Digital preparedness is climate preparedness: Lessons from nurses on the frontline
The world’s healthcare systems stand at a crossroads.
In the rush to digitise care and augment it with artificial intelligence and confront climate-driven disasters, we seem to be forgetting the hardest-won lessons of COVID-19.
This was when hospitals went virtual overnight, and nurses, midwives, doctors and allied health professionals learned new digital technologies on the run.
We witnessed both the ingenuity and exhaustion of a workforce asked to adapt faster than its systems could support.
Lessons that pandemic taught us then hold the blueprint for the climate-resilient, environmentally sustainable healthcare systems Australia now needs.
Our recent study of 94 Australian nurses, published in Contemporary Nurse, revealed that during the COVID-19 pandemic, more than 100 different digital technologies were introduced across clinical settings, from electronic medical records to telehealth platforms and remote monitoring tools.
While nurses rapidly adapted to this new challenge, their digital environment did not. Participants in our research described inadequate training, patchy internet, missing devices, and systems that were clunky to use or incompatible with infection-control procedures.
Many nurses were redeployed to unfamiliar wards with no time to learn new platforms, relying on peers to fill the gaps. Despite this, nurses kept care going, demonstrating agility that remains one of nursing’s most under-recognised contributions to pandemic response.
A deep digital divide
But beneath the surface of this resilience lies a deep digital divide. Nearly 80% of nurses in our study reported significant variation in digital literacy among staff, with less digitally confident colleagues often left behind.
Average system-usability scores were below 70, the global benchmark for acceptable ease of use, indicating that most technologies introduced under crisis conditions were difficult to navigate.
This matters because usability directly affects safety and quality of care. When systems are poorly designed or training is rushed, nurses spend more time troubleshooting than caring.
Workarounds become normal, documentation suffers, and the risk of error rises. The emotional cost is equally high – fatigue, frustration and the growing sense that technology is dictating practice rather than enabling it.
During the pandemic, many nurses told us they felt both indispensable and invisible, expected to master complex systems without being consulted about which ones to use or how to implement them.
As one participant put it:
“We need to be asked for feedback so this can lead to improvements.”
Those words should echo in every hospital boardroom planning the next wave of digital transformation, particularly as digital models of care become central to environmentally sustainable healthcare.
A workforce, not technological, issue
Digital transformation is too often framed as a technological or financial challenge, but in reality, it’s a workforce issue.
Nurses, the largest health profession in Australia and the backbone of disaster response, must be recognised not as passive end-users but as co-designers and leaders in digital implementation.
Our respondents want mandatory digital-literacy frameworks, consistent organisational training, and regular evaluation of the systems they use. They do not want another emergency that forces them to “learn on the go”.
Read more: International Nurses Day: Nursing people, and communities, to better health
When frontline clinicians are genuinely involved in decision-making, digital systems become enablers of safe, sustainable and climate-resilient care rather than sources of stress.
The World Health Organisation (WHO) defines a climate-resilient health system as one able “to anticipate, respond to, cope with, recover from and adapt to climate-related shocks and stress” while protecting population health.
Our research shows that digital readiness is inseparable from that goal. As floods, fires and heatwaves increasingly disrupt healthcare access, digital technologies, where reliable internet exists, will once again be the lifeline connecting clinicians and patients.
But these technologies will only succeed if the workforce using them is prepared, supported and confident, and if the tools themselves are designed to meet the realities of clinical practice.
Lessons from the pandemic
The same lessons that applied to pandemic-driven digitalisation also apply to climate-driven disruption – digital technology implementation without user engagement creates fragility, not resilience.
To build truly climate-resilient health systems, our findings point to four priorities for policy and education reform:
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Design with users, not for them. Healthcare professionals must be involved in selecting, testing and implementing technologies so that tools align with real workflows during public-health emergencies.
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Invest in digital literacy as critical infrastructure. Establish and mandate minimum professional digital-competency standards.
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Bridge the technology-equity gap. Ensure equitable access to hardware, connectivity and technical support across metropolitan, regional and remote services.
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Embed digital preparedness in emergency and climate-health planning. Frameworks for a globally resilient, digitally enabled healthcare workforce should include usability standards, rapid-deployment protocols, and wellbeing safeguards.
Simply put, in a world increasingly shaped by digital technology and the emergence of generative AI, digital preparedness is climate preparedness.
If the lessons learned during COVID-19 are ignored, the cost of forgetting will be high. Rapid, uncoordinated adoption of new systems during a heatwave, flood or epidemic will once again overwhelm staff and compromise patient care.
Burnout will deepen, attrition will accelerate, and communities will bear the consequences.
We’ve already witnessed “quiet resignations” post-COVID-19 from nurses fatigued by constant adaptation without adequate support.
Australia’s National Health and Climate Strategy calls for a resilient, low-emission health system, but that vision will falter unless workforce digital preparedness is built into its foundation.
Resilience is not only about installing solar panels on hospital roofs; it’s also about ensuring digitally literate clinicians and climate-resilient digital health systems that can sustain care when power fails, networks collapse, or patients are isolated by natural-hazard disaster.
Healthcare systems’ fragilities exposed
COVID-19 revealed both the fragility and the strength of our healthcare systems. The fragility lay in the absence of preparedness; the strength lay in the human response – in the choices we made to support one another.
Yet as climate change accelerates, we can no longer allow resilience to depend on improvisation. Australia’s climate-resilient, environmentally sustainable healthcare must be the supported, deliberate outcome of systems that value their workforce enough to prepare it properly.
Read more: Urgent need for universities to incorporate climate education in curricula
Investing in digital preparedness, through education, infrastructure, and genuine co-design, is an investment in the climate resilience of our healthcare systems.
It enables healthcare workers to adapt confidently to future shocks, from pandemics to floods and bushfires. It ensures that digital technology serves care, not the other way around.
This will become even more critical as generative AI transforms how we work, make decisions and communicate, both with each other and with the communities we serve.
The next health crisis is not a question of if, but when. Whether our healthcare systems bend or break will depend on what we do now with the lessons the pandemic left behind.
