In intensive care units, it is noticeable that there is intensive use of resources in the treatment and care process, leading to a significant amount of waste generation. In addition, the demand for intensive care, increasing life expectancy and surgical interventions, complex comorbidities and ecological crisis make it necessary to make critical care more sustainable. To explore the perspectives of nurses working in surgical intensive care units regarding responsible medical waste management, energy and medication consumption. This qualitative descriptive study was conducted in surgical intensive care units of a university hospital in Turkey in November 2023. Twenty-three nurses filled in an introductory form and participated in a semi-structured interview. Data were analysed using inductive content analysis. Three main themes were determined: environmentally sustainable intensive care, prevention of waste in intensive care; responsible consumption and recycling; suggestions for institutional and individual behavioural change regarding environmental sustainability. The majority of nurses lack knowledge about sustainable development goals. However, in the intensive care unit, they provided effective and creative solutions for medical waste management, energy and medication consumption and individual and institutional behavioural change regarding environmental sustainability. Sustainability strategies should be created in institutions to ensure responsible medical waste management, energy and medicine consumption and reduce carbon footprint. In accordance with this purpose, 'Green teams' including unit-based doctors, nurses and paramedics should be established. Training should be provided and awareness should be raised to reduce energy use resulting from heating, lighting, ventilation and air conditioning.