Allergies, nature prescribing and climate change: nurse practitioner Sigrid Pitkin on how the world harms and heals

‘Most politicians live in well-insulated, air-conditioned and heated homes. I raised my daughter as a single parent, and it was extremely difficult. I can appreciate when I hear patients saying “I have to choose between buying food or putting the heater on.” Those are everyday decisions for many people.’

In early November, Ballarat-based nurse practitioner Sigrid Pitkin joined a consortium of frontline workers, trade unionists and environmental campaigners in Canberra to share with federal politicians their lived experiences of climate change right now.

‘We were there, telling our stories about how we’re already being impacted,’ Sigrid tells ANMF. ‘A lot of politicians seem to think that climate change is a future problem, but our role there – as nurses, firefighters, home carers and the like – was to tell them that it’s here and it’s now, and it’s only going to get worse, and more expensive, if they don’t take action now.’

A career on the cutting edge

Sigrid graduated as a nurse in 2012 and began her career at the Royal Children’s Hospital. After taking a position at the Murdoch Children’s Research Institute a year later, she found her niche.

‘I always knew that I wanted to get into research,’ she says, ‘because research is at the cutting edge of new treatments, therapies and really making the difference to people, especially those with chronic illnesses. I just didn’t know how to get my foot in the door, or what area of research. I’m autistic and I have ADHD so I have lots of passions, and I tend to think they would all make for a really good study.’

At Murdoch, her role as an allergy nurse opened her eyes. ‘I’d never had any real exposure to allergies other than a patient on the ward who had a penicillin allergy or a peanut allergy. My daughter didn’t have any allergies, or any friends who had any allergies. So I really wasn’t exposed to it, but I found it really interesting – and I was a bit embarrassed at how little I knew about it!’

When she began working on oral immunotherapy trials, she was ‘blown away’ by how life changing a successful treatment could be. ‘There were families who had never been on a plane because they were petrified somebody would open a pack of peanuts. Families who never took their kids to parties because it was too risky.’

Wanting to do more to help, Sigrid did her master degree and became a nurse practitioner. She now runs her own private clinic servicing most of western Victoria and helping patients manage allergic diseases.

‘Victoria is kind of an epicentre of allergy,’ she explains. ‘We’ve unfortunately got the perfect climate for eczema, asthma, hay fever. But I started to see other patterns in what people were presenting with. There were lots of things that were probably preventable, but because of chronic stress or chronic inflammation, their immune systems are going into overdrive.’

Environmental stress, and de-stress

Sigrid also noticed a lot of environmental stress. For example, in the summertime when people can’t keep cool – because their homes don’t have insulation or air conditioning – allergy presentations would skyrocket. ‘Obviously, there were other factors as well but that stress on the body can exacerbate allergic conditions.’

Realising that climate change will amplify these conditions and that the situation in Victoria is ‘only going to get worse’, Sigrid felt like it was her responsibility to do whatever she could to address the issues. She joined the Planetary Health Collaborative for Nurses & Midwives and committed to using her voice, and her standing as a nurse practitioner, to provide nursing leadership.

The collaborative has four pillars: research, practice, advocacy and education. Sigrid’s focus is within the research pillar, aligning with her current interest in ‘nature prescribing’ – aka ‘how healthcare interacts with nature and the environment, and how we can utilise nature more and protect it at the same time,’ she says.

‘It’s been done for a very long time,’ she elaborates. ‘About 20 years ago in Japan, the government noticed there were a lot of suicides due to poor mental health and overworking. Now they officially encourage people to get out into nature, to go into the forest and just be at one with nature.’

Forest bathing

Also known as shinrin-yoku, or forest bathing, it has been since been officially adopted in other places too, including North America. ‘Over there, you have to pay to get into national parks. So they now have government-funded schemes where GPs can issue park passes for patients. So if a patient comes in stressed, rather than going straight to medication the GP can give them the park pass and time off work.’

Sigrid is planning to do her PhD on nature prescribing next year, ‘looking at the different types of connection with nature, and the effects on different mental health frames of mind. For example, with anxiety and stress relief we know that nature connection via water is better, whereas if you’re depressed being in a quiet forest is better,’ she explains.

While there are ‘plenty of papers that show that connecting in nature is really good for cardiovascular health as well as mental health more generally’, Sigrid says the more granular focus is under-researched, and as a consequence many people ‘don’t know how to connect in nature’ for the best benefits.

Those benefits also include equity and accessibility, both in terms of who can prescribe (not just nurse practitioners but registered nurses and midwives) and low or no cost barriers. ‘Everyone can go to the park,’ she notes. ‘If you can’t get to a national park, there’s botanic gardens in the city. Nature is everywhere.’

Everywhere, and integral to our health – in both negative and positive ways. But if we don’t safeguard it for the future, it’s likely to just be negative.