An analysis of sustainable decision-making using clinical reasoning

• Human health can no longer be separated from the health of the planet. • Nurses must learn to include planetary and human health in decision-making. • An adapted clinical reasoning cycle can scaffold sustainable decision-making. Educating future nurses to make sustainable clinical decisions is urgently needed to arrest or mitigate both planetary and human health challenges. Educating nurses to incorporate planetary health cues and consequences into clinical decision-making remains diffuse and unclear. The Clinical Reasoning Cycle has the potential to link sustainability literacy and practice with graduate capabilities to facilitate sustainable decision-making. Emerging nurses are delivering high carbon emission care whilst caring for persons who experience climate-mediated emergencies. An adapted clinical reasoning cycle helps nurses to adjust thinking and behaviors both at a macro and micro level. Evaluation and reflection of sustainable decisions will reinforce practice. Adapting the clinical reasoning cycle model for sustainable decision-making and practice will require a shift in thinking from person-centered to dual objectives of planetary and human health. This shift in nursing knowledge, theory and practice requires tacit examples to scaffold decisions and practice differently. Policy and practice change will have to continue if nursing is to actively mitigate the rising cost of carbon consumption on human and planetary health.