Some Recovering Nurses' Experiences of Being Labeled “Impaired”: A Phenomenological Inquiry

A critical review of knowledge on nurses with problematic substance use: The need to move from individual blame to awareness of structural factors

Problematic substance use (PSU) among nurses has wide-ranging adverse implications. A critical integrative literature review was conducted with an emphasis on building knowledge regarding the influence of structural factors within nurses' professional environments on nurses with PSU. Five thematic categories emerged: (i) access, (ii) stress, and (iii) attitudes as contributory factors, (iv) treatment policies for nurses with PSU, and (v) the culture of the nursing profession. Conclusions were that an overemphasis on individual culpability and failing predominates in the literature and that crucial knowledge gaps exist regarding the influence of structural factors on driving and shaping nurses' substance use.

Nursing under the influence: a relational ethics perspective

When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon.

Philosophical inquiry in nursing: an argument for radical empiricism as a philosophical framework for the phenomenology of addiction

Philosophical inquiry involves examination of the meaning of a phenomenon within the larger framework of the human condition and a particular view of reality. Argumentation is the method. In this study, the author argues that the metaphysics of radical empiricism enhances the understanding of the immediate subjective experience or phenomenology of addiction. When applied to subjective narratives of the addiction experience from literature, this metaphysics confers meaning to the changes in consciousness that occur in the immediate subjective experience of addiction. Conclusions revealed from the application of this perspective highlight novel feelings, the will and changing sense of self, and the human values of belonging and freedom. This study also revealed the value of the philosophical method of inquiry: to temporize our moral judgments and enrich our perspective of the human values within the addiction phenomenon. These values support and clarify the belief system of nursing.

Uncovering the secret: giving voice to the experiences of nurses who misuse substances

AIM OF THE STUDY

The aim of this study was to gain insight into the experience of being a nurse with a substance misuse problem.

RATIONALE

Several members of the research team work in a withdrawal programme specifically designed for nurses by nurses. Gaining insight into nurses' experiences will contribute to the development of appropriate guidelines to assist with prevention, identification and intervention strategies.

BACKGROUND

Published research is almost exclusively from North America. Much of it represents work completed in the 1980s, with very few research-based accounts from the perspective of nurses, highlighting that this is a poorly researched and understood problem in Australia.

RESEARCH METHODS

This phenomenological study used in-depth, unstructured interviews either face to face or via the telephone with a purposive sample of 12 nurses who had experienced problem substance use.

FINDINGS

Five major themes were identified: nurses' justification for using substances, the fear surrounding being 'discovered', the personal meaning for nurses, the professional impact and the turning point in their road to recovery.

DISCUSSION

The five themes derived from the data are inextricably linked to the nature of nursing and of the nursing workplace. Information about potential risk factors and the experiences of nurses with substance misuse problems is critical to the development of prevention and treatment strategies.

CONCLUSIONS

Issues of occupational health and safety are raised due to the increasingly demanding and often traumatic nursing work environment. Fears about stigma and loss of their nursing identity highlight nurses' perceptions that treatment programmes are often punitive in nature. Guidelines for the workplace addressing issues such as confidentiality, stress reduction and strategies for handling situations where a colleague is suspected of having a problem are beginning steps that will help address the problem of substance misuse in the nursing profession.