The Imprints of Neonatal Death: A Qualitative Study on Neonatal Intensive Care Nurses' Experiences of Neonatal Death.

To explore the processes neonatal intensive care nurses used in their child protection role with preterm infants. Neonatal nurses' screening for family violence is important in identifying at-risk preterm infants requiring protection upon discharge from neonatal intensive care settings. We know little about neonatal nurses and their role in child protection. A qualitative research design using Glaserian grounded theory. Ten in-depth semi-structured interviews were conducted with New Zealand neonatal intensive care nurses. Data were simultaneously analysed using constant comparative analysis and theoretical sampling to develop a substantive grounded theory. Dancing around families is the substantive grounded theory explaining how neonatal intensive care nurses respond to and manage an infant needing child protection. Knowing at-risk families is the process these nurses used, which draws on their personal and professional knowledge to identify an infant's child welfare requirements. A tension exists for neonatal nurses in shaping and framing the baby's safety and protection needs between their role of nurturing and protecting an at-risk infant and it belonging to the family. Child protection is a source of conflict for neonatal intensive care nurses. A lack of education, dodgy families and lack of confidence in child welfare services all compromise effective child protection. Their reality is tension between wanting the best possible outcomes for the baby, but having little or no control over what happens following its discharge. Neonatal intensive care nurses are ideally positioned to identify and respond to those preterm infants at risk of child maltreatment. They need education in child maltreatment, and protection focused on preterm infants, collegial support and clinical supervision.

Neonatal intensive care nurses have faced additional difficulties in adapting to a new work environment with a stressful situation brought about by the pandemic. The aim of this study is to evaluate the experiences of nurses working in neonatal intensive care units during the coronavirus disease-2019 (COVID-19) pandemic. Experiences were determined using phenomenology, a form of qualitative research. The study involved 14 neonatal intensive care nurses. The data were analyzed on the MAXQDA qualitative data analysis software in accordance with Colaizzi's 7-step method. Four themes were identified after the interviews: the experiences related to working conditions, neonatal care, psychosocial effect, and social life. In addition, 17 subthemes were created. The study revealed that neonatal intensive care nurses experienced physical, psychological, and social difficulties during the COVID-19 pandemic. It is thought that these results have become even more important to reduce the workload of nurses and to increase the quality of nursing care, especially in times of crisis such as pandemics.

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

It is important to study the awareness of retinopathy of prematurity (ROP) among neonatal care nurses in hospitals. Unfortunately, there is a lack of studies conducted among nurses on this subject in Palestine. Thus, this study purposed to assess the knowledge, attitudes, and practices toward ROP among neonatal intensive care nurses in Palestine. A cross-sectional was used to conduct this study. A convenience sampling method was utilized to recruit 289 neonate intensive care nurses working in private and governmental hospitals. The findings showed that around 48.0% of the nurses had low knowledge about preventing ROP. Most of the nurses (78%) reported a neutral attitude toward preventing ROP. Moreover, overall nurses' practices regarding ROP were fair (57.1%). There was a difference in practices regarding ROP according to the health sector (P < .05), in which the private sector had better practices compared to the governmental sector. Additionally, there was a significant difference in knowledge regarding ROP according to educational level (P < .05). Also, a significant difference was found in knowledge and practices regarding ROP according to nurses' experience. Attitudes and practices were the main significant predictors of knowledge (B = 0.153, P < .05; B = 0.172, P < .05, respectively). Knowledge and practices were the main predictors of attitudes (B = 0.126, P < .05; B = 469, P < .001), respectively. Knowledge, attitudes, and experience in neonate intensive care nurses were the main significant predictors of practices (B = 0.135, P < .05; B = 0.449, P < .001; B = 0.224, P < .05, respectively). It is necessary to develop an educational program and competency-based training programs for neonate intensive care nurses about ROP and implement preventive strategies.

ObjectiveKangaroo care (KC), a well-established parent-based intervention in neonatal intensive care units (NICUs), with documented benefits for infants and their parents. However, in China there remains a lack of knowledge...

To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance-exposed pregnancy (SEP). This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship-building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique. Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty-one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery. Study findings revealed nurses experienced challenges providing high-quality, family-centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care. The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high-quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments. This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high-quality care in stressful healthcare environments. EQUATOR guidelines were followed, using the COREQ checklist. NICU nurses were interviewed about their care-provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data.

This study aims to examine neonatal intensive care unit (NICU) nurses' perceptions of artificial intelligence (AI) technologies, particularly language models, and their impact on nursing practices. AI is rapidly spreading in healthcare, transforming nursing practice. Understanding the role of AI in NICUs in the discharge process is crucial for understanding nurses' perceptions of these technologies. The qualitative, phenomenological study used semi-structured interviews. Data were collected in a public hospital in Gaziantep from January to June 2024. Fifteen NICU nurses participated. Data were analyzed using content analysis. Most nurses found AI to be a valuable tool for saving time and simplifying information delivery in clinical processes. However, concerns were raised about AI potentially reducing human interaction and weakening the use of professional judgment. Serious concerns about AI's reliability and ethical implications were also expressed. AI is considered a potentially supportive tool in nursing practice, but its integration must consider the ethical implications and impact on the use of professional judgment. Nursing is based on human interactions and AI should be considered an additive tool to enhance care. AI integration in nursing requires careful and balanced implementation. Future research should delve deeper into the ethical dimensions of AI and its long-term effects on nursing practices.

The aim of this study is to explore neonatal nurses' perspectives of their role in facilitating family centred care in the neonatal intensive care unit. The philosophy of family centred care focuses on the health and wellbeing of the newborn and their family, through the development of a respectful partnership between the health care professional and the infant's parents. Many studies report family centred care in the context of paediatric care; however, few studies explore neonatal nurses' perspective of family centred care in the context of neonatal care. Qualitative interpretative approach. Four focus groups and five individual face-to-face interviews were conducted with neonatal intensive care nurses (total n=33) currently practicing in a tertiary Neonatal Intensive Care Unit in Australia. Each focus group and face to face interview was audio-taped and transcribed. Data was analysed using thematic analysis. Four dominant themes emerged from the data: (1) Getting to know parents and their wishes (2) Involving family in the day to day care (3) Finding a 'happy' medium (4) Transitioning support across the continuum. These findings revealed a general understanding of family centred care principles. Nurses reported the potential benefits and challenges of adopting a family centred care approach to deliver optimal care for neonates and their families. The study highlighted that nurses need ongoing organisation support, guidance and further education to assist them in delivering family centred care effectively. Family centred care is a central tenet underpinning neonatal care. Understanding neonatal nurses' perspectives will be useful when developing strategies to strengthen family centred care in the neonatal intensive care unit, and potentially improve neonatal care and family outcomes.

Certification and Core Review for Neonatal Intensive Care Nursing (3rd edition) is the companion to the Core Curriculum for Neonatal Intensive Care Nursing (3rd edition) and is a collaborative effort of AWHONN, NANN, and AACN. The editor (since the original work) has assembled a large group of practicing nurses from the three contributing organizations for this version. This text’s stated intent is to serve as a review tool or study guide for staff seeking certification in neonatal intensive care nursing. Its content is based upon the blueprints for the AACN Certification Corporation’s Neonatal CCRN exam and the National Certification Corporation’s Neonatal Intensive Care Nursing exam. Both of these outlines were used to guide identification of the subject matter discussed and the distribution of items in each content area. The content is divided into five sections.

Pilot Study of an Instrument to Measure Attitudes to Palliative Care Practice in Neonatal Intensive Care Nursing

The newborn care facilities, policies, and patient load in the perinatal care centers (PNCCs) in Saudi Arabia were assessed in 1985 as a first step toward providing data that would be needed in for...

BackgroundNeonatal intensive care unit (NICU) nurses face profound emotional distress due to frequent exposure to infant loss. This emotional burden, coupled with limited organizational support, can lead to significant psychological and professional challenges. Cultural and religious contexts uniquely shape resilience and coping mechanisms, particularly within Saudi Arabia, where these aspects remain understudied.AimTo explore and describe the lived experience of resilience and coping strategies among neonatal intensive care nurses following infant loss in NICUs in northern Saudi Arabia.MethodsAn interpretive phenomenological design grounded in Heidegger’s hermeneutic tradition was employed, with Lazarus and Folkman’s stress and coping theory providing the theoretical framework for analysis. Eighteen registered nurses from four NICUs (three public, one private) participated in semi-structured interviews and completed reflective journals. Purposive sampling ensured diversity in professional experience, cultural backgrounds, and religious affiliations. Data were analyzed using thematic analysis with concurrent collection and interpretation.ResultsFour thematic domains characterized NICU nurses’ experiences: (1) Emotional Processing of Loss (initial grief, disenfranchised professional grief, cultural-religious interpretations); (2) Adaptive Coping (faith-based practices, selective detachment, end-of-life ritualization, meaning-making through family support); (3) Resilience Development (career-stage evolution, professional identity integration, post-traumatic growth); and (4) Contextual Influences (institutional support disparities, multicultural team dynamics, resource constraints).ConclusionNICU nurses’ experiences of infant loss profoundly impact their psychological and professional well-being. Despite emotional and organizational challenges, nurses actively employ diverse coping strategies that are deeply influenced by their cultural and religious beliefs. Over time, these strategies facilitate significant professional growth and sustained compassion.Implications for practiceHealthcare institutions should adopt structured, culturally sensitive interventions, including formal debriefing, psychological support services, and education programs that focus on resilience-building, to enhance the well-being and professional sustainability of NICU nurses.Clinical trial numberNot Applicable.

This study explores neonatal intensive care unit (NICU) nurses' perceptions of artificial intelligence (AI)-assisted neonatal skin assessment, focusing on its benefits, challenges, and ethical implications. Optimizing AI integration requires understanding nurses' attitudes. A qualitative phenomenological approach was employed. Semi-structured interviews were conducted with 23 NICU nurses from a public hospital in Gaziantep, Turkey, between January and March 2025. Data were analyzed using inductive content analysis to identify emerging themes related to AI's impact on clinical decision-making, workflow efficiency, and professional autonomy. Findings revealed that nurses acknowledged AI's potential to enhance diagnostic accuracy, standardize assessments, and reduce interobserver variability. However, concerns were raised regarding algorithm reliability, professional autonomy, and ethical considerations. Nurses recognized AI's potential but stressed the need for transparency, training, and safeguards against over-reliance. Participants emphasized human oversight to ensure patient-centered care. Artificial intelligence may improve neonatal skin assessment, but integration must balance technology and ethics. Engaging NICU nurses in AI system development and implementation is essential to fostering trust and ensuring alignment with clinical needs. Future research should assess AI's long-term impact and support interdisciplinary tool development that complements nursing expertise.

The aim of this study was to analyze nurses’ professional burnout and health complaints and the relationship between the two components.MethodsThe anonymous survey included 94 neonatal intensive care nurses from two centers of perinatology. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to evaluate professional burnout; it consisted of 3 components, Emotional Exhaustion, Depersonalization, and Personal Accomplishments, with 22 items in total. Health complaints were evaluated by 21 items, where nurses were asked to report the occurrence of symptoms within the last year. Scale means were presented with standard deviations (SD). Inferential analysis was conducted with multivariate logistic regression, adjusting for age, residence, and work experience.ResultsThe mean score of professional burnout on the Emotional Exhaustion subscale was 14.4 (SD=7.91), Depersonalization 3.8 (SD=4.75), and Personal Accomplishment 29.1 (SD=10.12). The health assessment revealed that sleeplessness, lack of rest, nervousness, and tiredness were the most common complaints. The regression analysis revealed that tiredness was independently associated with significantly increased odds of professional burnout (OR=4.1).ConclusionsIn our study, more than half of the nurses in neonatal intensive care had moderate or high levels of emotional exhaustion, while levels of depersonalization were significantly lower. In contrast, the level of personal accomplishment was low in more than half of the nurses. The most common health complaints were sleep disturbances, nervousness, and tiredness. Tiredness was most strongly associated with professional burnout.

The increase of high-risk newborns due to societal changes has presented neonatal intensive care unit nurses with more ethical challenges and heightened their perception of neonatal palliative care. Therefore, this study was a descriptive survey exploring the perceptions of neonatal intensive care unit nurse regarding biomedical ethics and neonatal palliative care in neonatal intensive care units. The research participants were 97 neonatal intensive care unit nurses who had been directly involved with end-of-life care for high-risk babies. Data were collected from November to December 2021 through an online survey. The Korean version of Neonatal Palliative Care Attitude Scale and the tool of biomedical ethics were used. The collected data were analyzed using the T-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. The mean score for perception of biomedical ethics in neonatal intensive care unit nurses was 2.89 of 4, and that of neonatal palliative care in neonatal intensive care unit nurses was 3.10 of 5. Existence of a protocol of neonatal palliative care, the experience of patients dying, and the right to life of neonates were factors influencing the perception of neonatal palliative care. The explanatory power was 12.5%. The data support the importance of guidelines regarding systematic neonatal palliative care. Also, developing programs for sharing and supporting experiences of patients dying among colleagues and persistent education about the right to life of neonates for neonatal intensive care unit nurses can improve perception of neonatal palliative care.