The Planetary Health Report Card for Nursing: Development, Implementation, and Global Impact

Human health and natural ecosystems are deeply interconnected, a relationship captured by the field of planetary health. Anthropogenic environmental changes increasingly undermine the ecological foundations that sustain human wellbeing. While nurses constitute the largest segment of the global health workforce and serve on the frontlines of climate-related health impacts, evidence suggests they often feel underprepared to address these issues due to gaps in formalized education and engagement. This article describes the development and impact of the Planetary Health Report Card for Nursing (PHRC-N), a student-driven, metric-based tool adapted from the original 2019 PHRC for medical schools. The PHRC-N evaluates nursing programs across five key domains: curriculum, interdisciplinary research, community outreach, student-led initiatives, and campus sustainability. Since its 2022 pilot, the tool has expanded to 13 institutions across seven countries. Findings indicate that repeated assessment cycles catalyze institutional change, with average curriculum scores rising from 66.3% to 80% and support for student-led initiatives increasing from 70.1% to 83.3% between cycles. By providing a standardized evaluative framework, the PHRC-N moves planetary health into nursing education so that graduates are better prepared to provide care and act as change agents in the ever urgent environmental crisis.