49 “You’re sad for the mom, you’re sad for the baby”: Nurses’ experiences with custody apprehensions of substance-exposed newborns
Bibliographic record
Abstract
Abstract Background The post-partum period is a cherished time for mothers and babies; the interruption of this bonding opportunity, and the trauma and social challenges following child apprehension have been well-articulated. Few studies have captured the perspectives of providers involved in custody loss of newborns whose birthing parents who use substances. The perspectives and experiences of New Brunswick nurses involved in the care of birthing parents who use substances and their newborns during custody apprehension has not been illustrated by previous studies. Objectives This study seeks to address this gap in the literature through the exploration of newborn custody apprehensions from the perspective of the New Brunswick nursing staff who provide direct care to substance-exposed newborns or their birthing parents who use substances. The study aims to address two research questions. First, the study seeks to understand how nurses providing direct care to affected families experience the custody apprehension of substance-exposed newborns. Second, the study examines the nurses’ perceptions of barriers to providing trauma-informed care to birthing parents who use substances when their newborn is apprehended. Design/Methods The present study utilized qualitative methods to describe the experiences of nurses during a custody apprehension of a newborn. Nine nurses employed with the labour and delivery or NICU units of hospitals participated in semi-structured interviews. The interview data was subject to thematic analysis. Results The results of the analysis led to the development of six key themes, including 1) The emotional toll of caring for families undergoing a newborn custody apprehension, 2) Nurses’ desires for support for themselves and their patients, 3) Nurses’ desires for training to care for affected families, 4) Communication as a foundation component of care and inter-professional collaboration, 5) Conflict, including both intrapersonal and role conflicts, and 6) The provision of trauma informed care. The findings from this study were utilized to generate key recommendations for hospital policy and decision makers, which include the implementation of trauma-informed care training, specific to substance use disorders, in undergraduate nursing and continuing-education activities. Conclusion The present study demonstrated that nurses experience challenges, both emotionally and professionally, with custody apprehensions of substance-exposed newborns. Additionally, nurses perceive barriers to providing trauma-informed care to birthing parents who use substances when their newborn is apprehended. Barriers are evident through a lack of education and training pertaining to the provision of trauma-informed care to people who use substances.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.011 | 0.011 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".