Navigating paradoxes in open-bay neonatal intensive care: A qualitative study of nurses' experiences

Purpose: To explore nurses' lived experiences of working in open-bay neonatal intensive care units and how the visible environment influences their professional practice. Methods: A qualitative descriptive study using focus group methodology. Twenty-five nurses participated in five focus groups. Data were analyzed using thematic analysis. Results: Three interconnected paradoxes emerged: professional visibility versus personal exposure; collective support versus individual autonomy; and professional boundaries versus emotional connection with families. Nurses developed adaptive, context-sensitive strategies to navigate these paradoxes through dynamic professional reasoning. Conclusions: This study reveals paradox navigation as a fundamental yet unrecognized competency in neonatal intensive care nursing. Unlike traditional approaches seeking resolution, effective neonatal nurses hold contradictory demands in dynamic tension. Practice implications: Nursing education must incorporate paradox management skills essential for contemporary neonatal care. Healthcare organizations should recognize that certain workplace tensions represent inherent features requiring navigation rather than elimination, offering new pathways for supporting nurse resilience.