Katie Huffling, DNP, RN, CNM, FAAN is a champion of children’s health. As the Alliance of Nurses for Healthy Environments Executive Director, Dr. Huffling works with national nursing organizations on a variety of environmental health issues, including climate change, chemical policy, environmental health as part of nursing education, and sustainable healthcare. She has written numerous peer-reviewed articles on environmental health issues and was an editor of “Environmental Health in Nursing” which won the 2017 AJN Book of the Year in Environmental Health. Dr. Huffling is a SafetyNEST Science advisor.
Dr. Huffling—or Katie, as we know her—sat down with us to talk about the pivotal experiences that have guided her deep involvement and strong leadership in environmental health advocacy. First, we asked how she got started in nursing.
“I knew I wanted to go into healthcare, but I started college and I wasn’t really sure what I wanted to do. Then one of my good friends had taken a gap year where she did a bunch of cool volunteer activities. One of them was with this place called The Frontier Nursing Service.”
Her friend’s positive experience intrigued her. When she decided to take time off from school after her freshman year, she chose to go exactly where her friend had been—to Wendover, Kentucky, home of The Frontier Nursing Service.
There, in a town veiled in oak and poplar, just north of one of the many winding bends of the Middle Fork River in central Appalachia, she began as a volunteer courier.
Katie explains, “The Frontier Nursing Service was created in the early 20th century when Mary Breckinridge, a midwife from the UK, set out to improve maternal and infant mortality in the rural area. She formed a coalition of midwives who would ride out on horseback and deliver babies and take care of women and infants.
“Together, they really changed the trajectory of health in that area. At that time, they had a number of different clinics with nurse practitioners, physicians, nurse midwives, and a small hospital. They had this volunteer program where you’re called a courier.”
Wendover’s closest city is Hyden, just a few miles north with a population of 303.
“This is the Appalachia you’d see with hollars and people living up in these hills. It’s still kind of like that in parts of Appalachia today: extremely rural, with very low income and low access to education.”
“As a courier, you would spend part of your time driving stuff around. You’d drive X-Rays to a bigger hospital [for them to be read] because this was ‘93, ‘94, so there wasn’t the internet like we do now where you can send things easily. But the really cool part of that volunteer program was you could shadow different healthcare providers. I would be able to go one day a week and work with a family practice physician or a nurse practitioner.
“I shadowed nurse midwives and was able to follow a family throughout labor, be there for the birth, see them afterwards, and I thought, ‘This is amazing.’ I just loved the care that the family received from the nurse midwife, and I said to myself, ‘That’s what I have to do.’”
She recalls shadowing a public health nurse during home health visits. If it rained the day before, they weren’t able to reach patients’ houses. The roads, muddied and flooded, remained impassable for several days.
“You don’t think of places in the United States being like that and yet there are so many communities that are still so incredibly rural. It’s really challenging for folks living in those areas, never mind the transportation issues.”
After her experience with the Frontier Nursing Service, Katie decided to go to nursing school. In love with her chosen field of work, Katie went on to complete her master’s in midwifery at the University of Maryland at Baltimore. At the time, the university had one of the only environmental health programs for nurses in the United States.
She started the program not knowing much about environmental health, but in one of her classes, one of the department’s professors gave an eye-opening lecture.
“They were really kind and when I showed interest, they found me a research assistant job, so I was able to work with them throughout the rest of my midwifery program.”
“When I started working as a nurse midwife, I quickly realized there were so many environmental health issues outside of our control as individuals. For example, ingredients in personal care products, on grocery store shelves, and in department stores…nobody is really checking them for safety.”
“I thought, ‘How is this even possible?’
With time, Katie discovered that she could be an educated consumer by reading the labels and researching her purchases, but the process could be overwhelming—even for someone knowledgeable in the topic. She saw the importance of regulations to prevent harmful chemicals from showing up in everyday products.
Committed to improving community health and access to safe products, she started diving deeper into policy and regulation. When the chance came to work full time with the Alliances of Nurses for a Healthy Environment, where she currently serves as Executive Director, the opportunity felt meant-to-be. She went from working in a clinical setting seeing individual patients to working with a national organization connecting nurses across the country.
“I was helping individual patients in the office seeing maybe 25 patients in a day. Working with a national organization, I could potentially reach hundreds of thousands of patients through the connections we make with all the nurses around the country. I thought that was where my real passion kind of shifted: offering a bigger impact than individual care.”
“I think that nurses and other health professionals have a really powerful role to play in helping shift regulations, in helping shift the thinking of policymakers and the public. We are able to talk with individual patients and make them aware of environmental health issues. As we start educating our clients and colleagues, we build momentum for change.”
Katie’s animation and passion are evident as she shares how nurses play an important role in improving the landscape of environmental health. We asked her what made her happiest on the day-to-day in her job. She’s was quick to answer.
“I love the nurses that I work with. I get to meet so many cool nurses doing so many cool things. It makes me really proud to be a nurse. I was just in a nursing research meeting, and listening to different nurses talking about their research, I just couldn’t wait to read about the results. My mind was spinning with all the things I could do with the information these nurses are coming up with.”
We also asked: What kind of future do you wish for children to have?
“One of the things I’m working for is where every kid has the potential to lead their fullest lives, to be able to thrive, to be in communities that truly support them, for them to live in healthy environments, that they’re getting the things that they need.
“The social determinants of health are everything from where a child lives, plays, goes to school—all those things support that child to have the healthiest future that they can. That is so compelling to me.”
“Kids”—she reflects—“Giving them the best start in life possible…How can anyone be against that?”