It is without question that clues signaling the impact of global warming are all around us, as climate change advances and extends its influence far beyond simply increasing the earth's surface temperature. As a consequence of global warming, sea level is rising at an accelerating rate. Heat waves and storm events are increasingly severe (Union of Concerned Scientists, n.d.). Around the world, agricultural productivity has been lessened through desertification, loss of biodiversity, and reduced fresh water resources (Rossati, 2017). And increasingly, the effects of climate change on the health of the world's population are apparent.

Not only increases in infectious and noncommunicable diseases (Altizer, Ostfeld, Johnson, Kutz, & Harvell, 2013) but also mental health concerns (Holden, 2019) are clear outcomes of climate change. Individuals and communities suffer health consequences as a result of direct exposure to the overwhelming aftermath of extreme weather and climate events (Rossati, 2017) and through the indirect effects of exposure to the cumulative influences of media and social communication (Doherty & Clayton, 2011). Whether exposure is direct or indirect, it is traumatizing, and its occurrence contributes to growing concerns about its impact on health.

Internationally, broad strategies are proposed to reduce the physical and emotional vulnerability of individuals and communities to climatic events, to support community adaptation to accelerating climatic changes, and to build resilience into planning for the uncertainties that climate change entails (Chaudhury, 2017). Alternatively, understanding the links between climate change events and responses at both individual and community levels can be challenging (Clayton, Manning, Krygsman, & Speiser, 2017). Vulnerability to the ravages of climate change is not shared equally. Instead, vulnerability is skewed by factors such as geographic location, socioeconomic status, community demographics, and the individual's preexisting physical and mental conditions.

By virtue of their roles in addressing human responses, nurses have important roles to play in mitigating the health effects of climate change (International Council of Nurses, 2018). Their efforts can help not only to reduce the vulnerability of individuals and communities but also to build resilience against climate change-a force that seems largely unstoppable in support of the work of those directly involved in stemming climate change. Both independently and through their professional organizations, nurses can impact the quality of health, as they commit to addressing human response and clarifying the confusion that surrounds the complexity of climate change and global warming.

By acting thoughtfully to reduce waste and limit demand for energy in their own practice, nurses can begin to contribute directly to limiting the greenhouse gases that figure so prominently in the rapid increase of climate change. Working with their employers and professional agencies to introduce policy change, nurses can foster incentives that support broad implementation of responsible environmentally healthy practices, collaborate broadly in efforts to mitigate climate change, and work for strengthened financing aimed to remediate the ravages of climate change. Nurses can engage with the media to inform the public about the incredibly wide range of physical and emotional health risks linked to climate change: allergies; pregnancy complications; heart and lung, renal, integumentary, and digestive disorders; infection; and mental health and neurological disruptions (Holden, 2019).

The very extent of global warming and climate change-argued to be the greatest threat to human health in history (Introcaso, 2018)-demands a sustained, focused collective effort to mitigate its effects; however, we may be beyond opportunity to remediate its ongoing, growing, and increasingly devastating impacts. As the most trusted health professionals, nurses have ample leadership opportunities open to them for addressing the devastations of climate change (Cook, 2017). As they increase awareness and engage others, nurses can exert a significant impact on the health of people and communities worldwide.

Laura Dzurec, PhD, PMHCNS-BC, ANEF, FAAN

RNJ Editorial Board Member

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