Caring for abused and neglected children on inpatient child psychiatric units presents many difficulties for staff. This cross-sectional ethnography explored the context, conditions, factors, and interactive processes which influenced how staff perceived caring for these children in inpatient child psychiatric settings. Three different child psychiatric units participated in the study: (a) a private for-profit, (b) a private not-for-profit, and (c) a public unit. The sample, identified as "consultants" (n = 29), included staff from various disciplines. The Ethnoscience perspective, Symbolic Interactionism, and Human Caring framed this study. Data collection methods included participant observation, interviews, case studies, review of organizational documents, and focus groups. Systematic data analysis identified twelve major issues that concerned staff. Staff considered six of these twelve issues as the "most important", "most difficult" or issues the staff most wanted to talk about during the focus groups. They were: (a) developing a relationship with abused and/or neglected children, (b) dealing with aggressive behavior, (c) dealing with sexual acting out, (d) Satanism and ritualistic cults, (e) dealing with abusive parents, and (f) the need for more education and training in caring for abused and neglected children. Specific factors, that staff felt impeded caring for these children, included organizational issues, unit issues, staff-patient issues, staff-parent issues, and staff's personal issues. Administrators, educators and practitioners, may use these data to improve the context, conditions, personal and social processes which may impact staff's ability to care for abused and neglected children on inpatient child psychiatric units.