Island Health has taken big strides in sustainable kidney care thanks to the efforts of a veteran nurse and her colleagues at Royal Jubilee Hospital (RJH) – a result to celebrate during National Nursing Week. 

Led by registered nurse (RN) Gertie Michaelis-Martin, the “Going Green in the RJH Hemodialysis Unit” initiative has reduced waste, encouraged recycling and improved medication disposal.

Puru Shah, a member of Island Health’s Innovation team who has helped support this work, highlighted how nursing informs the unit’s sustainability efforts. “What’s particularly compelling is that this work has been deeply embedded in day-to-day nursing practice,” he said. “These are nurse-initiated, nurse-championed, nurse-led activities.”

Michaelis-Martin, who has worked as a registered nurse in the RJH Renal Unit for about 25 years, noted that kidney care – like many other areas of health care – is resource-intensive. It uses a lot of single-use plastics, and consumes large amounts of energy and water. For example, five million litres of water are used annually for hemodialysis procedures at the RJH Renal Unit – an amount that’s equivalent to two Olympic-sized swimming pools.

A few years ago, Michaelis-Martin was inspired by a presentation on sustainable kidney care by Dr. Caroline Stigant, a nephrologist at Island Health. And in 2024, she attended Island Health’s first Climate Change and Planetary Health Conference, held in Nanaimo. 

“That was a game-changer, because it made me realize that so much was going on here that I was just not aware of,” she said. “I thought, oh my gosh, I want to be a part of this change. This is just too important.”Dr. Stigant referred to Michaelis-Martin as an outstanding sustainability leader in the hemodialysis unit. “Gertie brings kindness and generosity to her sustainability work,” she said. “She works hard and leads with purpose, and we all want to make her happy and to ‘do the right thing,’ so she is achieving excellent results!”

Recent highlights include improvements to the disposal of heparin, a medication used in most hemodialysis sessions. Used vials with leftover heparin are now placed in pharmaceutical waste pails for incineration – thereby diverting large amounts of medication from the landfill and avoiding possible groundwater contamination. This process began in September 2025; by the following April the Renal Unit had filled 27 pails with unused heparin, weighing nearly 350 kilograms.

Another win has been waste reduction. Once supplies are taken to a patient’s bedside, they must be disposed of even if they are not used, due to infection control protocols. As a result, large amounts of clean, unused supplies can end up being thrown out.

But a simple improvement has made a big difference. Previously, supply bags were pre-filled by staff well in advance of a patient’s scheduled treatment. Now, supplies are prepared by a member of the nursing team shortly before a patient’s arrival, using a more tailored process for supply selection. This change was introduced near the end of January 2026; by March the weight of unused supplies earmarked for disposal had already fallen by 30 per cent.