A nurse-led initiative at Royal Jubilee Hospital (RJH) is helping make kidney care more environmentally sustainable by reducing waste, improving recycling and changing medication disposal practices.
The Going Green in the RJH Hemodialysis Unit initiative, led by registered nurse Gertie Michaelis-Martin, is being recognized during Nursing Week for its efforts to reduce the environmental impact of kidney care at the Victoria hospital.
Michaelis-Martin has worked in the hospital’s Renal Unit for about 25 years and said health care, including hemodialysis treatment, relies heavily on resources such as water, energy and single-use plastics
According to Island Health, the RJH Renal Unit uses approximately five million litres of water annually for hemodialysis procedures, roughly equivalent to two Olympic-sized swimming pools.
“What’s particularly compelling is that this work has been deeply embedded in day-to-day nursing practice,” said Puru Shah, a member of Island Health’s Innovation team. “These are nurse-initiated, nurse-championed, nurse-led activities.”
Michaelis-Martin said her interest in sustainable health care grew after attending presentations on environmentally responsible kidney care, including Island Health’s Climate change and Planetary Health Conference in Nanaimo in 2024.
“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.’”
One of the initiative’s largest changes involves the disposal of heparin, a medication commonly used during hemodialysis treatments. Previously leftover medication risked ending up in landfills. Since September 2025, used vials containing leftover heparin have been diverted into pharmaceutical waste containers for incineration.
By April 2026, staff had filled 27 pharmaceutical waste pails containing nearly 350 kilograms of unused heparin, helping reduce the risk of groundwater contamination.
The Renal Unit has also reduced unnecessary medical supply waste. Previously, supply bags were prepared well before patients arrived for treatment, often leading to unused supplies being discarded because of infection control rules.
Now, supplies are assembled shortly before appointments using a more customized process. Since the change was introduced in January, the amount of unused supplies marked for disposal had dropped by 30 per cent by March, according to Island Health.
Another significant change came through the adoption of reusable gowns.
Before joining Island Health’s reusable gowns program in 2024, the Renal Unit used more than 30,000 disposable plastic gowns annually. In 2025, after switching to reusable gowns, the unit ordered only 800 disposable gowns and has not needed to restock since.
“It’s a huge win,” Michaelis-Martin said. “Staff almost exclusively wear reusable gowns now.”
Additional sustainability measures include recycling personal protective equipment, reducing paper use and improving waste sorting procedures throughout the unit.
Dr. Caroline Stigant, a nephrologist with Island Health, described Michaelis-Martin as a strong sustainability leader within the hemodialysis unit.
“Gertie brings kindness and generosity to her sustainability work,” Stigant said. “She works hard and leads with purpose.”
The initiative received funding support from BC Renal, which praised the project for integrating environmental stewardship into daily patient care.
During National Nursing Week, Michaelis-Martin said she hopes more health-care workers recognize the impact of small environmental changes.
“I think small changes can make a big difference,” she said. “Once you see things through a green lens, there’s no turning back.”