Nurse addiction -- an unexpected journey: a phenomenological study of nurses in recovery

206 Pages·2016·3.13 MB·English

by  Karen Lee Burton

University of Northern Colorado
Scholarship & Creative Works @ Digital UNC
Dissertations Student Research
8-1-2013
Nurse addiction -- an unexpected journey: a
phenomenological study of nurses in recovery
Karen Lee Burton
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Burton, Karen Lee, "Nurse addiction -- an unexpected journey: a phenomenological study of nurses in recovery" (2013).Dissertations.
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© 2013

KAREN LEE BURTON

ALL RIGHTS RESERVED
UNIVERSITY OF NORTHERN COLORADO

Greeley, CO

The Graduate School

NURSE ADDICTION--AN UNEXPECTED JOURNEY:
A PHENOMENOLOGICAL STUDY OF
NURSES IN RECOVERY

A Dissertation Submitted in Partial Fulfillment
of the Requirements of the Degree of
Doctor of Philosophy

Karen Lee Burton

College of Natural and Health Sciences
School of Nursing
Nursing: Education

August 2013
This Dissertation by: Karen Lee Burton

Entitled: Nurse Addiction--An Unexpected Journey: A Phenomenological Study of Nurses
in Recovery

has been approved as meeting the requirement for the Degree of Doctor of Philosophy in
College of Natural and Health Sciences in School of Nursing, Nursing: Education, PhD
Program.

Accepted by the Doctoral Committee

____________________________________________________
Lory Clukey, PhD, PsyD, RN, CNS, Research Advisor

____________________________________________________
Vicki Wilson, Ph.D., RN, Committee Member

____________________________________________________
Kathleen Sitzman, Ph.D., RN. CNE, Committee Member

____________________________________________________
Kristina Phillips, Ph.D., Faculty Representative

Date of Dissertation Defense May 28, 2013 .

Accepted by the Graduate School

____________________________________________________________
Linda L. Black, Ed.D., LPC
Acting Dean of the Graduate School and International Admissions
ABSTRACT

Burton, Karen Lee. Nurse Addiction--An Unexpected Journey: A Phenomenological
Study of Nurses in Recovery. Published Doctor of Philosophy dissertation,
University of Northern Colorado, 2013.

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 were 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. 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
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subject in nursing school. Implications for nursing education were then discussed,
including using peer educators, namely, recovering nurse addicts, as teachers of this
subject. 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.
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ACKNOWLEDGMENTS
This study could not have been done without the expertise, encouragement,
compassion, and advocacy of Dr. Lory Clukey at the University of Northern Colorado.
Her ability to mentor, teach, and truly care are inspiring. She fought to bring this subject
to light just as I did. Even when it seemed like everyone else had lost faith in the study,
she never faltered in her support of the effort. Words cannot express the gratitude she
deserves for that. I also need to thank Doctors Vicki Wilson, Kathleen Sitzman, and
Kristina Phillips for serving on my committee and not losing faith in me. Thanks to the
four of you for allowing this to happen.
I also acknowledge the support of the Utah Recovery Assistance Program
(URAP) committee, a program within the State of Utah’s Department of Professional and
Occupational Licensing (DOPL). I especially appreciate the support and confidence
received from committee members Debbie Harry, Susan Higgs, and Dr. Charles Walton.
Finally, I offer special thanks to Theron Burton, my number one supporter,
husband, and friend. He has never wavered in his expressions of confidence and support.
He, along with my children Porter, Sander, Cannon, and Lucy, have put up with a lot of
fast food, a messy house, and an absentee wife and mother. I am so grateful to them for
believing in me and encouraging me to finish.

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TABLE OF CONTENTS

CHAPTER
I. INTRODUCTION .......................................................................................1

Introduction to the Problem .........................................................................1
Background ..................................................................................................3
Statement of the Problem .............................................................................5
Purpose of the Study ....................................................................................6
Significance of the Study .............................................................................7
Research Design.........................................................................................10
Research Question .....................................................................................11
Definition of Terms....................................................................................11

II. LITERATURE REVIEW ..........................................................................15

Theoretical Basis for Study ........................................................................15
Literature on Addicted Nurses ...................................................................18
Literature and Nurse Addiction Education ................................................23
Conclusions ................................................................................................27

III. METHODOLOGY ....................................................................................28

Introduction ................................................................................................28
Research Problem and Purpose ..................................................................29
Research Design.........................................................................................29
Target Population and Sample ...................................................................30

Sampling ........................................................................................30
Recruitment of Subjects .................................................................31

Procedures ..................................................................................................33

Methods for Data Collection ..........................................................33
Data Analysis Procedures ..............................................................36
Validity and Reliability ..................................................................37
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CHAPTER
III. continued

Ethical Considerations ...............................................................................39

Disclosed or Discovered Relapse...................................................39
Risks and Benefits to Participants..................................................41
Protection of Human Subjects .......................................................43
Measures to Ensure Trustworthiness .............................................43
Audit Trail ......................................................................................44

Summation .................................................................................................46

IV. RESULTS AND DISCUSSION ................................................................47

Introduction ................................................................................................47
Study Data ..................................................................................................47

Interviews .......................................................................................48
Participants .....................................................................................48

Participant 1-AL.................................................................52
Participant 2-ANNIE. ........................................................53
Participant 3-ASHLEE.......................................................54
Participant 4-BEN ..............................................................56
Participant 5-BETH ...........................................................57
Participant 6-CRAIG .........................................................59
Participant 7-DAN. ............................................................61
Participant 8-LACEY.........................................................63
Participant 9-LINDA. ........................................................65
Participant 10-MELISSA ...................................................67
Participant 11-MIKE. .........................................................69
Participant 12-TAMARA...................................................71
Participant 13-TERRY .......................................................73
Participant 14-VALERIE ...................................................75

Results and Findings ..................................................................................78
Presentation of Themes ..............................................................................78

Theme 1. Fear is a Significant Part of the Experience
of Being a Nurse Who is Addicted ....................................78
Theme 2. Shame and Guilt are Felt by Nurses Who are
Addicted .............................................................................89
Theme 3. Poor Coping: Addicted Nurses Report Having
Underdeveloped Coping Skills ..........................................95
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CHAPTER
IV. continued

Theme 4. Addicted Nurses Feel an Increased
Need to Control Their Environments ...............................105
Theme 5. A Core Problem Inherent in Nurses Who are
Addicted is a Belief that Addiction Would Never
Happen to Them ...............................................................114
Discussion ................................................................................................121
Lived Experience of Nurse Addicts .............................................121
Perception of Risk, Access to Drugs............................................121
Is There Anything that Might Prevent Nurse Addiction? ............127
Nurse Addiction in Nurse Education ...........................................130
Recovering Nurse Addicts as Peer Teachers ...............................135

Overall Finding: Nurses in Recovery Feel Misunderstood and
Judged, and Just Want to be Accepted.........................................144
Summation of Analysis ............................................................................151

V. CONCLUSIONS AND RECOMMENDATIONS ..................................153

Conclusions ..............................................................................................153
Significance of the Study .........................................................................156
Limitations ...............................................................................................157
Recommendations for Further Research ..................................................159
Summary ..................................................................................................160

REFERENCES ................................................................................................................162

APPENDICES
A. IRB Approval Letter ................................................................................175

B. Letter from State of Utah Department of Commerce Agreeing to
Help Recruit .............................................................................................177

C. Recruitment Flier .....................................................................................179

D. Participation Demographic Form .............................................................181

E. Interview Guide .......................................................................................183

F. Consent Form ...........................................................................................185

G. Referral Sources for Participants .............................................................188

H. NVIVO® Query Graphics .......................................................................190
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