Navigating the Implementation of Pediatric Palliative Care: Nurses’ Perspectives and the Emerging Role of the Advanced Practice Nurse

Purpose: This study explores nurses’ attitudes and support needs during the implementation of a pediatric palliative care (PPC) concept at a tertiary children’s hospital in Austria. Methods: A qualitative, participatory research design was employed. Four moderated focus groups involving 18 nurses from two PPC-integrated wards were conducted. Data were transcribed verbatim and analyzed using Braun and Clarke’s Thematic Analysis. Results: Analysis revealed four themes: (1) experiences with PPC, (2) PPC as a new model of care, (3) challenges of implementation, and (4) expectations toward PPC. While nurses viewed PPC as a valuable, family-centered concept, they reported emotional strain, time constraints, and communication barriers. The term “palliative” was frequently associated with death, highlighting the need for cultural reframing and education. Conclusions: Successful PPC implementation requires emotional readiness, interprofessional collaboration, and dedicated support structures. Nurses expressed a strong desire for structured guidance, training, and the presence of an Advanced Practice Nurse (APN) to provide clinical and emotional support.