Respiratory Nurse Leadership Requires Increased Profile, Role Clarity and Stronger Career Pathways: Binational Delphi Consensus Process and TSANZ Position Statement

Introduction/Aim: The World Health Organisation recognises the integral role of respiratory nurses in the management and promotion of lung health to minimise substantial international health burden and health system costs. This Position Statement presents the Priorities for the Recognition of Respiratory Nursing as a Specific Field of Expertise, as validated through a binational Delphi consensus process, and endorsed by the Thoracic Society Australia and New Zealand Board on 25th October 2024. Methods: A cross-sectional online Delphi consensus survey delivered over two rounds using purposive sampling of leading respiratory nurse clinicians, managers, educators and/or researchers. In Round 1, participants rated generated priority statements on a 7-point Likert scale. In Round 2, mean item scores were provided and statements ranked to establish those of highest priority. Consensus cut-off was set at ≥ 75%. Results: One hundred and four Round 1 and sixty-four Round 2 participants from all Australian states and NZ regions confirmed 14 items, under three overarching priorities: the need to (1) raise the profile and influence of nurses within national and international respiratory organisations and policy; (2) define respiratory nursing as a field of specific expertise; and (3) articulate career progression and education frameworks as a roadmap to specialisation. Conclusion: Consensus on joint priorities supports respiratory nurses as integral to health strategy and articulates pathways for future workforce. Optimising the scope of nurses, including addressing barriers to contribution, and prioritisation and retention of specialist respiratory workforce, are necessary to meet population and health service demands and adequately support those living with lung conditions.