Farmers are on the frontline of extreme weather events and experience many farming and wellbeing impacts. While farmers are dependent on the land for their livelihood, wider society depends on farmers for food, fibres and employment opportunities. This exploratory pilot study provides a timely examination of the impacts of extreme weather events reported by participating Australian farmers. We investigated impacts on farming and wellbeing, preparedness for extreme weather events, current and ideal farm adaptation strategies, and barriers faced. The mixed-methods survey was completed by 79 farmers from predominantly New South Wales, Australia. On average, participants reported negative impacts from 3.2 +/- 1.4 different types of extreme weather events, including drought, bushfire and extreme precipitation or flooding. There was no statistically significant relationship between the type of extreme weather event reported as impactful and mental health outcomes. Among participating farmers, 39.2% reported high or very high psychological distress, 31.7% reported elevated PTSD symptoms, and 22.9% reported suicidal ideation. Psychological distress was higher among participants who reported impacts from a broader range of extreme weather event types. Greater reported impacts of extreme weather events and poorer levels of psychological preparedness were reported among participants with high/ very high psychological distress. Participants rated the most important adaptation strategies as storing water, grain or fodder, establishing financial strategies, and developing farm management tools and strategies. The most common barriers to adaptation were time, finances and competing priorities. As an exploratory pilot study, these findings provide early insight into the farming and wellbeing impacts of extreme weather events and highlight important associations that warrant further investigation. Larger and more representative samples are needed to understand how extreme weather events affect farmer wellbeing, preparedness and adaptation.

Background/Objectives: Nursing involves repeated exposure to emotionally, morally, and psychologically distressing experiences, yet the mechanisms through which low-intensity occupational stressors accumulate and contribute to psychological harm remain conceptually unclear. This scoping review examined how the nursing literature conceptualises the cumulative effects of repeated occupationally distressing experiences and identified the conceptual gap created by the absence of a unifying term such as micro-trauma. Methods: A scoping review was undertaken to map concepts used to describe cumulative occupational distress in nursing and determine whether any terminology captures the cumulative impact of repeated low-intensity exposures. Searches were conducted across CINAHL, MEDLINE, and Emcare, supplemented by citation searching, Google Scholar, targeted grey literature searching and structured generative artificial intelligence-assisted source identification. Data were extracted using a priori criteria and synthesised narratively. Consistent with Joanna Briggs Institute guidance, quality appraisal was not undertaken. Results: No included publication applied the term ‘micro-trauma’ to nursing or healthcare workers. Seven publications met the inclusion criteria following expanded searching across supplemental pathways. The literature used heterogeneous and overlapping terminology, including burnout, compassion fatigue, cumulative grief, moral distress, workplace trauma, and post-traumatic stress disorder symptomatology, to describe cumulative psychological burden, but none provided a unifying conceptual frame for repeated low-intensity exposures. Conclusions: The current literature does not yet clearly define or consistently apply micro-trauma in nursing, despite evidence that repeated occupational exposures contribute to cumulative psychological burden. This review highlights a conceptual space before end-point conditions such as burnout, compassion fatigue, or post-traumatic stress disorder symptomatology are recognised. Future research should develop and test a clearer conceptual framework for micro-trauma in nursing before it is applied as a distinct unifying concept.

Background: Digital health capability is a core requirement for contemporary nursing graduates; however, undergraduate curricula often provide limited structured exposure to electronic health records prior to clinical placement. Aim: To examine the impact of embedding an academic electronic health record (AEHR) into a first-year nursing curriculum on students' digital readiness and perceived preparedness for practice. Methods (Design): A mixed-methods exploratory design was used with first-year nursing students (N = 336) at an Australian university. An eight-item adapted survey was administered before and after AEHR learning activities delivered across a 10-week teaching period. Descriptive and inferential statistics were applied, and free-text responses were analyzed thematically. Results: Students reported increased confidence in navigating digital systems and completing clinical documentation following AEHR exposure. Qualitative findings indicated enhanced preparedness for placement, reduced anxiety, and greater awareness of digital skill development, with students valuing early, hands-on exposure. Conclusions: Embedding AEHR in first-year nursing curricula supports the development of digital literacy, confidence, and readiness for clinical practice. Broader adoption of AEHR may help address persistent digital readiness gaps in nursing education. (c) 2026 The Authors. Published by Elsevier Inc. on behalf of Organization for Associate Degree Nursing. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

BACKGROUND:Stroke nurses must perform dysphagia screening on all suspected stroke patients, adhering to best practice guidelines. While comprehensive training is essential for safe and competent screening, the variability in dysphagia screening tools leads to significant differences in education. AIM:This scoping review aims to collate and report what education is provided to stroke nurses on the use of dysphagia screening tools. DESIGN:A scoping review guided by the PRISMA-ScR checklist. METHODS:A systematic review of three electronic databases identified 318 peer-reviewed studies. After screening and eligibility assessment in COVIDENCE, 10 studies were included. Data from these studies was analysed using Arksey and O'Malley's thematic framework. DATA SOURCES:MEDLINE, CINHAL, Scopus. RESULTS:Ten studies were included in this review which yielded the following major themes: (1) comprehensive and structured training; (2) diversity of training methods; (3) ongoing education and competency assessment; and (4) standardised protocols and tools. CONCLUSION:Offering comprehensive training programs to stroke nurses on dysphagia screening tools is associated with more timely interventions and improved outcomes; however inconsistent approaches to training make it difficult to benchmark outcomes of the education provided. Future research should explore stroke nurses' experiences with current training to guide future training program development. RELEVANCE TO CLINICAL PRACTICE:This review highlights the importance of training stroke nurses to use dysphagia screening tools to improve patient outcomes. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

Background: Promoting a representative and supportive industry for Aboriginal, Torres Strait Islander and M & amacr;ori nursing and midwifery academic staff is a key tenet of Australian and Aotearoa New Zealand universities, and fundamental to strengthening the health workforce. Surprisingly, information about this workforce is unknown. Aim: The aim of the study was to gain an understanding of the Aboriginal, Torres Strait Islander and M & amacr;ori nursing and midwifery academic workforce. Methods: A cross-sectional study was conducted using an online survey of organisations that provide accredited nursing and midwifery education within Australia and Aotearoa New Zealand. Demographic, academic and employment information relating to Aboriginal, Torres Strait Islander and M & amacr;ori nursing and midwifery staff was collected. Findings: Thirty-three organisations responded, reporting a total of 55 staff. Aotearoa New Zealand universities (n = 6) had between one and four M & amacr;ori or Aboriginal staff members. Australian universities (n = 27) reported between one and nine Aboriginal and Torres Strait Islander staff, with 10 universities reporting that they had none. Most staff held a PhD or Master's degree and were employed at lecturer level in a fulltime continuing position. There were 10 appointed into a professoriate level position. Workload was predominantly allocated to teaching and research. Discussion: Neither country has reached parity with the Aboriginal, Torres Strait Islander and M & amacr;ori overall population. Substantial efforts are required to grow this workforce. In addition, as most staff hold lowerlevel academic positions, greater succession planning through increased mentorship and professional development is urgently needed. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Nursing Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

AIM:This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. DESIGN:Mixed methods. METHODS:A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic. RESULTS:There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19. CONCLUSION:Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives. PATIENT OR PUBLIC CONTRIBUTION:Not applicable. IMPACT:Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.

There is widespread acceptance of our nation's history and agreement that the wrongs of the past should never be repeated. For nursing and midwifery, there still needs to be truth telling, historical acceptance, acknowledgement of professional and institutional racism, and social justice before we can begin on the road to healing. Nursing at its premise is about healthcare to all individuals in the community. We must recognise and acknowledge the role that nurses and midwives have played since colonisation, through the influence of successive punitive government policies that led to nurses and midwives acting as agents of government, contributing to the harms and trauma of Aboriginal and Torres Strait Islander peoples. It is reported that of the Aboriginal and Torres Strait Islander student enrolments in undergraduate nursing and midwifery courses in Australia, approximately 30% are likely to complete. To improve the likelihood of success, a multipronged approach is needed. The Gettin em n keepin em (GENKE I) (Indigenous Nursing Education Working Group 2002Indigenous Nursing Education Working GroupGettin em n keepin em. Department of Health and Ageing, 2002Google Scholar) advocated for a strategic national approach to increase the number of Aboriginal and Torres Strait Islander nursing graduates and to improve Cultural Safety in the practice of all nurses. GENKE I included a Strategic Framework that aimed to; increase replacement, recruitment, retention and completion of nursing students. In 2002, at the time of GENKE I, Aboriginal and Torres Strait Islander registered nurses comprised 0.4% of the nursing workforce (Indigenous Nursing Education Working Group 2002Indigenous Nursing Education Working GroupGettin em n keepin em. Department of Health and Ageing, 2002Google Scholar). However, one of the stark reminders in the 2022 GENKE II report (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives 2022Congress of Aboriginal and Torres Strait Islander Nurses and Midwives'gettin em n keepin em n growin em': Strategies for Aboriginal and Torres Strait Islander nursing and midwifery education reform. Congress of Aboriginal and Torres Strait Islander Nurses and Midwives., Brisbane2022www.catsinam.org.auGoogle Scholar) highlights just how little progress has been made. In 20 years, the number of Aboriginal and Torres Strait Islander registered nurses occupy just 1.16% of the registered nursing workforce (Department of Health and Age Care 2022Department of Health and Age CareNational Aboriginal and Torres Strait Islander health workforce strategic framework and implementation plan 2021–2031..2022https://www.health.gov.au/resources/publications/nationalaboriginal-and-torres-strait-islander-health-workforce-strategic-framework-and-implementation-plan-2021-2031Google Scholar), only a 0.76% improvement in 20 years. Our report card surely reads, 'must do better, or puts in little effort'. It is up to nursing and midwifery academic leaders to ask why so little progress has been made and what needs to be done to improve the numbers of Aboriginal and Torres Strait Islander students enrolling and successfully completing nursing and midwifery undergraduate courses. The now seminal 'call to action' paper (Geia et al., 2020Geia L. Baird K. Bail K. Barclay L. Bennett J. Best O. et al.A unified call to action from Australian Nursing and Midwifery leaders: Ensuring that black lives matter.Contemporary Nurse. 2020; 56: 297-308https://doi.org/10.1080/103761.2020.1809107Crossref PubMed Scopus (0) Google Scholar) published in the wake of the global outcry at the death of George Floyd and the Black Lives Matter movement, laid out clear issues of racism and called for the action of nursing and midwifery academics. The Council of Deans of Nursing and Midwifery, Australia and New Zealand (CDNM) is the peak body representing the 43 members who deliver accredited programs of education that lead to registration as a nurse or midwife across both countries. Council has a history of standing with the then Congress of Aboriginal and Torres Strait Islander Nurses (CATSIN; now CATSINaM) through its participation in the Indigenous Nursing and Education Working Group that led to the publication of the GENKE I report. The Council embarked on a program of meaningful engagement and constitutional reform that began with a formal apology from Council for the place nursing and midwifery education in contributing to the harms and intergenerational trauma of Aboriginal and Torres Strait Islander people. To acknowledge this truth, it is important to acknowledge the place of nursing and midwifery education and research, and how this has contributed to culturally unsafe practices which has contributed to ongoing suffering of Aboriginal and Torres Strait Islander nurses and midwives and their communities through having their cultural practices and contributions to the professions and healthcare ignored, or minimised, through privileging colonial approaches. This acknowledgement is about facing up to the harm of the past and recognising that harm can and will have enduring impacts that affect future generations. The formal apology is the first step to acknowledge this harm, with Council members, as leaders of nursing and midwifery education and research, partnering with CATSINaM to deliver a program of reform that promotes meaningful reconciliation to build a better future that supports culturally safe spaces for education and research, and supports Aboriginal and Torres Strait Islander academics, and students to flourish and to take their place as leaders in our professions. This apology does not erase the pain of the past, nor the intergenerational trauma that has occurred, but it is a vital first step in our future, a vital first step towards healing, a vital first step towards walking together building on our shared history, learning from the mistakes of the past, and it is hoped that this apology opens a way forward to build a better future for nursing and midwifery in partnership with CATSINaM. Reconciliation Australia states that 'in a just, equitable and reconciled Australia, Aboriginal and Torres Strait Islander children will have the same life chances and choices as non-Indigenous children, and the length and quality of a person's life will not be determined by their racial background' (Reconciliation Australia 2022Reconciliation Australia (2022). Available from: https://www.reconciliation.org.au/reconciliation/what-is-reconciliation/ [Accessed 5 February 2022].Google Scholar). They go on to state that there is a need to understand the truths of the past to avoid repeating the wrongs of the past today. This Apology, our moment of truth, is where we make our stand to stop repeating the wrongs and make space to build a new way of healing and reconciliation that supports and privileges the voices and place of Aboriginal and Torres Strait Islander students, scholars, and academic leaders. •Council of Deans Nursing and Midwifery (CDNM) as National Leaders we apologise to Aboriginal and Torres Strait Islander peoples, for the past harms and injustices.•Council acknowledges the profound hurt and harm nurses and midwives have caused through their practice in the professions, and we say sorry.•We express our deep grief that Aboriginal and Torres Strait Islander people have been harmed by the colonial practices of nurses and midwives, informed by the policies of previous government agendas, perpetuated through normalisation of professional behaviours and institutional racism, we are sorry,•We are sorry that those harms have contributed to the inter-generational trauma of Aboriginal and Torres Strait Islander nurses, midwives, families, and communities,•Council expresses our profound grief at the suffering that has occurred in the First Australians. We say sorry. We shall never forget, but together we can heal and build a better future for our nursing and midwifery professions. Through this apology, it is hoped to build a strong foundation towards culturally and clinically safe nursing and midwifery practice. CATSINaM's vision is that `Aboriginal and/or Torres Strait Islander Nurses and Midwives play a pivotal and respected role in achieving health equity and equality across the Australian health system for Aboriginal and/or Torres Strait Islander Peoples and communities'. This requires all nursing and midwifery peak bodies to form genuine partnership with CATSINaM to develop the new way forward to providing safe nursing and midwifery practice to Aboriginal and Torres Strait Islander people. This can begin with entry to practice education pathways. The Uluru Statement from the Heart calls for constitutional reforms to include the voice of Aboriginal and Torres Strait Islander people in Parliament that acknowledges and affirms your rightful place and voice on your Country, and in the places of governance (The Uluru: statement from the heart /Central Land Council Library 2017Uluru: statement from the heart /Central Land Council LibraryFirst Nations National Constitutional Convention. The Statement., 2017https://ulurustatemdev.wpengine.com/wp-content/uploads/2022/01/UluruStatementfromtheHeartPLAINTEXT.pdfGoogle Scholar). In recent months the Council have worked on developing the new strategic plan that will guide its constitutional reform called for in the Uluru Statement from the Heart, to ensure that Aboriginal and Torres Strait Islanders Nursing and Midwifery leaders through CATSINaM are rightly positioned in partnership with Council and that through our work together, as nurses and midwives, we work together to improve Aboriginal and Torres Strait Islanders People's Health. In addition to the constitutional change, Council will work in partnership with CATSINaM to develop a sustained plan of action to reform how we work with Aboriginal and Torres Strait Islander nursing and midwifery colleagues to implement GENKE II report (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives 2022Congress of Aboriginal and Torres Strait Islander Nurses and Midwives'gettin em n keepin em n growin em': Strategies for Aboriginal and Torres Strait Islander nursing and midwifery education reform. Congress of Aboriginal and Torres Strait Islander Nurses and Midwives., Brisbane2022www.catsinam.org.auGoogle Scholar) to improve student outcomes and increase the success of academic careers paths of Aboriginal and Torres Strait Islanders colleagues who are currently underrepresented in academia. Universities, as institutions preparing future nurses and midwives, must also be culturally safe places for Aboriginal and Torres Strait Islander students to succeed. We used Reconciliation Action Plans (RAP; at some universities termed Aboriginal and Torres Strait Islander plans) as a proxy indicator of a safe cultural milieu because these plans are visible and explicit expressions to support Aboriginal and Torres Strait Islander students and academic. In preparation for the Apology, a desktop audit of the 37 universities offering programs leading to the registration of Australian nurses and midwives, found that only 25 universities had a RAP, yet only 14 of these RAPs were current. As a fundamental step to embracing cultural safety which recognises that universities have much to do in making reparations to healing the hurts of the past, it is disappointing that less than 40% have an active RAP. In terms of student success, 34 universities did have Aboriginal and Torres Strait Islander student support centres (Indigenous Teaching at Australian Universities 2022Indigenous Teaching at Australian UniversitiesIndigenous Centres at Australian Universities..2022http://www.indigenousteaching.com/indigenous-centres-australian-universities#:∼:text=Our%20information%20shows%20that%20across,Indigenous%20centres%2C%20schools%20and%20unitsGoogle Scholar). Whilst this finding may be more encouraging, without an accompanying RAP, the culture of the wider institution may still not be culturally safe, nor provide support for Aboriginal and Torres Strait Islander students and staff to enter and have a successful pathway to graduation or, for staff, career progression. Action beyond that of RAP and meeting ANMAC accreditation standards are needed. The employment of Aboriginal and Torres Strait Islander nursing and midwifery academics are urgently needed help to improve student success. Currently, however, understanding of the number and level of appointment of Aboriginal and Torres Strait Islander academics from both professions is unknown and warrants urgent investigation which CATSINaM and CDNM are collaborating on. In addition, there is an urgent need to develop explicit, flexible, and alternative pathways into academia. The principles of GENKEII equally apply to tertiary sector and that Aboriginal and Torres Strait Islander nursing and midwifery academics have access to and are embedded into culturally safe and mentored career development pathways. Nurses and midwives, and in particular the system of higher education and practices of research have not always been culturally safe, and in fact have and continue to cause harm. All nursing and midwifery entry to the profession programs are required to include at a minimum, a stand-alone subject that addresses Aboriginal and Torres Islander people's history, culture, and health in Australian universities.

Safe shelter from cyclones for individuals with disabilities, who are at greater risk of injury and death than other populations, requires close attention. The purpose of this study was to gain the perspective of individuals with disabilities on the experience of sheltering during the three most recent severe tropical cyclones in northern Queensland, Australia. A qualitative, interpretive methodology was used to explore the experience of 12 individuals with disabilities. Data was col-lected using semi-structured interviews and interpreted using inductive thematic analysis. The experience of sheltering was characterised by three factors and the dynamic interaction between these factors before, during and when recovering after the cyclone: capacity of the physical envi-ronment; the physical and psychological impact of the cyclone; and availability and capability of support networks. Hearing first-hand from individuals with disability on their sheltering experi-ence, reinforced the need for an individualised risk reduction approach, to accommodate each in-dividual's changing needs over the course of a severe cyclone event, and which draws on their own capabilities and resources. Furthermore, to ensure safe sheltering for people of all abilities in a public shelter, consideration of the changing needs of individuals with disability and their in-clusion in the process of design is essential.

Timor-Leste faces many challenges implementing quality maternal, newborn and child health (MNCH) services due to resource constraints and socio-cultural factors that disproportionately affect the health of women and children. A scoping review was conducted to map the quality of MNCH services against WHO quality standards on: 1. Provision of care, 2. Experiences of care, and 3. Cross-cutting standards. The literature search identified 1058 citations, from which 28 full-text articles met the inclusion criteria. The findings highlight health workers' limited capacity to provide quality services and referrals. The major reasons for this are: a lack of essential supplies, poor infrastructure and transport, limited opportunities for ongoing learning, and gaps in health information systems. Provision of care standards and cross-cutting standards require attention at a broad systems level. Findings related to experiences of care highlight the importance of effective communication, respect, and emotional support, particularly for vulnerable women and children who have difficulty accessing services, and for those who have experienced violence. These experience-related standards could be addressed at an individual health worker and health service level, as well as at a systems level. This review provides direction to focus quality-improvement initiatives within local health facilities, as well as at municipal and national level.

The aim in this study was to explore and determine the priorities in nursing research for disaster management. A systematic literature review was conducted to identify and compile a list of statements on research priorities in disaster nursing. Next, a Delphi survey was conducted among experts identified from international disaster nursing professional societies and disaster nursing education programs to obtain their insights on the priorities in nursing research for disaster management. Lastly, an international web-based survey was conducted to collect data from frontline nursing practitioners, researchers, educators, and leaders. Through the systematic literature review, 327 research statements on disaster-related issues were derived from 28 publications. The Delphi survey generated a final list of 90 nursing research statements on disaster management. There were 133 responses to the web-based survey from 26 different countries/ areas. The top three research priorities were "education and preparedness in the nursing profession " (mean = 4.45, SD = 0.79), "nurses' competency to respond to disasters " (mean = 4.44, SD = 0.82), and "emergency management planning in healthcare, community and aged care facilities " (mean = 4.40, SD = 0.84). Significant differences were observed among those of different age groups, lengths of experience in disaster management, primary work settings, affiliated nursing society memberships, and WHO regions. The findings of this research provide a general picture of the priorities in nursing research for disaster management, and led to the identification of the overarching research priorities in this area and of areas in need of further research. Furthermore, it provided valuable suggestions for funding organizations and policy makers to decide on those areas of disaster nursing that warrant further research.

Given the area of disaster nursing remains deplete of robust evidence required to drive effective and efficient nursing interventions, this special section aimed to present an overview of current disaster nursing evidence to promote excellence in nursing practice, research and education. As the call for papers coincided with the COVID-19 pandemic, we also recognised the need for a disaster nursing evidence base to help guide the pivotal role of nurses in health care delivery during this pandemic. Since the emergence of, and ongoing nature of the pandemic, the important role played by nurses has been highlighted. Given that nurses comprise the largest part of the healthcare workforce (Said & Chiang, 2020), undertake most of the infectious disease containment and provide most of the front-line care during pandemics (Usher et al., 2009), the need for evidence to support nurses and to understand their issues and concerns during pandemics is crucial. In addition, the challenges faced by nurses as they carried out these important roles have been immense. For example, not only are they burdened by the increased volume and intensity of their work, but they are also challenged by a constant need to adapt ways of working (Maben & Bridges, 2020). We also know that nurses are at risk of burnout (Zhang et al., 2020), compassion fatigue (Alharbi et al., 2020), emotional/psychosocial exhaustion (Maben & Bridges, 2020) and issues related to the use and supply of personal protective equipment (PPE) (Fernandez et al., 2020). Nurses have also expressed concern about treating infectious patients, the risk of infecting family members (Fernandez et al., 2020) and stigma associated with their work (Chiang et al., 2007). While it is not surprising that most of the articles submitted for the special section relate to the COVID-19 pandemic, all provide important updates and insight related to disaster nursing. The collection of papers provides an interesting and informative compilation of the currently available evidence in the area. This evidence will help front-line nurses in the delivery of healthcare to the many who continue to be impacted by COVID-19 and other disasters, and provide important information for managing future disasters. The papers also offer important insights for those in management responsible for staffing hospitals and other services, as well as those responsible for ensuring safe working environments for nurses.

Abstract Aim The study aimed to measure and describe the mental health impact of COVID‐19 on Australian pre‐registration nursing students. Background The COVID ‐19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID‐19 on Australian pre‐registration nursing students currently. Design A cross‐sectional study was conducted across 12 Australian universities. Methods Using an anonymous, online survey students provided demographic data and self‐reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID‐19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale‐Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS‐21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20‐188). All participating universities obtained reciprocal approval. Results Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID‐19. Close to half of students (n = 255, 49.4%) reported signs of post‐traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID‐19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID‐19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. Conclusion The COVID‐19 pandemic has considerably impacted pre‐registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. Impact statement This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID‐19. In this study, we found that students with a pre‐existing mental health issue and final‐year students were most affected. The changes to education in Australian universities related to COVID‐19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. Patient or public involvement The study was designed to explore the impact of COVID‐19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

BackgroundMandatory placement-based work-integrated learning (WIL) poses challenges for nursing students who work whilst studying. The financial burden of WIL links to other known direct and indirect challenges, yet no Australian study has quantified the financial challenges resulting from attending mandatory WIL placements. Placement-based WIL costs may preclude some students from completing WIL, which may impact student attrition and the future health workforce.AimTo investigate Australian nursing students’ financial challenges related to mandatory WIL.MethodsAn online cross-sectional survey conducted with nursing students from nine Australian universities across five Australian states. The 28-question survey investigated the location of, and travels to, the most recent WIL placement; and students’ employment, accommodation, financial support, expenses and debts, and financial strain pertaining to WIL placements.ResultsOverall, 2,359 students participated. The majority were employed (84%); 65% of these reported that they were unable to work during WIL, affecting their employment. One-third incurred a financial liability from their placement, 79% reported financial hardship, and 73% found their placement stressful due to financial strain. Financial issues affected 62% of students’ health and wellbeing.DiscussionFinancial pressures related to WIL impact nursing students. While students have strategies to reduce these pressures, universities can also better manage their placement preferencing and support of students to reduce financial impacts of placement-based WIL on students.ConclusionsNursing students face substantial financial challenges related to placement-based WIL. Scholarship programs and other forms of support are required to assist nursing students to undertake WIL.

Healthcare associated infections are the most common complication of a person's hospital stay. Contemporary infection prevention and control programs are universally endorsed to prevent healthcare associated infections. However, western biomedical science on which contemporary infection prevention and control is based, is not the only way that staff and patients within healthcare settings understand disease causation and/or disease transmission. This results paper reports on one aspect of a study which ascertains perceptions of disease transmission and how these influence infection prevention and control practice at Atoifi Adventist Hospital Solomon Islands. Photovoice was used as the primary data collection method with staff and patients. The germ theory and hospital hygiene processes were only one of many explanations of disease transmission at the hospital. Many social, cultural and spiritual influences played an important role in how people understood disease to be transmitted. Although infection prevention and control models based on western science continue to form the premise of reducing healthcare associated infections in Solomon Islands and locations across the globe, local social, cultural and spiritual beliefs need to be considered when planning and implementing infection prevention and control programs to ensure success.

Medical home models of care, including Australia’s Health Care Homes, have the potential to improve health service delivery. This qualitative study explored the primary healthcare experience of people living with chronic conditions in a regional community. The study aim was to use consumer perspectives to inform the further development of a medical home-type model for regional Australia. Participants were recruited from the emergency department of a north Queensland hospital. Twenty-one adults (aged ≥18 years) participated in interviews, using a semi-structured schedule. Inductive, deductive and abductive analyses were guided by grounded theory methods. Participants were committed to an individual GP, rather than a practice organisation. This finding has implications for medical homes, as individuals may choose not to access team-based practice care. Most participants perceived they currently received high-quality GP care, although challenges were identified. These challenges included disconnected after-hours care and uncertainty around the cost of care. Those living with complex, uncommon, chronic conditions felt the most disenfranchised from existing care models, and could benefit from increased engagement with a medical home-type model. Strengthening the continuity of care between GPs both within and outside the practice may enhance service delivery. Involving consumers in the design of care models supports health services that are fit-for-purpose.

Background: Despite the development in disaster nursing and the increasing research and related publications, little efforts have been directed to map the global development and trends of disaster nursing literature, identify gaps and guide future research directions in the field. Objectives: To generate a comprehensive picture of publications in disaster nursing over the past three decades and provide a discussion on the gaps and directions for future developments in disaster nursing-related research. Methods: A bibliometric analysis was used. The Scopus database was utilized to retrieve disaster nursing publications for the period from 1990 to 2019. Findings: A total of 1075 publications on disaster nursing were retrieved. The analysis indicated a rapid growth in publications from 2001 to 2014, followed by a plateau. Disaster nursing publications were geographically polarized within the Anglo-Saxon, European Union and Asian countries, with the United States, Australia, and the United Kingdom being the top three most productive countries. Both the number of publications by year and countries were significantly correlated with the number of total damages caused by disasters (r = 0.42, p < 0.05 and r = 0.41, p < 0.001 respectively). The analysis also highlighted that most of the impactful cooperation among different authors was found within the same countries only. The main keyword-based themes of the publications included disaster, nurses/emergency nurses/military nurses, preparedness, communication, and knowledge. The disaster phase of response received the most attention in disaster nursing followed by preparedness, while very few publications addressed disaster mitigation and recovery. Conclusions: This study provides nursing leaders, educators, researchers, and practitioners a comprehensive map of the development of disaster nursing literature in the past three decades. However, the field of disaster nursing is still far from being mature. More empirical and theoretical research, especially in the full spectrum of disaster management, should be investigated to meet the global challenge of disasters. International collaboration should be a significant way in improving the quality of the related research.