The Experiences of Nurses Engaging in Therapeutic Relationships with Mothers of Newborns Diagnosed with Neonatal Abstinence Syndrome

Abstract

The therapeutic nurse-client relationship is at the core of nursing practice and is meant to benefit the health and wellbeing of clients (CNA, 2017; CNO, 2006; RNAO 2002). Mothers of newborns diagnosed with neonatal abstinence syndrome (NAS), however, have reported negative relationships with their newborns’ nurses (Cleveland & Gill, 2013; Cleveland & Bonugli, 2014). Likewise, neonatal nurses have also discussed their challenges working with this population of mothers (Demirci et al., 2015; Murphy-Oikonen et al., 2010; Raeside, 2003; Romisher et al., 2018). The purpose of this study was to explore neonatal nurses’ experiences of engaging in therapeutic relationships with mothers of newborns diagnosed with NAS. This qualitative study follows the methods of interpretive description (Thorne, 2016). Eligible participants were recruited using purposeful and convenience sampling. Data was collected by semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim, and a thematic analysis was conducted following Thorne’s (2016) alternative sorting technique. Two major themes were identified by researchers. The first theme, building the relationship, is broken down into subthemes assessing the mother and choosing an approach, caring for and involving the mother, making a connection, and getting to know mom and her needs. The second theme, the competing pressures of working with NAS, is further categorized into the subthemes working with baby and mother, collaborating with the Children’s Aid Society, and struggling with stigma. The findings from this study have implications for nursing practice, education, policy, and research that promotes the success of establishing therapeutic relationships with mothers of newborns diagnosed with NAS.