As a nurse caring for paediatric patients, it is important to develop the ability to recognise and respond to a sick infant or child. This is so important that a variety of projects have been undertaken, both internationally and throughout Australia and New Zealand, to ensure that nurses working with paediatric patients are able to recognise, respond promptly to and appropriately manage sick and deteriorating infants and children. Paediatric early warning tools help clinicians to recognise a deteriorating infant or child, and trigger an escalation in care to prevent further deterioration and achieve favourable outcomes. This chapter provides a basic understanding and knowledge so you will be able to recognise and respond to a sick and deteriorating child.

In this chapter, we broadly distinguish research as a process for deriving new knowledge, and evidence as the knowledge that is produced and used within a specific context. Evidence from other sources is also used to inform health and treatment decisions in paediatric settings.

We introduce audits and benchmarking as important tools for measuring healthcare quality and safety, and discuss their relevance to the generation of clinical research questions. Within the construct of research co-design and evidence-based decision-making, this chapter also discusses special considerations for conducting ethical research with children and young people. Acknowledging that there may be age or developmental challenges, we explore ways in which children and young people can be supported to become more involved in setting their own research priorities and designing and ‘doing’ research.

Although most children in Australia and New Zealand enjoy a long life expectancy and high level of wellbeing, paediatric death remains a sad reality for some families, and end-of-life care for children presents an important and challenging area of paediatric nursing practice. Paediatric palliative care begins when a disease is first diagnosed and continues throughout the illness trajectory. It therefore includes, but is not limited to, end-of-life care. Paediatric end-of-life care is the care provided to the child and family towards the end of a child’s life and includes care of the child’s body and support for the family following the child’s death. Although there are distinctions between the two terms, in this chapter they will be used interchangeably. This chapter provides a beginning understanding of some of the common symptoms experienced by, and concerns for, children in end-of-life care and their management, including pain, the management of side-effects of opioids, fatigue, dyspnoea, gastrointestinal disturbances and anxiety. It also discusses communication with dying children and adolescents, and the importance of family communication and support.

In paediatric nursing, families are central to the care of children – in fact, the patient is considered to be both the child and their whole family. In this chapter, you will begin to explore current approaches to the care of the woman and family during pregnancy, birth and parenting.

Becoming a parent is a life-changing transition for women and their partners, resulting in a range of changes during pregnancy and after birth that can present challenges to parents, and impact their babies. In addition to the profound physical changes that take place during pregnancy, women and their partners experience changes in their roles and relationships with each other as well as others in their social networks. In this chapter, preconception health, and antenatal and postnatal care will be discussed, including considering factors that influence maternal and infant health and wellbeing.

This chapter provides a basis for nursing students to understand the ways in which children and young people’s rights are upheld in Australia and New Zealand, particularly within the healthcare systems. It provides insight into the ways in which human rights, and particularly child rights, inform paediatric nursing policy and practice. It begins by looking at the international agreements and covenants regarding the protection of child rights that have been endorsed by Australia and New Zealand, before moving on to examine the national legislation and the implications for health and social support systems. The second part of the chapter looks at some of the ethical challenges regarding child and family rights that you will consider as a paediatric nurse. In particular, we look at issues surrounding access to family, advocacy and consent to treatment of specific diseases in some situations. It provides a basis for understanding the way in which children and young people’s rights – including the right to be protected from all forms of violence and neglect – are upheld in Australia and New Zealand, particularly within the health and welfare systems.

It can be difficult to determine when a child can be defined as having complex medical needs (Cohen et al., 2011). What one family finds complex, another family may adapt to more easily. One child with a particular condition may have less severity and more function than another child with the same or a similar condition. Furthermore, the discussion around the care of children with complex medical needs has often used different terms for similar things – care that is ‘medically complex’, or children who are ‘technology dependent’ or ‘medically frail’.

This chapter explores some of the causes of complex medical needs in children and young people, and discusses related nursing care and interventions. The important and central role of parents, caregivers and families in the care of children with complex needs is also considered. The chapter concludes by discussing the challenges facing young people with complex conditions and their families as they transition from paediatric to adult healthcare services.

This introductory chapter examines the health and wellbeing of children and young people growing up in Australia and New Zealand. Itlooks at the population characteristics of future generations, facilitators and challenges to healthy growth and development, and emerging health and social trends. It considers the health and wellbeing of children and young people as situated within their individual developmental journey. Whether born in New Zealand or Australia, or arriving as a child or young person, growth is nested within the social and cultural traditions of familyduring times of rapid social and environmental change.

The chapter begins by reviewing some of the common demographic and statistical indicator measures used to monitor the health and wellbeing of children and young people across the world. Being aware of the many different ways in which age and other measures are used to describe the health of children and young people can support the best use of the international evidence. The chapter then explores how these principles can be applied to key conditions and societal constructs relevant to the health and wellbeing of children and young people growing up in Australia and New Zealand.

This chapter presents guidelines and recommendations for managing emotional and behavioural responses related to children’s experiences of illness. It provides an overview of psychosocial development to best illustrate the relationship between child development and response and adaptation to illness. The relationship is bidirectional – that is, responses are shaped according to the psychodevelopmental stage of the child or young person, and at the same time developmental outcomes are impacted by the experiences and challenges of both acute and chronic illness. The family is also impacted when a child or young person is experiencing illness. Families are central to the care of children – in fact, the paediatric patient and their wider family provide the focus for care. This chapter therefore also explores what it means to be a family and family-centred care, and presents frameworks that can be used to assess and consider the psychosocial needs of families when a child is experiencing illness.

What do you expect the first year of professional nursing practice to be like for you, personally and professionally? This chapter encourages you to consider how you will manage the change, the skills you need to refine and self-support strategies you need to develop in your final year so that you are well placed for a successful transition to professional registered nursing practice. There are many things you can do to prepare yourself for this journey of transition to the role of registered nurse. This chapter focuses on preparing you to enter the nursing workforce. For the beginning registered nurse, this process is known as the transition to professional practice. Key concepts related to professional socialisation and the reality shock that can occur for new graduate nurses are examined to help you understand what you may experience during this journey. The expectations of new graduates regarding identity, autonomy and professionalism as they enter the nursing workforce are also investigated. Finally, this chapter explores preparing for the graduate year through professional portfolios and resumes, refinement and preparing applications for graduate nurse positions.

What does it actually mean to be professional? How can students develop their own sense of self, and how might this interact with their professional identify and performance? This chapter explains self-awareness and the importance of understanding your own values, beliefs and motivations in order to better understand the diverse experiences of others, and to nurture the therapeutic and professional relationships that are essential for quality nursing practice.

The role of emotional and social intelligence in understanding ourselves and others is also explored, as this concept is closely linked to self-awareness. Critical reflection and mindfulness are suggested as two strategies for fostering the development of greater self-awareness and better self-care, which may assist in caring for others with empathy, compassion and ‘intelligent kindness’. In essence, enhancing your self-awareness,self-care, understanding and compassion for others will help you interact and communicate more effectively, reconcile any differences or conflicts that may arise, and better cope with the emotional demands inherent in healthcare practice (Foster et al. 2015, Kelly, Runge & Spencer 2015).

A ‘nursing philosophy’ underpinning the curriculum is mandated by the accrediting body, the Australian Nursing and Midwifery Accreditation Council (ANMAC). We believe that a rigorous philosophical position underpinning nursing theory and practice can provide a focus for the discipline in terms of practical reasoning and moral commitment.

This chapter introduces the concept of gratitude as an example of a virtuous character trait. Aristotle recognised the importance of properly trained emotions for acquiring the virtues; thus his account is consistent with our emphasis on emotional intelligence and self-awareness. We show how excellent practice as a nurse aligns with doing well as a human being. The main point argued in this chapter is that Aristotle’s conception of virtue can provide a philosophical ‘basis for nursing that focuses on moral competence in a robust, coherent and systematic way, while at the same time accommodates the demand for discipline-specific knowledge and high levels of technical skill’ (Bliss et al. 2017, p. 1). We contend that this underpinning philosophy allows the knowledge and caring aspects of nursing to be united.

Critical thinking and problem-solving, clinical reasoning, self-reflection and self-awareness are valued attributes of the contemporary nurse. These skills are essential for the provision of safe and competent person-centred care to clients with ever-increasing acuity and multiple, often complex comorbidities. This chapter focuses on critical thinking, clinical reasoning and reflective practice, and personal documentation using e-portfolios, along with strategies to assist beginning nurses in the development of these specific skills, which should be honed, practised and adapted to everyday clinical practice. The chapter also assists the professional nurse to develop methods to demonstrate their personal and professional development through the use of e-portfolios.

The challenges associated with delivering quality client care within healthcare systems and environments are characterised by increasing complexity and acuity in client needs, rising consumer (and public) expectations, and increasingly constrained human and financial resources, all of which are everyday realities for many nurses (Courtney et al. 2015). In this context, empowering nurses with the skills, attributes and confidence needed to have control and influence over their own practice is critical. This chapter makes explicit the notions of leadership and empowerment inherent in other chapters, with a particular emphasis on the responsibility we all have to advance the quality and excellence of nursing practice and also to be a voice for our profession and leaders in the changes and improvements necessary to promote optimal health outcomes for local and global communities (Grossman & Valiga 2021, Komives, Wagner, & Associates 2016). This chapter presents various perspectives on leadership and empowerment in nursing, and proposes some strategies and ideas for developing your own leadership potential.