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The effects of climate change, such as air pollution and extreme heat events, can adversely affect the physical and mental health of children and young people at all ages. This article explores the effects of climate change on children and young people's development and explains the effects of air pollution and heatwaves on their health. The article also discusses how children and young people are knowledgeable and concerned about the effects of climate change and can offer new perspectives on addressing these effects. Finally, the authors consider the role of nurses in raising awareness of the adverse effects of climate change on children's health, incorporating climate change in their practice and promoting opportunities for children's involvement in healthcare decision-making, strategies and policy development.

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The development of an empathetic approach when working with parents and families is fundamental to both social work and children's nursing; however, opportunities to develop this are limited. RealCare Baby infant simulator dolls were used with the aim of enabling students to gain an empathetic insight into parenting. A qualitative, evaluation study involving semistructured interviews with 10 social work and 11 children's nursing students was undertaken to evaluate experiences and views of infant simulator dolls, in relation to professional learning. Using reflexive thematic analysis of interview data, six key themes were identified: (1) positive experiences, (2) challenges, (3) impact on self, (4) empathy toward parents, (5) realism and (6) learning by reflection. All themes were evident from the participants' accounts in the context of the parenting experience. In addition to the overall positive impact on students, practical and technical challenges were also identified. However, despite these difficulties, participants valued the learning experience gained from caring for a doll and many articulated how an empathetic understanding of the parenting role was enhanced. This will potentially enable social work and children's nursing students to support parents more sensitively and empathetically.

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According to data collected by NHS England in 2022 1,721 children and young people were awaiting treatment for eating disorders compared with 603 patients in 2016. This reveals an increase of 185% in eating disorders among children and young people and suggests that this increase will continue to occur even with the government pledging £79 million ( GOV UK 2021 ) to expand children and adolescent mental health services (CAMHS) and early intervention services ( NHS England 2022a ). This is due to the already extensive CAMHS waiting list managing the sizeable accumulation of referrals combined with the consistent increase of new referrals. This article outlines the most common types of eating disorders, the importance of the school nurse and factors that have affected the prevalence of eating disorders in young people, highlighting that early intervention and prevention is vital. The authors argue that this can be achieved through increased funding for services such as CAMHS and the First Episode and Rapid Early Intervention for Eating Disorders service, stricter legislation surrounding social media and greater mental health education in schools for teachers, young people and their families.

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BACKGROUND: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. RESEARCH QUESTION: This article reports on one component and dataset from a larger study - 'the positives, perils and pitfalls of Facebook for nurses'. It explores the specific issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. PARTICIPANTS: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and 'snowballed' through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. ETHICAL CONSIDERATIONS: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. FINDINGS/RESULTS: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme 'blurred boundaries' was generated, which comprised three sub-themes: 'follow the science, 'abuse of power and erosion of trust' and 'the moral and ethical responsibility to safeguard public health'. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. CONCLUSION: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of 'every act has a consequence'; however, in this article, the theme 'blurred boundaries' offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education.

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Breastfeeding offers one of the most fundamental global health benefits for babies. Breastmilk is lifesaving, providing not only nutrition but immunologic benefits and as such is strongly supported by the World Health Organization and leading healthcare associations worldwide. When the COVID-19 pandemic started in 2020, the impact of the restrictions to prevent the spread of the disease created challenges and questions about provision of safe, quality care, including breastfeeding practices, in a new 'normal' environment. Mothers were temporarily separated from their babies where infection was present or suspected, parents were prevented from being present on neonatal units and vital breastfeeding support was prevented. This discussion paper provides an overview of essential areas of knowledge related to practice for neonatal nurses and midwives who care for breastfeeding mothers and babies, in the context of the COVID-19 pandemic and the latest global guidance. Three areas will be discussed; the protective benefits of breastfeeding, keeping breastfeeding mothers and babies together and supporting mothers to breastfeed their babies. Finally, care recommendations are presented to serve as a summary of key points for application to practice for neonatal nurses and midwives.

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AIM: This study aimed to investigate the confidence levels, knowledge base and learning needs of community-based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format. DESIGN: An online survey methodology was used. METHODS: A 32-item questionnaire was distributed via social media platforms to community-based nurses in Australia. RESULTS: Descriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community-based health professionals, tailored to the specific features of preterm babies and support needs of parents.

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BACKGROUND: Neonatal nurses are ideally placed in practice to undertake research enhancing the care of families. More information is required, however, around neonatal nursing led research to advance leadership in this area. The aim of this study was to determine neonatal nursing led research activity within the UK. METHODS: The study used a web-based survey design and neonatal nurses were eligible if they were working at or towards Masters or Doctoral level qualification in the UK. The survey was distributed to members of the Neonatal Nurses Association, UK Schools of Nursing and shared on social media pages of authors and professional organisations. Results were analysed using descriptive and frequency statistics and content analysis. RESULTS: Of the 56 respondents, 14% (n = 8) had a Doctoral level qualification and 43% (n = 24) of participants held a Masters qualification. Lack of time and funding knowledge was the largest barrier to research. Only 30% (n = 3) of participants had a research mentor and only 18% (n = 3) were from a neonatal nursing background. CONCLUSIONS: There are limited numbers of neonatal nurses undertaking or leading nursing research in the UK. Further support is required to enhance clinical academic career trajectories to ensure research is a viable pathway for future generations of neonatal nurses.

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BACKGROUND: Being an empathetic researcher can be crucial in understanding participants' perspectives. However, while the need for empathy is recognised in qualitative interview research, there is less acknowledgement of its value with other methods of collecting data. Researchers can face various challenges when the instruments and approaches used to collect data are new to them. The value of researchers acting as participants when undertaking pre-pilot work are not be underestimated. AIM: To provide a reflective account of the pre-pilot work undertaken by the authors before their main study. DISCUSSION: Pre-pilot work that involves the researchers as participants can develop cultural competence, as well as empathetic insight into participants' perspectives, thus enabling them to refine and strengthen their main study. CONCLUSION: It takes time when planning research to incorporate appropriate pre-pilot work that assists personal training and learning. However, this can pay dividends in terms of the empathetic insight gained for the refinement of the proposed study. Pre-pilot work and a reflective approach can strengthen rigour, as well as assist in planning research and collecting data. IMPLICATIONS FOR PRACTICE: Experienced researchers may be novices at using specific tools or methods of collecting data. Pre-pilot work enables a greater understanding and deeper appreciation of participants' perspectives.

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BACKGROUND: The COVID-19 pandemic has resulted in significant changes and restrictions to neonatal care. The aim of this study was to explore the impact of these changes on neonatal nurses globally. METHODS: We conducted a thematic analysis on written reflections by neonatal nurses worldwide, exploring their experiences of COVID-19. Twenty-two reflections were analysed from eleven countries. RESULTS: Thematic analysis revealed 4 main themes relating to the nurses' role: 1) protector 2) challenges to human quality of care 3) vulnerability and 4) resilience. The measures taken as protector were described as compromising the human qualities of care fundamental to their role. This tension, together with other new challenges, heightened feelings of vulnerability. Concurrently, nurses identified role resilience, including resourcefulness and peer support, which allowed them to navigate the global pandemic. CONCLUSION: By identifying global challenges and strategies to overcome these, neonatal nurses may be better equipped as the pandemic continues. The reflections underscore the importance of family integrated care and the tension created when it is compromised.

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BACKGROUND: The emotional challenges experienced by parents of infants admitted to the neonatal unit are well documented. Stories based on parents' narratives can be an effective method for nursing students to learn about parents' experiences and develop empathy for them. AIM: To explore the contribution of arts-based digital storytelling based on parental experiences of neonatal care to enhancing empathy in children's nursing students. METHOD: A collection of digital stories based on parental narratives were developed using the ASPIRE (aim, storyboarding, population, implementation, release, evaluation) framework. A mixed-methods approach was used to evaluate the effects of three of those digital stories, whereby 67 children's nursing students completed questionnaires and seven of them were interviewed individually about the stories. FINDINGS: The mix of illustrations, animation, voice and text was well received by participants, not only aiding their learning, but also eliciting an emotional response from them. However, some aspects of the digital stories were found to hinder learning and some participants questioned the power of digital stories. Despite this, overall, the use of digital storytelling was found to be engaging, hold students' interest and enable learning via their senses. CONCLUSION: Arts-based digital storytelling can convey the complexities of parents' emotional experiences in the neonatal unit, so that nursing students are better equipped to understand and empathise with them.

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BACKGROUND: An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their 'comfort zone', all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.

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Retention of staff presents major challenges within children's palliative care; this has substantial implications for children, families and the nursing workforce. To address this, a programme was undertaken that provided pathways of professional development for senior nurses working in this field. This study reports the views of nurses completing this programme, the overall project manager (PM) and the day-to-day programme lead (PL) as well as factors that influence nurse retention within children's palliative care nursing. The study drew on an Appreciative Inquiry approach that comprised of interviews with the PM and PL as well as focus groups and questionnaires with senior nurses from the children's palliative care sector, who participated in the training programme. Thematic analysis of data from interviews and focus groups revealed factors influencing nurse retention: speciality, positivity and making a difference, support, provision of adequate resources, tailored education/professional development and resilience. These themes were supported by the questionnaire findings. The programme was perceived as having a positive influence on nurse retention within the children's palliative care workforce. In addition, it was felt to be very beneficial in terms of shared learning and development. Participants highlighted the need for similar opportunities in the future.

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During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.

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COVID-19 has changed the way that newborn babies are cared for within the neonatal setting due to the introduction of social distancing and wearing of face masks to limit the spread of the infection. Potential implications exist related to the normal development of bonding and connections with others. This paper discusses the importance of face to face interactions for early attachment between babies and parents within the context of relevant underpinning developmental theory. Mask wearing can also potentially impact relational communication, requiring us to change our current ways of working. Decreasing face to face interactions and relational communication, along with key recommendations for both parents and health professionals are further highlighted to mitigate the potential negative effects of masks on long-term development related to human connection and attachment.

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Within neonatal nurse education, learning to understand the compelling emotional experiences of parents following the birth of their premature baby is essential to give person-centred empathic care. A collection of digital stories informed by parents' experiences was created to use as a pedagogical tool for students and staff within the neonatal speciality. This study reports on an exploration of the value of these digital stories for the enhancement of empathic learning. Using the principles of narrative inquiry, a mixed-methods design comprising 'point-of-view', reflective exercises, interviews and a questionnaire distributed to nursing students and practice staff ascertained views of three digital stories. The participants evaluated the digital stories positively overall and it was clear they were an effective and innovative way to learn about emotional experiences of parents. Powerful emotional messages from parents enhanced awareness, understanding and insight into their affective experience. Within the context of narrative-based neonatal education, there is a place for digital storytelling as a pedagogical strategy informed by parent narratives, to teach students and staff about the emotional impact of the neonatal care experience. In turn, this can potentially lead to more empathic, person-centred care relating to the families of sick, vulnerable babies.

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Infection is a leading cause of death worldwide in babies under one month of age who are more susceptible to sepsis due to immature host defence mechanisms. Usually, babies may become acutely unwell from infective pathogens due to specific differences in their respiratory and immune systems. However, with the COVID-19 virus, the focus of this paper, it appears that the neonatal population is not significantly affected in the same way as adults. That said, knowledge about this novel virus is rapidly emerging. Therefore, it is vital that neonatal nurses, midwives and other healthcare professionals are adequately informed and educated about the potential impact on neonatal practice. This review paper draws upon key findings and themes from a selection of recent literature to provide an overview of current knowledge on COVID-19 and the implications for care within the neonatal field. The discussion focuses on the nature of COVID-19, its pathophysiology and transmission relevant to maternal and neonatal care. This is followed by implications for practice; namely, maternal issues, the importance of human breast milk, neonatal care relating to parenting and specific management before a final review of the current World Health Organization guidance.

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This study focuses on how metaphors are used by parents who have had a premature baby to describe their neonatal care experience and how these can contribute to empathic learning of health professionals. In health, metaphors are commonly used to communicate and explain difficult topics. When patients tell their story, metaphor can be a means of expression from which we can learn about their experience of illness or hospitalisation. Limited research exits on how metaphor can improve our understanding of parent's emotional experience in neonatal care and subsequently inform education in this field. Employing narrative inquiry within an interpretive, constructivist paradigm, 20 narrative interviews with 23 parents of premature babies were analysed using a process of metaphor identification. Findings revealed common metaphors used to describe experience. Metaphor clusters used by parents in order of frequency were journeying, altered reality, darkness, breaking, connections, fighting, salvation and being on the edge. Parents widely used compelling and emotive metaphors to describe and express both difficult and challenging times as well as progression forward. Metaphors serve as a powerful way for health professionals to learn about the emotional experiences of parents and potentially enhance their empathic understanding.

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Improving survival rates for children and young people with complex health needs requires a robust system for transition to adult services. Effective planning is essential to ensure a smooth transition process that is in the best interests of the young person and their family. This article discusses the needs and requirements for planned and purposeful transition processes to support young people with complex healthcare needs and their families. It considers the preparation of adult services, the team, the young person and their parents in line with an integrated approach and the nurse's role. Recommendations for practice include the necessity for an integrated approach to ensure optimum outcomes and ascertaining the potential value of a nurse-led service in delivering the transition process. A carefully tailored planning strategy should be developed to prepare and support young people with complex health needs through transition.

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Improving survival rates for children and young people with complex health needs requires a robust system for transition to adult services. Effective planning is essential to ensure a smooth transition process that is in the best interests of the young person and their family. This article discusses the needs and requirements for planned and purposeful transition processes to support young people with complex healthcare needs and their families. It considers the preparation of adult services, the team, the young person and their parents in line with an integrated approach and the nurse's role. Recommendations for practice include the necessity for an integrated approach to ensure optimum outcomes and ascertaining the potential value of a nurse-led service in delivering the transition process. A carefully tailored planning strategy should be developed to prepare and support young people with complex health needs through transition.

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