A case study combining semi-structured interviews with documentary evidence was undertaken to ascertain whether neonatal nurses provide care in response to the developmental needs and consequent future quality of life of high risk babies (See Part 1 in May 2003 issue for the background, literature review and design of this study). Findings indicated that neonatal nurses are unable to focus their priorities for care on the long-term development of babies. Limited knowledge of, and unrealistic attitudes towards, potential outcomes posed a high challenge for nurses. Low staffing levels, reduced autonomy and conflicting responsibilities within the multidisciplinary team, were seen to be the main factors obstructing nurses in their caring roles. The overall picture was of a nursing service under pressure, with no continuous focus for care. Raising the profile of neonatology nationally may lead to the allocation of resources necessary to develop nursing practice in relation to outcomes. Creating a focus for care via a nursing model, with continuing infant development at its core, could enhance care provision and allow all babies to receive the optimal care to achieve their full potential.