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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 Follow this and additional works at:http://digscholarship.unco.edu/dissertations Recommended Citation Burton, Karen Lee, "Nurse addiction -- an unexpected journey: a phenomenological study of nurses in recovery" (2013).Dissertations. Paper 87. This Text is brought to you for free and open access by the Student Research at Scholarship & Creative Works @ Digital UNC. It has been accepted for inclusion in Dissertations by an authorized administrator of Scholarship & Creative Works @ Digital UNC. For more information, please contact [email protected]. © 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 iv 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. v 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. vi 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 vii 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 viii 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 ix

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Scholarship & Creative Works @ Digital UNC · Dissertations These types of substances cause habits or addictions to form. For a person to . specifically. Heath, Andrews, Kelley, and Sorrell (2004) saw the connection between.
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