This chapter focuses on supporting families to promote optimal child development. It takes a systems-based approach to examining factors that influence child development, explores some of the most common problems and concerns that nurses who care for children and young people encounter on a regular basis, and draws on the latest research evidence to outline foundational principles for improving health and developmental outcomes.

The chapter is grounded in an understanding that the family environment has a tremendous influence on children’s health and development, and that a strong working partnership with parents and caregivers is essential. It begins with a brief overview of current challenges faced by children in Australia and New Zealand before examining important social and environmental determinants of children’s development. The remainder of the chapter comprises a series of case studies illustrating common child development concerns and outlines current best-practice, evidence-based strategies to support families with child behaviour, sleep, nutrition, physical activity and technology use.

The focus of this chapter is the role of the nurse in optimising child and youth mental health. An overview of mental disorders experienced during childhood and adolescence is followed by a discussion of mental health promotion for children and young people. Although the lifetime prevalence of eating disorders is very low, they are common, and nurses play an important role in the care of those affected children and young people admitted to hospital for treatment. The chapter looks specifically at how nurses can help support children and young people with eating disorders, and also considers the effects of digital technologies on the mental health of young people growing up in today's society. The importance of working closely with the parents and families of children and young people disabled by mental illness and the services available to them is emphasised throughout the chapter.

This chapter focuses on the role of the school nurse. It begins by exploring conceptual frameworks underpinning school nursing practice, and the range of factors that influence the target and scope of their role activities. Readers then learn how the Health Promoting Schools Framework may be used to guide nursing activities to create a health-promoting environment that encourages and supports healthy behaviours. This includes an examination of how nurses work with children and families to promote their health literacy through both formal and informal health education.

The chapter concludes with an overview of the priority health and wellbeing issues for children and adolescents, and evidence-based strategies required to address these concerns and optimise their healthy growth and development. This entails a close examination of the impacts of childhood overweight and obesity, and consideration of the primary, secondary and tertiary prevention activities that may be used by school nurses to help arrest this alarming epidemic.

This chapter covers the systems and services aimed at supporting Māori, Aboriginal and Torres Strait Islander children, their families and communities in achieving optimal health and wellbeing outcomes. New Zealand and Australia are separate countries with distinct colonial histories, policies, healthcare systems, practices and ways of life, although their First Peoples may share common experiences. Contemporary health services in each country are also separate and unique, so the content in this chapter is provided in discrete sections. Throughout the chapter, you will be able to identity key concepts related to the delivery of care that is culturally safe for Māori tamariki (children) and rangatahi (young people). This includes a whānau (family) and community approach to health and wellbeing. The Aboriginal and Torres Strait Islander authors use their cultural lens of knowing, being and doing through Aboriginal ways to highlight the key challenges in relation to meeting the needs of Aboriginal and Torres Strait Islander children and their connections . The authors bring to your attention cultural awareness, sensitivity, and safety in paediatric settings.

Children contract infections regularly during early childhood, so they can experience episodes of acute illness. They are also at greater risk of injury. For the most part, these episodes are of short duration and resolve with the care of parents at home, sometimes with support from community healthcare professionals such as a general practitioner. However, in some instances the illness can reach a level of severity that requires nursing care and medical treatment in a hospital setting. Infants and children are still developing, so they have physiological and anatomical differences from adults that require specialist skills and knowledge. Hospital environments can be challenging for both the young child and their family. In this chapter, some key nursing considerations and interventions for the acutely unwell and injured child and adolescent will be discussed. This is followed by an exploration of some of the illnesses and injuries children and adolescents can acquire that may require hospital care. You will be asked to reflect upon the nursing management of some of these conditions through review of case studies and reflective questions.

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.