Providing newborn care in eat sleep console: A qualitative exploration of nurses’ experiences

,Perinatal substance use and neonatal withdrawal are increasing across Canada, creating significant challenges for families and the healthcare system. Traditional approaches to care, which rely heavily on pharmacological interventions, often result in prolo nged and costly admissions to neonatal intensive care units (NICUs). In response to these concerns, a team in the United States developed the Eat, Sleep, Console (ESC) model, which shifts the focus toward parental involvement and non-pharmacological care strategies rather than highly medicalized NICU care. In British Columbia, the ESC model has been adapted to emphasize trauma informed and culturally safe principles, placing greater responsibility on perinatal nurses who provide dyad care. Exploring nurses’ experiences of delivering newborn care within this model is essential to understanding the relational, clinical, and workload demands they face. Gaining insight into these perspectives is critical for supporting the sustainability of ESC in practice. An integrative literature review of 18 articles revealed that nurses’ experiences of caring for newborns with neonatal abstinence syndrome is complex and multifaceted. However, most of the existing evidence centers on NICU nurses and emphasizes traditional, pharmacological approaches. The perspectives of perinatal nurses, particularly those providing neonatal withdrawal care in settings outside the NICU, remain underexplored. To address this gap, this study set out to explore how perinatal nurses in Northern British Columbia experience providing newborn care in the context of ESC. Using Interpretive Description as the guiding methodology, semi-structured interviews were conducted with six perinatal nurses in one northern community. Data were analyzed thematically through an iterative coding process that began with structural coding aligned to the research questions, followed by pattern coding to identify broader themes across the dataset. The findings suggest that nurses experienced ESC care as complex and labour-intensive, requiring them to move well beyond the provision of direct newborn care. Their work encompassed fostering relationships with parents, providing extensive teaching to sup port parental independence, and managing the dynamics of team-based practice change. The overarching theme, The Work Really Isn’t About the Baby, reflected this emphasis, and was further articulated through three main themes: The Work Perinatal Nurses DO for ESC, TeamWORK in ESC, and the Work to embrace the change. Overall, the study highlights a persistent tension between the holistic intentions of ESC and the biomedical, task-oriented structures that continue to shape healthcare delivery. Nurses’ experiences illustrate the need for stronger organizational and structural supports to sustain trauma informed, culturally safe, and relational care, especially in the face of fluctuating patient volumes and entrenched systemic pressures. The clinical implications of these findings point to the importance of policies and staffing models that recognize the acuity of both newborns and their parents. Providing adequate capacity for nurses to deliver relational, family-centered care is essential. Strengthening interdisciplinary collaboration and supplementing limited social supports with dedicated roles can help reduce nursing burden and improve care for families affected by substance use disorders. Finally, organizational commitment to trauma informed and culturally safe practice is crucial for optimizing ESC implementation and fostering trust with families.

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