nursing paradigms incorporating aspects of feminism, holism, ecofeminism, and ecocentrism.39 The relationships in nature function well unless disturbed by new, radical forces. Human technology is often cited as one such radical force. Technology not only has been promoted as an enhancer of human health but can also be seen as 52 ADVANCES IN NURSING SCIENCE/JANUARY–MARCH 2006 ing research within an ecological paradigm would reinforce the propositions of holistic healthcare. Addressing both the total, not just individual or economic, costs and benefits of nursing activities will likely provoke practice dilemmas that challenge our role as caregivers. In a nursing ecological paradigm, “no free lunch” implies finite resources and challenges to choose professional practices that balance the needs of the individual with the benefits for the majority. CONCLUSION We must widen the focus of our scholarly attention. Consequences of ecologic devastation threaten peoples’ health on a global scale.49(p3) creating new problems that detract from human health. What is an example of a new, radical force within the human health ecosystem? The widespread use of antibiotics is one example of a technological Pandora’s box. Advances in antibiotic therapy have provided significant reductions in human morbidity and mortality. However, the overuse and misuse of antibiotics have also promoted the development of “superbugs”;strains of common bacteria are now resistant to many antibiotics. The antibiotics are an example of a radical force developed by humans, which influence human ecosystems. Unfortunately, the ecosystem’s human members have not yet evolved survival relationships with these new bacteria strains, and untreatable infections are arising. Understanding and adopting the concept of “Nature knows best” within a nursing ecological view would promote an expanded view of our professional activities and the interactions with natural ecosystems. An ecological worldview would promote a more egalitarian view of all life. Nursing practice would also be challenged to use resources and products that engage with natural processes. Commoner’s43 fourth law of ecology, “There is no such thing as a free lunch,” is borrowed from economics and in some ways embodies the previous 3 laws. Every gain may also be said to create a loss; for ecosystems are composed of intricate and intimate connections of relationships. Within a nursing ecological theory, the realities of this concept may be applied to the human health ecosystem. For example, the oncology nurse is aware that the health benefits of the toxic medications administered in chemotherapy also produce serious side effects. Another case is the challenges of public health nurses to equitably distribute their services within the reality of finite resources: Should children receive immunizations or should the elderly be supported with drug reimbursements? Adopting and promoting a better understanding of the “no free lunch”concept within a nursing ecological framework may help the profession in addressing the challenges of costly technology and finite resources. Nurs- Theory derivation is a process that may be used to borrow concepts and models from one field of study to develop new theories within another field. In this article, this process was used to explore concepts amenable to developing a nursing ecological theory from general ecological theory. Informed by Walker and Avant’s derivation guidelines,3 the current state of the phenomenon was examined, ideas were explored in other literatures, and a parent theory from the ecological sciences offered transferable concepts and models. From these borrowed concepts, a new nursing ecological model was proposed and general ecological principles were applied to examples from nursing and healthcare. The need still exists for further refinement of the nursing ecological model and theory. In addition, testing of a nursing ecological theory provides a challenge for future research and development within the nursing discipline. Research supporting an ecological paradigm for nursing may encompass both qualitative and quantitative methods. The concept of nursing ecological behavior is unexplored and needs qualitative methodologies such as descriptive inquiry and phenomenology to derive the underlying themes and context of this phenomenon. Questions of interest might include the Environment, Ecosystems, and Ecological Behavior following: What are the behaviors or actions nurses participate in that they believe are environmentally friendly? Why is it important to nurses to practice ecologically at work? What are the ways in which nurses learn about ecological behavior? Quantitative experimental designs could also be used to inform the theoretical foundations for a nursing ecological framework. Analysis and management of healthcare waste streams using educational interventions in a pretest-posttest design may help elucidate the interventions that promote waste reduction by nurses. The emerging nursing concepts of the ecosystem and ecological behavior may be beyond the traditional scope of nursing discipline. Adequate exploration and evaluation of these areas of interest may also require intradisciplinary and interdisciplinary research and communication. A challenge for the nursing profession is to translate a concern for the global environment and general ecological beliefs into professional activities. Developing ecological theory and behaviors in the nursing profession has implications for developing a more environmentally “friendly” nursing practice. 53 A “green” nursing profession has implications for improving local and global ecosystems. In addition, promoting ecological behaviors in the work setting may reduce the conflict between nurses’ personal desire to live ecologically and their ability to work ecologically. The nursing ecological model and the application of Commoner’s ecological “laws” presented in this article are seedlings ready to propagate into a mature and fruitful new perspective for nursing. However, to prosper, the seeds must be sown in a field prepared to accept and nurture the new growth. 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