May 2023 • Volume 17, No. #5

From the Editor

When plastics became available for use in healthcare, they were a life-saving boon, providing safety, sterility and convenience.

PVC, the most widely used plastic in healthcare, was first used in a medical setting during World War II. After that, lavish, one-time use of plastic and other resources became standard in US healthcare settings. Besides the pollution stemming from all that waste plastic, there are greenhouse gas emissions from facility energy usage, transportation, food procurement, and anesthetic gas.

Many of us came of age professionally in an environment where all this usage for the sake of healthcare wasn’t even questioned.
But as the impacts of climate change have become more pressing, we’re questioning it now.

“The healthcare industry accounts for about 10% of all greenhouse gas emissions in the United States, with operating rooms considered to be the main energy consumers and waste producers,” states a November 2022 article in the ACS Research News. “ORs can use up to six times more energy than the rest of the hospital and put out more than half of the waste across the hospital.”  

Although there are many resources out there for hospital-level measures ranging from building energy and transportation to pharmaceuticals and food,we are particularly interested in steps you, our reader can take, either individually or with others in your workplace. We’ve collected some of them in this issue.

In this month’s Student Spotlight we feature Lexis PeoplesRN, BSN, of Edwardsburg, MI.

Scroll down to see available jobs and NIFA’s favorite links.


Julie Lancaster, Editor

Globe photo by Anna Shvets on


Recycle Blue Wrap

If your OR is not already recycling blue surgical wrap, check with your waste disposal company and see if they have a program your clinic or hospital is not yet taking advantage of. Or just Google the phrase “recycle blue medical wrap” and you will find information from a variety of waste disposal companies about how to start. Plus, you’ll find some inspiring stories.

For instance, a few years ago the University of Vermont Medical Center worked with a local waste systems company that, in turn, worked with a recycling company to transform the center’s annual 7 tons of No. 5 polypropylene into resin pellets that another company then molded into patient-care products, such as totes, bed pans and wash basins, some of which UVMC then purchased. Read more . . .

And Blue Renew, a recycling program from surgical blue wrap supplier Halyard Health, is helping more than 400 U.S. hospitals divert over 4 million pounds of blue wrap from landfills. One recycling company they work with helps people with disabilities find gainful employment in hand-sewing wallets, totes and neckties. Read more . . .

Or . . . take matters into your own hands. University of Chicago Health staff collected clean disposable blue wrap for a few months, created a prototype of a sleeping mat for homeless individuals and, in a one-day event, nurses donated their time and skills to sew blue wrap sleeping maps, which provide a warm and water-resistant surface to sleep on. Read more . . .

Photo by Mikhail Nilov on

Recycle Personal Protective Equipment

If you’re not already recycling face masks and disposable gloves, you can Google “recycle face masks disposable gloves” and come up with a variety of services you could contact . . . not to mention some interesting articles:

  • An Australian lab shows the possibility of diverting face masks and rubber gloves from landfills and mixing them into concrete, thereby reinforcing the concrete and making it more durable. Read more . . .
  • Researchers have made batteries from face masks and drug blister packs; the batteries hold as much energy per weight as commercial lithium-ion batteries.Read more . . .

Photo by Lucas Menses on

Go Green in the OR

An article review in the Journal of the American College of Surgeons evaluated 23 studies involving quality improvement initiatives that combat emissions, curb waste, and reduce hospital costs. Many were in the sustainability category called “refuse,” where surgical teams use fewer supplies or alternative supplies of a specific item to reduce waste. Educating hospital staff about the proper disposal of medical waste led to the greatest cost savings among the efforts studied. Read more . . .

Making Health Care More Sustainable

Stanford medical researchers and administrators discuss how to make U.S. health care more sustainable. Although this discussion pertains to the healthcare field in general, it is an interesting and not-too-long read. Read more . . .

Two of the participants in that Stanford discussion, above, recently co-authored a commentary in the AMA Journal of Ethics, How Should U.S. Health Care Lead Global Change in Plastic Waste Disposal? As they point out, “In an updated version of the Hippocratic Oath, physicians swear: ‘I will abstain from all intentional wrong-doing and harm.’ Yet, currently, the health care sector faces little liability for consequences of its supply chain decisions.” This article suggests ways to reframe social and ethical responsibility for health care waste production and management. Read more . . .

Hospitals Take Steps to Reduce Carbon Footprint

“Several years ago Praveen Kalra, MD, was doing research to prepare a talk about anesthesia when he read a report that stunned him: It said that each year, emissions from anesthetics used in surgeries harm the climate as much as the carbon dioxide emissions from 1 million cars.”

That’s the opening of a July 2022 article by Patrick Boyle in the AAMC (American Association of Medical Colleges) News. The article goes on to explore approaches that have been shown to help reduce the health-care carbon footprint, from substituting far less environmentally damaging anesthesia drugs in surgery; to sending single-use devices to authorized vendors to be cleaned, sterilized, and repackaged. Read more . . .

Photo by Evie S. on Unsplash


Green Surgery Conference 2021

This video reports on results from the Green Surgery Challenge 2021, a project in which five teams in the UK were selected to work with sustainable healthcare specialists to design and implement sustainability projects and then measure the outcomes. The UK’s National Health Service “is responsible for more than one-third of total public sector carbon emissions,” according to an article about the conference. “Operating theatres contribute towards this, with energy requirements four to six times that of other hospital areas and as significant users of medical equipment and supplies.”
Read a summary about the project
Watch video . . .


Sustainable Surgery and Climate Change. What Can and What Must We Do?

A joint webinar co-hosted by the Royal College of Surgeons of Edinburgh and the Royal College of Surgeons of England. Experts take a look at what it would take to cut OR emissions to net zero. “Achieving net-zero is surgery is a major challenge and will mean a substantial change in clinical practice, but we surgeons always love a challenge,” the notes on this video read.
Watch video . . .

In The Spotlight: Lexis Peoples


Student Status
Current student in NIFA’s RNFA program

City & State
Edwardsburg, MI

Current Position
Robotic/Gyn Coordinator

Where did you get your RN degree?
RN: Kellogg Community College, MI
BSN: Capella University, Minneapolis, MN

How did you come to choose perioperative nursing?
I got interested in medical occupations during high school.

What is the scariest moment you’ve ever seen at the table?
A patient fell off the table. Fortunately, the patient was fine.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
Needle-driving skills and one-handed ties.

How do you feel having your RNFA will impact your life/career?
It will advance my practice to be able to travel and work across the states.

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Thursday, 8:00am – 5:00pm
Friday, 8:00am – 4:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2020 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.