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the parents have improper manners with me because they are too worried about their children” (T3 N3) Challenges in parent relationships T1:6% T2:38% T3:50% Challenges to nursing role Gallagher et al. BMC Pediatrics (2017) 17:161 Page 4 of 11 work time, and sharing knowledge amongst team members to improve the team process as a whole. Nurses increasingly shared the impact that increased knowledge from the professional training modules had upon their approach to the nursing environment in the neonatal unit, discussing various practices from positioning the baby, to noise and light exposure. When contemplating advice for new neonatal nurses, there was a small number of nurses at each time point who shared the importance of professional standards such as hygiene (T1:13% T2:9% T3: 9%) and continued learning and development (T1:19% T2:35% T3:22%), and a larger number who would share the importance of ‘caring’ for the babies (T1:30% T2:50% T3:50%). Parent participants Manifest content analysis of the transcripts of parent interviews identified 14 basic categories of text, which Table 2 Nursing interview analysis theme 1 and subthemes: perception of the neonatal nursing role Theme: (subtheme) T1 T2 T3 Perception of role of neonatal nurse: Professional role “I get along with my colleagues well” (N2) “I take care of baby, supply the doctors’ order” (N15) “The relationship with the doctors and nurses is much better than before. Previously we have long distances and work under their command but after the training we become more intimate and interactive” (N6) “After the training course, the knowledge of nurses is raised much so they are more confident talking to doctors” (N1) Interaction with parents “I feel like I’m a bridge between babies and their parents, I tell the parents what the babies need, such as: when the baby need to breastfeed” (N6) “We replace the parents to care for their babies and instruct them how to support us in the infant care” (N10) “The relationship between nurses and parents plays an important role in caring for the babies. Nurses are the bridges to help parents understand the babies better because the babies are able to perceive everything around them” (N11) Parental support “Some parents are not nice but I can’t blame them, because they have small sick babies. I assure them and make them less nervous. The parent roles are very important, because they are the closest ones to the baby” (N3) “We always sympathise with the patients parents because they are worried about their children. In any cases, I always behave gently and try to lessen their anxiety” (N3) “We encourage parents to communicate with their children in order that they can develop more comprehensively and that will make their love more cohesive” (N13) Challenges to the nursing role “To me the challenge is sometimes I am not trusted by parents and they don’t listen to what I say and explain” (N9) “Some parents are very intolerant, they do not understand and hear me explain the reasons for the non-positive situation of babies” (N8) “Some of the parents have improper manners with me because they are too worried about their children” (N3) Ethical challenges (question changed from T1 – T2 so no data from T1) “My biggest challenge as a neonatal nurse is to inform parents that their babies died” (N10) T2: “I was extremely upset when we could not save babies’ lives” (N4) “I was in a very awkward situation when I knew that we could not save the baby, but we still tried hard to win his life even though that would leave a legacy for him in the future” (N9) Table 3 Nursing interview analysis theme 2 and subthemes: nurses perceptions of parents Theme (subtheme) T1 T2 T3 Perceptions of parents: Parental role “Very important in caring the baby and help the baby’s condition become better” (N12) “If they know how to take care of the baby, it would be very helpful for the nurses” (N7) “The role of the parents is very important here. I noticed that the babies who received loving care from their parents would recover sooner than the babies who their parents less concerned with” (N9) “Parents should pay attention to their babies condition more to inform the nurses, it helps to reduce the
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