Rebecca Disler

Aims: To explore Australian nurses' experiences of grief in paediatric palliative and end‐of‐life care, its impact on professional practice and their utilisation of supports. Design: Qualitative Interpretive description study. Methods: In‐depth, semi‐structured, online interviews were conducted with ten Australian nurses experienced in palliative and end‐of‐life care in paediatrics. Interviews were audio‐recorded, transcribed and analysed using constant comparative thematic analysis. The COREQ checklist guided reporting. Results: Six interconnected themes were identified, reflecting the evolving and pervasive experience of grief: ‘exposure to grief’; ‘impact on personal life’; ‘impact on professional role’; ‘coping with grief’; ‘workplace supports’; and ‘reflection, growth and adaptation’. Findings suggest that grief is an under‐recognised psychosocial phenomenon and potential occupational hazard in paediatric palliative and end‐of‐life care. Nurses valued informal supports, including peer support and compassionate leadership, more than formal debriefing. Barriers to organisational support persisted, yet many nurses reported increased resilience and growth through reflection. Conclusion: Grief is an intrinsic yet often overlooked aspect of paediatric end‐of‐life care. Context‐sensitive, individualised supports and compassionate leadership can foster openness and reflection, recognising grief as both a natural process and potential occupational hazard and support nurses' resilience and long‐term wellbeing. Implications: Acknowledging grief as a potential occupational hazard and psychosocial phenomenon requires organisational accountability and a systemic approach at leadership and policy levels. This aligns with clinical governance standards and occupational health principles while affirming nurses' right to emotional safety at work. When supported through compassionate leadership and open emotional dialogue, grief may become a source of personal and professional learning and resilience. Impact: By acknowledging nurses' experience of grief, this study highlights the need for formal adjustments in policy frameworks, supervision and education at all levels to ensure safety, quality and staff support through competencies in grief and trauma management. Reporting Method: The authors followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Patient or Public Contribution: No patient or public contribution was made.

Introduction/Aim: The World Health Organisation recognises the integral role of respiratory nurses in the management and promotion of lung health to minimise substantial international health burden and health system costs. This Position Statement presents the Priorities for the Recognition of Respiratory Nursing as a Specific Field of Expertise, as validated through a binational Delphi consensus process, and endorsed by the Thoracic Society Australia and New Zealand Board on 25th October 2024.Methods: A cross‐sectional online Delphi consensus survey delivered over two rounds using purposive sampling of leading respiratory nurse clinicians, managers, educators and/or researchers. In Round 1, participants rated generated priority statements on a 7‐point Likert scale. In Round 2, mean item scores were provided and statements ranked to establish those of highest priority. Consensus cut‐off was set at ≥ 75%.Results: One hundred and four Round 1 and sixty‐four Round 2 participants from all Australian states and NZ regions confirmed 14 items, under three overarching priorities: the need to (1) raise the profile and influence of nurses within national and international respiratory organisations and policy; (2) define respiratory nursing as a field of specific expertise; and (3) articulate career progression and education frameworks as a roadmap to specialisation.Conclusion: Consensus on joint priorities supports respiratory nurses as integral to health strategy and articulates pathways for future workforce. Optimising the scope of nurses, including addressing barriers to contribution, and prioritisation and retention of specialist respiratory workforce, are necessary to meet population and health service demands and adequately support those living with lung conditions.

Background: Dementia is a major international health issue with high impact on the patient, relatives, and broader society. Routine screening for dementia is limited, despite known benefit of early detection and intervention on quality of care and patient outcomes. Screening is particularly limited in rural and regional areas, despite high burden and projected growth of dementia in these populations. The current study aimed to implement a new general practitioner (GP) led, multidisciplinary, model of care providing dementia detection and referral pathway to a community-based specialist clinic across six regional general practices. Methods: Cross-sectional analysis of dementia screening and referral characteristics in the St Anthony Family Medical Practices group based in the regional area of Loddon-Mallee, Victoria. Data were collected on demographics and relevant medical history. Cognitive state was assessed using the Mini-Mental State Examination (MMSE), GP Assessment of Cognition (GPCog), and Geriatric Depression Scale (GDS). Referrals and referral outcomes were recorded for geriatrician, psycho-geriatrician, or both. Results: Eight hundred and eighteenth patients over 65 years were screened, accounting for approximately 24.2% of 65 and over presentations for the practice network. Of those screened, 68.9% were indicated for referral and 30.3% of these were successfully referred. Of the indicated patients who received referrals, 34.2% declined. Many who declined referral had intermediate scores on the cognitive assessments utilized. Conclusion: Standardised models of care, integrated within community services, are necessary to improve access to early detection, referral and quality management of dementia. The St Anthony Memory Service model will be invaluable in informing future service development, and in particular the development of services for people living with dementia in rural and regional communities.