Emerging from the darkness and stepping into the light: Implementing an understanding of the experience of nurse addiction into nursing education

Abstract

Abuse of drugs and alcohol occurs across all cultures, generations, and occupations, including nursing. Nurse addiction is a topic of serious concern that is often dismissed or ignored in the profession. Impaired nurses can become dysfunctional in their ability to provide safe, appropriate patient care. This qualitative study explored the lived experience of nurses who have been addicted to substances. Knowledge of this phenomenon may help guide nurses, nurse educators, and nursing students more accurately understand the reality of substance use disorder in the profession. In this qualitative study, 14 nurse addicts in recovery were interviewed about their experiences and risk perceptions. Analysis was conducted through coding, the identification of meanings and themes, and the use of qualitative research software. Five themes were identified from the study: (a) Fear was a significant part of the experience of being a nurse who was addicted; (b) Shame and guilt were felt by nurses who were addicted; (c) Poor coping: Addicted nurses reported having underdeveloped coping skills; (d) Control: Addicted nurses felt an increased need to control their environments; and (e) A core problem inherent in nurses who were addicted was a belief that addiction would never happen to them. Discussion of the five identified themes was followed by a discussion about addiction risk, prevention, and suggestions for application in nursing education. Participants discussed their experience with nurse addiction in their nursing education experiences and offered suggestions for more effective ways to teach the subject in nursing school. Implications for nursing education were then discussed, including using peer educators, namely, recovering nurse addicts, as teachers of this subject. Implications for nurses globally are presented. Finally, the overall theme identified was that addicted nurses often felt misunderstood and judged, and they desired to be accepted among others in the profession.

“A Two Glass of Wine Shift”: Dominant Discourses and the Social Organization of Nurses’ Substance Use

“…Our participants reported their basic education did not prepare them with factual knowledge about nurses’ substance-use problems, and that they merely learned, as Molly said, “how to report” other nurses’ transgressions. These data were consistent with findings in the scholarly nursing literature that undergraduate nurses receive scant, if any, evidence-based knowledge on substance-use problems in general and nurses’ in particular ( Burton, 2014 ; Cares, Pace, Denious, & Crane, 2015 ), and that the education they did receive took a highly individuated perspective ( Ross et al, 2018 ).…”

“…These discourses are also consistent with those found in the scholarly nursing literature, in which a highly individuated ( Ross et al, 2018 ), neoliberal ( Kunyk, Milner, & Overend, 2016 ) perspective exists toward nurses’ substance-use problems, which pays little heed to the institutional context of nurses’ work lives. For instance, Burton (2014) concluded a common characteristic of nurses who had problems with substance use was that “they did not know how to effectively cope” (p. 157). Health care professionals are also counseled to “accept responsibility to modify a lifestyle burdened by stress, chronic overwork” ( Storr, Trinkoff, & Hughes, 2000 , p. 1463).…”

Substance Use in Registered Nurses: “I Heard About a Nurse Who . . .”

“…An inconclusive but, nonetheless, important finding is the apparent direct relationship between professional stress and increase SU in nurses. In an attempt to understand the lived experience of the nurse with SU addiction, Burton (2014) interviewed 14 nurses who were “addicted to substances” (p. 151). Themes such as guilt, shame and embarrassment, and poor coping were discovered and are in alignment with the current study findings.…”

“…Themes such as guilt, shame and embarrassment, and poor coping were discovered and are in alignment with the current study findings. Yet there were novel findings uncovered by Burton (2014): Nurses felt a need to control their environment and a central belief that they were immune to becoming addicted. The need for control is often cited as an outcome of past trauma, and such control may be elusive in high-acuity specialty units, such as ICU.…”

Disciplining virtue: investigating the discourses of opioid addiction in nursing

“…Yet oftentimes efforts to support nurses to seek help for addiction are thwarted by stigma, shame and guilt (ten Hoeve, Jansen, & Roodbol, ). Fear of discovery and the risks of job, income and/or licensure loss are further barriers to help seeking for nurses with addiction (Burton, ). Failure to confront nurse‐colleagues suspected of having an addiction is also common (Canadian Nurse ; Lillibridge et al., ).…”