TABLE 3

Experiences of Postpartum Nurses Taking Care of Infants With NAS: Description of Subthemes

ThemesSubthemes
Managing the expectations of parents of newborns with NASManaging parents’ expectations about the use of medication
Parents’ emotional state during the newborns’ withdrawal
Family complexity, such as maintaining confidentiality around NAS treatment and need for social work
Maternal smoking, specifically encouraging mothers to not leave the unit and maximize time being with the infant
Current NAS protocol: positive aspects of rooming-in and challenges with withdrawal scoring toolFinnegan scoring tool as subjective and disruptive to newborns
Mothers taking an active role with the newer approach
RNs perceive improved outcomes, such as fewer withdrawal symptoms
Inconsistencies in care and communicationBreastfeeding in infants of mothers who are drug dependent differs between clinicians and units
Criteria for discharge may differ across pediatric clinicians
Perceived increase in nursing workload on the postpartum unitWorkload shift from the NICU to maternity and well-newborn units
Increase in acuity, specifically more focused care, education, attention, and support for families
Nurses’ emotional response to the care of infants with NASNegative emotions, such as worry, frustration, and feeling powerless
Positive emotions, such as hope and empathy
Bias of self and peers when caring for newborns with NAS and their families