Objective <p>Most Neonatal Intensive Care Unit (NICU) literature focuses on parent perspectives, overlooking how staff perceive and respond to family needs. We examined NICU staff perceptions to understand family experiences through a relational and systemic lens.</p> Design <p>We conducted five focus groups (<i>N</i> = 22) with multidisciplinary staff and used an inductive-deductive approach to identify themes.</p> Results <p>Staff emphasized that families have both unique journeys and common experiences. Staff described how sociocultural barriers, trauma histories, and the reproductive/NICU journey shape family stress. Common stressors include multiple traumas, grief and guilt, and ongoing uncertainty. Although coping strategies are influenced by family values/goals and prior experiences, staff commonly observed emotion-driven behaviors, involvement in care, and less self-care. Staff also noted that the NICU can disrupt family dynamics and communication, yet existing relationship dynamics shape family impact.</p> Conclusion <p>Staff perspectives provide additional context for understanding family experiences and highlight the need for tailored family-centered care.</p>