Educating for Climate-Resilient Care: Findings from a Multi-Methods Study in Nursing

Abstract Background Climate change poses a serious threat to public health by exacerbating physical, mental, and social health risks, especially among vulnerable populations. Nurses are at the forefront of healthcare responses to climate-related challenges, yet nursing education has not systematically integrated climate-health content. This study addresses how nursing education can better prepare future nurses to recognize, prevent, and manage the health impacts of climate change. It studies educational gaps and proposes actions to strengthen climate-health competencies in nursing education. Methods This study employed a three-phase multi-methods design: 1. A qualitative descriptive study (n = 6) explored Finnish nurses’ observations of climate-related health effects. 2. A scoping review (n = 47 studies) synthesized global evidence on how climate change is integrated into nursing education. 3. A cross-sectional survey for nursing students in Finland (n = 351) and the U.S. (n = 352). Confirmatory factor analysis (CFA) evaluated model fit and internal consistency. Results Nurses reported climate-related impacts including respiratory illnesses, mental health challenges, and heat-related stress, but lacked formal education on these topics. The scoping review identified diverse teaching methods but found climate-health content inconsistently implemented. Survey results showed that U.S. students scored higher than Finnish students in awareness and workplace-related behavior. Finnish students demonstrated more consistent behavior across home and workplace settings. Both groups showed strong concern but limited practical engagement. Conclusions The findings support updating nursing curricula at all levels to include climate-health education. Emphasis should be placed on culturally relevant and evidence-based teaching strategies. These actions will strengthen nurses’ capacity to address climate-related health challenges and enhance the resilience of healthcare systems Key messages • Nursing education must integrate climate-health content to prepare nurses for future public health challenges. • Curriculum reforms are essential for strengthening nurses’ climate-related competencies and healthcare sustainability.